Lecture 1: Approach to the MSK Pt

Question 1

SEADS

Answer 1

• Swelling
• Erythema
• Atrophy
• Deformity
• Scars/Skin

Question 2

What is a goniometer?

Answer 2

Measures degree of flexion

Question 3

How is manual muscle testing graded?

Answer 3

0 - absent (muscle doesnt move)
1 - trace (twitch/contraction but no joint motion
2 - Poor (ROM only if gravity eliminated)
3 - fair (ROM against gravity but not resistance)
4 - good (ROM against gravity w some resistance)
5 - normal (ROM against gravity w/ full resistance)

Question 4

What is a myotome?

Answer 4

Group of muscles with their corresponding nerve innervation

Question 5

What is the MC first-line imaging modality for bone and joint imaging?

Answer 5

XRAY

Question 6

If you order a long-bone XRAY, what should you make sure to include?

Answer 6

Joint above and below

Question 7

What scan has the highest bony detail?

Answer 7

CT

MRI is best for soft tissue

Question 8

What is US quality highly dependent on?

Answer 8

Technician skill

Question 9

What does scintigraphy measure?

Answer 9

Blood flow and metabolic activity of bone

scans entire skeleton

Question 10

What is myelography mainly used for?

Answer 10

Spinal cord pathology for pts who cannot undergo MRI.

Injection of contrast into subarachnoid with fluoroscopy.

Question 11

What is arthrography?

Answer 11

Imaging of joint + contrast for viewing soft tissue borders of a joint.

Question 12

what is arthrocentesis

Answer 12

• removes fluid from joints (google)
• indicated when pts have joint effusion or s/s suggesting inflamm or infection
• improves ROM and comfort.

Question 13

do we need to know this? idk

Answer 13

Question 14

What is muscle biopsy used to distinguish between?

Answer 14

Myopathy vs neuropathy

Question 15

What lab studies are indicated if there is a bloody effusion with no evidence of trauma

Answer 15

PT
PTT
Platelet count

Question 16

what lab studies are indicated with fever and joint erythema

Answer 16

blood cultures

Question 17

what lab studies are indicated when suspecting lupus or other rheumatological problems.

Answer 17

• antinuclear antibodies (ANA)
• can also order serum rheumatoid factor if suspicion of RA

Question 18

What does HLA-B27 check for?

Answer 18

Ankylosing spondylitis (Young adults 20-30)

Question 19

What would indicate urgent referral to ortho?

Answer 19

• Closed and stable Fx
• Reduced joint dislocation
• Locked joint
• Tumor

Question 20

what would indicate early referral to ortho?

Answer 20

• motor weakness
• constitutional s/s
• multiple joint involvement