Lower Extremity Flashcards by Lauren F

What age group commonly gets osteochondirtis dessicans

10-20yo

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If the pt has greater trochanter pain syndrome on their right hip, which leg will they have trouble standing on?

Their right leg (left hip will drop)

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What is thei treatment for greater troachanter pain syndrome?

Self-limiting

Heating pad

Steroid injections work very well

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What specialized test is done for LCL injury

Varus stress at 0 and 30 degrees flexion

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Should you do imaging for FAI? What type?

Yes, X-ray initially

Maybe CT or MRI for soft tissue

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What is the most common location of osteochondirtis dessicans?

Knee (specifically the lateral portion of the medial femoral condole)

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Is ACL tear more common in men or women?

Women

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Should we do imaging to diagnose patellorfemoral pain syndrome/

No, not unless there is trauma or severe instability

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Are steroid injections a good idea for patellar tendonitis? Why’?

No, not recommended. Because it is a direct insertion point.

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What is the most common MOI to injure ACL

Non contact!

Quick position change with cutting/pivoting that causes a lateral bend

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What is the treatment for snapping hip

Don’t do that

Stretching, ice, etc

NSAIDS

Steroid injection if it caused bursitis (not in kids)

Not surgery

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Name it:
Bone overgrowth or abnormality that changes the function of the hip joint. (Either through labral tear of destruction of articular cartilage)

Femoroacetabular impingement

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How can a patient prevent plantar fasciitis?

Improve shoes

Stretching the Achilles

Massage of the fascia (painful)

Ortho/podiatry referral for SEVERE cases so they can do steroid injections

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Is osteochondirist dessicans a process?

Yes, and it can be caught at any point

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Can pts reproduce their snapping hip on command

Yes

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What causes a syndesomtic ankle sprain?

Dorsiflexed/rotational ankle injury

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What can cause rupture of Achilles’ tendon?

Sudden pivoting or rapid acceleration. “Sensation of violent hit or pop.”

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How will Achilles’ tendon injuries present?

Tendionpathy: burning pain that increases with activity

Rupture: “sensation of violent hit or pop” and pain may be absent

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What is the treatment for patellofemoral pain syndrome

Ice

NSAIDS

Activity modification

PT to strengthen quads, stretch hammies, and stabilize core.

Taping or brace PRN

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What ligaments are injured with a medial ankle sprain?

Deltoid ligament complex

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How would you test for external snapping hip

Passive internal/external rotation while lying on side

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Is osteochondirittis dessicans visible on x ray?

Yes, you will see flattening of articular surface (crater)

You can do an MRI if the x ray is inconclusive

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What is the name for an accumulation of joint fluid in the popliteal fossa?

Bakers cyst

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What constitutes a grade III knee sprain and what is the treatment?

Complete tear.

Treatment:
Surgery

Crutches

Brace

Aggressive PT

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What is it: | Idiopathic osteonecrosis of subchondral bone

Osteochondirits Dessicans

What specialized test is done for MCL injury

Valgus stress at 0 and 30 degrees

Where will it hurt on a physical exam for osteochondritis dessicans?

Elbow: pain/guarding with passive motion. Lateral pain with valgus stress Knee: pain with flexion over medial condyle. Gait disturbances

What is knee bursitis?

Inflammatory disorder of the bursa

What is the treatment for FAI?

“Don’t do that” NSAIDS PT Surgery for bony abnormalities

What are the two ways that the Achilles’ tendon can be injured?

Tendinopathy Rupture

What is the treatment of knee bursitis?

Avoid precipitating factors (tilers, roofers, etc) NSAIDS Aspiration/steroid injections Padding/bracing

What is the clinical presentation of patellofemoral pain syndrome (Runner’s knee)?

Anterior pain UNDER the patella Pain with stairs Positive theater/car ride sign Usually crepitus, popping, feeling of instability

What is the treatment for ankle sprain?

RICE and NSAIDS +/- short immobilization for grades 2-3 PT to prevent repeat injuries, bracing/taping

What is the most common knee complaint in primary care medicine?

Patellorfemoral pain syndrome (runners knee)

What is the treatment for patellar tendinitis/

Ice NSAIDS Bracing/strapping Rest/PT NOT steroid injections

Should you do imaging for an ankle sprain?

Only to RO fracture

How would you test for internal snapping hip?

FABER and then extend hip while in FABER position

What are the specialized tests for ACL injury?

Lachman Anterior Drawer Pivot shift (pt must be sedated)

How will Femoroacetabular impingement (FAI) present?

Groin/lateral hip pain that is aggravated with turning, twisting, squatting, or prolonged standing

What is important to do when a pt presents with IT band syndrome?

Evaluate for limb length discrepancy

What is the treatment for bakers cysts?

NSAID Aspiration Compressive brace Surgery almost never

What causes external snapping hip

IT band over the greater troachanter

Does snapping hip always hurt?

What should you always think when you hear “catching or clicking”

Soft tissue tear

What should you be sure to do if someone presents with knee bursitis?

Rule out infection

Who is most likely to get osteochondritis dessicans in the knee?

Preteens

What constitutes a grade II knee sprain and what is the treatment?

Partial tear Treatment: RICE Brace immobilization +/- crutches, PT, surgery

The PCL is rarely injured, but what sport most commonly causes it to tear if it does

Soccer

What causes osteochondirtis dessicans

We don’t know | Maybe repetitive trauma, vascular disruption, ischemia following trauma, genetic predisposition

How does labral tear of hip present?

Groin pain that can radiate to lateral hip, thigh, or butt

What specialized tests are done for patellofemoral pain syndrome/runners knee?

Patellar glide Apprehension test

Are bakers cysts painful?

They can be with prolonged standing or activity

Which meniscus is more susceptible to injury? Why?

Medial | -greater medial forces and it is less mobile than the lateral meniscus

What does the PCL do to provide stability to the knee

Prevents posterior translation of tibia

How does the ACL provide stability to the knees

Prevents anterior translation of tibia*******

What causes iliotibial band syndrome

Overuse | Which is why its common in runners and cyclists

What is the treatment for Achilles’ tendon injury?

Equinus Splinting***** Ortho referral Boot allowing for continued plantar flexion

What is the most important structure for stability of the knee****

ACL

What kid of injury will cause a Medial ankle sprain?

Eversion

What are the two types of femoroacetabular impingement (FAI)

Pincer- acetabular “roof” overgrowth Cam- femoral head too fat.. can’t slip under (Can be a combo)

What is the treatment for ACL tear

RICE Ortho referral Surgery maybe Brace PT

How will pt present with greater trochanteric pain syndrome?

Very localized pain over greater trochanter that they can point to with one finger Pain with resisted abduction

What is the most common cause of lateral hip pain in adults?

Greater trochanter pain syndrome | Aka trochanteric bursitis

Who do we give surgery to for ACL tear

Young people and athletes

How do you injure your meniscus

Rotation force of the femur on the tibia

Who is most likely to get patellar tendonitis (jumpers knee)?

Athletes involved in running, jumping and kicking sports 16-40 M>F Excessive foot pronation (“weak ankles”) and running hills can exacerbate these symptoms

What is it: Anterior pain under the patella Pain with stairs Positive theater sign/car ride sign Crepitus, popping, feeling unstable

Patellofemoral pain syndrome (Runner’s knee)

Who commonly gets osteochondirtis dessicans in their elbow?

Teens, young adults Throwing/gymnastic sports

What is the treatment for IT band syndrome?

RICE NSAIDS PT

What are the specialized tests for PCL tear

Posterior drawer sign Sag sign

What is it: Joint Line pain Inability to fully extend knee “Locking” or “catching” when extending knee Stairs and squatting are painful

Meniscus injury

Should we do imaging on IT band syndrome?

No, not unless traumatic

What is the largest and strongest knee ligament

PCL

What is the specialized test for Achilles’ tendon rupture?

Thompson test

What will increase the pain of plantar fasciitis?

ROM that strains the fascia, such as dorsiflexion of the toes or ankle

Where in the elbow is most commonly affected by osteochondirtis dessicans

Capitulum

What is the most common way to injure the MCL

Knee flexed, foot planted, and a lateral blow

What shape are the menisci?

C-shaped

Is imaging needed for an Achilles’ tendon injury?

Not always

What is the gold standard test to diagnose a labral tear of the hip?

MR Arthrogram

Are bakers cysts often asymptomatic and found incidentally?

Yes

What constitutes a Grade I knee sprain and what is the treatment?

Mild stretch Treatment is: RICE WB as tolerated

What is the treatment for plantar fasciitis?

Conservative- ice, NSAIDs, rest

What can cause Achilles’ tendon tendinopathy

Recent increase in training regimen

What specialized test can be done for a syndesmotic ankle sprain?

Squeeze test

How does snapping hip present?

Snapping/popping sensation Might hurt Sensation of the hip popping out of socket

Should you do imaging for plantar fasciitis?

Only if you are concerned about bony abnormalities such as bone spurs

Who most commonly gets iliotibial band syndrome?

Runners and cyclists

What is one of the most common causes of foot pain?

Plantar fasciitis

What causes snapping hip syndrome?

Muscle or tendon sliding over a bony prominence

Is LCL sprain common?

No very difficult MOI

What is the clinical presentation of iliiotibial band syndrome?

Gradual onset of pain on lateral knee (insertion point of IT band) Starts as a Sharp and burning pain with activity Develops into constant deep ache

What is the Triad of O’Donoghue (unhappy triad)

ACL MCL Medial meniscus

What will a patient with plantar fasciitis complain about?

Pain in the heel with the First Step of the day ***

What is the clinical presentation of ankle sprain?

Swelling, pain, bruising, difficulty with weight bearing

What is a syndesmotic ankle sprain?

A high ankle sprain | Tons of ligaments + interosseous membrane are injured

What causes internal snapping hip?

Iliopsoas tendon over iliopectineal eminence of femoral head

What specialized test can be done for a lateral ankle sprain>

Anterior drawer

What is the most common location for ankle sprain, and which ligaments are torn?

Lateral ligament complex: Anterior talofibular ligament Calcaneofibular ligament Posterior talofibular ligament

What knee ligament do you think is injured if the pt doesn’t really complain about instability, but says “something doesn’t feel right”

PCL

If a pt comes in and says “ i feel so unstable, like my knee could give out at any moment” what should you suspect

ACL tear

What is the clinical presentation or osteochondritis dessicans?

Gradual onset of poorly localized deep pain Popping/locking/catching in late disease due to loose fragments Limited WB in knee lesions Decreased ROM in elbow lesions +/-swelling

What is the go-to imaging modality for meniscus injury?

MRI

What kind of injury will cause a lateral ankle sprain?

Inversion

What is the most common ligament in the knee to be injured?

ACL

What kind of imaging do we do for ACL tear?

MRI X-ray maybe

What causes patellar tendinitis?

Inflammation from Repetitive trauma

Who is most at risk for snapping hip?

Dancers Runners Adolescents (Anyone who does extreme ROM or repetitive movements)

How do you test for FAI?

FADIR for impingement FABER/figure 4 for determining ipsilateral hip pathology vs contralateral SI joint dysfunction

Where will a pt point to their pain if they have patellar tendinitis/ jumper’s knee?

Just distal to the patella

What are the different bursae in the knee that can become inflamed and which ones are the more common ones?

Prepatellar Suprapatellar Infrapatellar Pes anserine Prepatellar and pes anserine are the most CLASSIC presentations****

What is a common cause of Labral tear of hip?

FAI

Why do pts with greater troachnter pain syndrome have a positive trendelenberg test?

Due to PAIN not actually weakness

What specialized tests do we do for meniscus injury?

McMurrays Apley‘s compression/distraction

Lower Extremity Flashcards

(114 cards)