MSK Flashcards
1
Q
2 COMMON locations for compartment syndrome
A
Anterior compartment of lower leg
Volar compartment of forearm
2
Q
Don’t forget that what can be a cause of compartment syndrome
A
Circumferential burn
3
Q
What pressure is positive for compartment syndrome
A
Delta pressure over 30
4
Q
Muscle breakdown causes what two things
A
Release of myoglobin leading to myoglobinuria
Kidney dysfunction = hyperkalemia // increased phosphate // LOW CALCIUM
5
Q
MC complication of compartment syndrome
A
Rhabdomyolysis
6
Q
BMI greater than what can cause osteoarthritis
A
25
7
Q
5 things to remember about osteoarthritis
A
LOSS
Loss of joint space
Osteopphytes
Subchondral cysts
Sclerosis
And
Pip-E Bouchard Nodules with Heberden Nodules at the DIP Joint
8
Q
4 management options for osteoarthritis
A
Oral or topical NSAIDS
Topical capsaicin
Duloxetine
CC Injections
9
Q
With HLA B27 think ?
A
Ankloysing Spondylitis
Axial spine and Sacroiliac joints
10
Q
Risk factors for AK
A
Male under age 45
11
Q
Pain is what with AK
A
Worse in the morning and improves with activity
Just like osteoarthritis
12
Q
1 extra articulate manifestation of AK
A
Anterior uveitis
13
Q
1 st line for AK
A
NSAIDs and PT
14
Q
Nerve distro effected by cauda equina
A
L2 - S1
15
Q
Post void residual volume = + for urinary retention in cauda equina
A
Greater 100
16
Q
Lateral upper arm
Lateral forearm and thumb
Posterior forearm and middle finger
Fifth finger
Nerve Roots.
A
C5
C6
C7
C8
17
Q
Root associated with loss of
Brachioradialis reflex
Biceps reflex
Triceps reflex
A
C5
C6
C7
18
Q
How does the leg get its innervation
A
S1 the butt
L5
L4
L3 wraps around the groin
19
Q
What is a positive straight leg test
A
Hold the knee
Raise the leg
Pain shoots from back PAST the knee
20
Q
Knee extension vs. Knee Flexion roots
A
Extension = L3/L4 —> KICK THE FLOOR
Flexion = L5/S1 —> RIDE ONE, FLEX.
21
Q
In spinal stenosis sxs improve with
A
Flexion
22
Q
A
23
Q
What red flag is significant from seronegative splodylarthropathy
A
Morning stiffness in a greater than 30 yr old adult
24
Q
When is a good time to X-rays for low back pain
A
Persists longer than 6 weeks despite conservative treatment or if ALARM sxs
25
Most shoulder dislocations are
Anterior
26
Mechanism for posterior shoulder dislocation
Seizure or electric shock
27
Special tests for shoulder instability
Apprehension and O’Brien Test
28
What movements aggravate each RTC muscle
Supraspinatus = abduction
Infraspinatus = ER
Tree Minor = ER
Subscapularis = IR
29
What are good tests for shoulder impingement?
Anterior = Hawkins Kennedy
Posterior = Neers Test
30
Shoulder lift off and belly press test what
Internal rotation of the shoulder
31
Shoulder impingement gets surgery for what
Full thickness tears
32
2 diseases associated with frozen shoulder
Diabetes
Hypothyroidism
33
Movement most effected in frozen shoulder
External rotation and abduction
34
Lateral epicondylitis is what?
Tennis Elbow
Lateral tendonidopathy of the Extensor carpi radilais brevis
35
Medial epicondylitis is?
Golfers elbow
Medial tendonopathy of the pronator teres
36
Lateral epicondylitis vs medial epicondylitis = PAIN WITH WHAT MOTIONS?
Lateral = activities where the arm and wrist are extended
Medial = activities that involve wrist Flexion and Pronation
37
Pain with resisted what in LATERAL VS. MEDIAL EPICOND
LATERAL = extension
MEDIAL = Flexion
38
Two tests if you suspect scaphoid tenderness
Ulnar wrist deviation PAIN
Exist compression of the thumb PAIN
39
When do you have surgery in scaphoid fracture
Displaced fractures
40
Type of splint for boxer fracture
Ulnar gutter splint
41
Colles vs. Smith fracture
Colles = volar displacement of wrist = R/o Schaphiod injury!
Smith = distal displacement
42
Colles vs. Smith Fracture
Colles = volar
Smith = distal
43
If you are gonna do surgery on Colles or smith what is the surgery / splint
ORIF = unstable or communited
Splint = sugar tong splint
*Colles = Eat something sweeet with that FORK = Sugar Tong*
44
Mallet finger is what?
Disruption of finger extensor tendon mechanism at the DIP.
45
Treatment mallet finger
Maintain the DIP joint in full extension for 6-8 weeks
46
Mallet finger can lead to what
Swan neck deformity
DIP in Flexion
PIP in hyperextension
47
Skiers game keeper thumb is a disruption of what ligament
Ulnar collateral ligament avulsion fracture by forced ABDUCTION
48
Posterior hip dislocation is described as
Leg shortened with hip flexed ; adducted ; internally rotated
FADIR
49
Anterior hip dislocation is defined as
Hip extended , abducted, and externally rotated
FABER
50
How does the femoral head appear in anterior vs. posterior hip dislocation
Anterior = larger and medial or inferior to the acetabulum
Posterior = smaller and superimposes on the roof of the acetabulum
51
Time frame for closed reduction in hip dislocation
6hours
52
Most common type of hip fx
Intertrochaneteric
53
What is the story for ACL tear
Pop sensation with effusion and instability
54
What would a plain film show in knee ligament injury
Segond fracture
55
What artery is injured in PCL tear
Popliteal artery injury
56
MCL vs LCL stress
MCL = Valgus
LCL = VARUS
57
What is the story for meniscal tear
Twisting motion of a flexed knee on a planted foot
58
Meniscus makes you think?
Mechanical symptoms
59
Ankle INVERSION injury is most common and effects what ligament
Anterior talofibular ligament
60
Ankle eversion is uncommon and effects what ligament
Deltoid
61
High ankle sprain effects what location
Distal tibiofibular syndesmosis
62
Brief explanation of Ottawa ankle rules
Pain in the malleolar region :
-Bone tenderness posterior edge of medial mall. or lateral mall. [6cm]
-Pain in the same area when walking [ 4 steps ]
Pain in the midfoot region :
-TTP at the Navicular
-Base of 5th metatarsal pain
-Pain in the same area when walking [ 4 steps ]
63
Maisoneueve fracture combination ? 2 things.
1st. Medial Malleolous fracture
2nd. Spiral fracture of proximal tibia
64
JONES VS. PSUEDOJONES definition
Jones = transverse fracture of the proximal diaphysis of the fifth metatarsal
PSUEDOJONES = avulsion fracture of the 5th metatarsal tuberosity
65
Jones vs. Pseudojones management
Jones = Non weight bearing 6-8 weeks
PSUEDOJONES = walking boot 2-3 weeks
66
What three ligaments are involved in the lesfranc fracture
Plantar
Lesfranc
Dorsal ligament
67
Lesfranc management
ORIF non weight bearing cast 6-12 weeks
Non weight bearing case and repeat X-ray every 2 weeks = no dislocation
68
Puncture wound from nail what pathogens
Staph A
Psuedomonas = shoe de Mona’s
69
Most sensitive study for osteomyelitis
MRI
70
Osteomyelitis treatment if
Psuedomonas
GBS
MSSA
Pseudomonas = Cefepime ; Ceftazidime
GBS = Vancomycin
MSSA = nafcilin oxacilin
71
If something looks like septic arthritis dont forget to think about
N. Gonnorhea
72
Antibiotics of choice for septic arthritis
Vancomycin + Ceftriaxone
73
What part of the bone is effected in Ewing sarcoma
Diaphysis of long bones
74
Biopsy of Ewing sarcoma looks like
Small round blue cells
Psuedorossetes
75
What age is effected by osteosarcoma
13-16 and greater than 65
76
Osteosarcoma think what
Sunburst
77
Osteosarcoma think what
Sunburst
78
5 PLATE, medications that can cause gout
Pyrazinamide
Loop diuretics
ASA
Thiazides
Ethambutol
“Too much seafood on your plate”
79
Gout arthrocentesis shows what
Negative birefringent crystals
80
Psuedomonas gout shows what
Positive birefrigent crystals
81
Mainstay treatment gout
Indomethacin
Colchicine for ATTACKS
MX = allupurinol
82
Allupurinol is what type of medication and what side effects
Probenacid
Xanthine oxidase inhibitor
probenacid = urate reputake inhibitor
Hematuria
Bleeding gums
Blue/pale skin
83
4 disease states assoc with pseudo gout
Hyper PTH
hypothyriodism
Hemochromatosis
Thiazides diuretics
84
X-RAY for pseudogout shows what
Chondrocalcinosis
85
Shape of crystals gout vs. psuedogout
Gout = sharp
Psuedogout = rhomboids
86
MC primary cause of osteoporosis
Post menopause loss of estrogen
Loss of zinc / ca2+
87
What is the defintion of osteoporosis
Less than -2.5 with fragility fracture
88
Osteoporosis treatment of choice
Dronates! Bisphosphonates
89
Screening for osteoporosis [5]
Age over 65 women
Hx of fragility fracture
BMI less 21= LOW
Current smoker or drinker
Rheumatoid Arthritis
Medication cause of bone loss
90
Polymaylagia rhuematica is associated with ?
Giant Cell Arteritis
91
Pain in PMR is what?
Symmetric with prolonged morning stiffness greater 30 mins ; impacts ability to do daily activities.
PROXIMAL JOINTS
92
Lab findings associated with Reuters syndrome
HLA B27
93
Rheumatoid affects what joints? And what deformity is associated
MCP and PIP
Swan neck and Bouteniere deformities ; ulnar finger deviation
94
Lab studies positive in rheumatoid arthritis
Rheumatic factor
Anti cyclic citrullinated peptide
95
1st line RA and what do you also give
Methotrexate
Folic acid supplements
96
SLE think what meds? HIMP
Hydralazine
Isoniazid
Minocycline
Procainamide
97
SLE affects who?
Young women age 16-55
98
What is the eye involvement in SLE
Kerratoconjunctivitis sicca
99
SLE Lab antibodies
Anti double stranded DNA
Anti smith antibodies
100
SLE management
Hydroxycloroquine or chloroquine
101
Limited scleroderma is what?
CREST
Calcinosis
Raynauds
Esophageal dysmotitility
Telangiectasias
102
Lab testing in scleroderma is positive for
Diffuse = ANA -SCl-70
Limited = anticentromere antibodies
103
3 complications of systemic scleroderma
Interstitial lung disease
Pulmonary hypertension
Cardio renal complications
104
Sjorgen syndrome causes destruction of what two glands
Salivary and lacrimal [exocrine glands]
105
Antibodies positive in Sjogrens
Anti ss A Rho
Anti ss B LA
106
How to combat dryness in Sjogrens
Cholinergic agonists // artificial tears
107
2 complications of Sjogrens
Dental caries
MALT // lymphoid tissue lymphoma
108
2 things lost in osteoporosis
Bone matrix and mineral
RF : ETOH, smoking ; steroid use=2ndary
109
Osteopenia vs. osteoporosis
Penis = 1.0 -2.4
2.5 or more
Females = screen at 65 yrs
Males = 75 yrs
110
Teaching points for Bisphosphonates
Take it in the AM ; while sitting up
ADE’s = esophagitis ; Jaw necrosis ; femoral shaft fx
STOP after 3 yrs that the condition has resolved
111
If advanced renal dz w osteoporosis what treatment
Denosomab
112
Last line for osteoporosis
Raloxifene = sERM
Given to pts with increased risk of breast cancer ; to decrease hormone receptors responsible in cancer development
113
What is an effective analgesic after acute vertebral fx
Miacalcin nasal spray
114
Paget’s bone disease [4]
Osteoclastic then osteoblastic activity = weak bone formation —> CORTICAL THICKENING SKULL AND PELVIS
Highly vascular ; high ALK PHOS
Deformed ; Multiple bones involved
TXMN = IV zolendronate -single dose
115
Pagets of the skull
Would show mod severe cortical thickening
116
Compartment syndrome has pain with
Passive stretch
117
Osteoarthritis is a
Non inflammatory arthritis
Pain in the AM > moving makes it better
Crepitus
Heberden -DIP
Bouchard-PIP
118
Normal dexa scan =
-1.0 or greater
119
In adults osteomyelitis affects the
Spine - diabetics
120
Chronic osteomyelitis [4]
Weeks to months with mild incr ESR/CRP
Localized inflammation or cellulitis
X-ray —> bone destruction // CT for bone bx ; MRI best view
TXM = Lon term IV abx ; Surgical debridement
121
Septic arthritis is commonly what kind of spread
Hematogenous
122
DIG infection may have lesions where with septic arthritis
Palms and Soles of feet
123
Non gonnococcal arthritis TXM
Vanco + 3rd gen ceph
4-6 weeks
124
Gonnocoal arthritis TXM
Doxy PO + IV Ceftriaxone
125
Do ganglion cysts transilluminate
YES
126
Benign vs. Malignant bone tumor
Benign = defined sclerotic margins and SLOW growth
Malignant = permeative lesion with Lytic destruction poor margins = RAPID growth
127
Primary tumors that often Metz to the bone : Lettuce tomatoes pickles ketchup bacon
Prostate
Breast
Lung
Kidney
Thyroid
128
How can you manage bone cysts
Bx=Dx
Watch and Wait
Asp/inj w/ steriods
Curettage and bone graft
129
Osteoid osteoma = FULL OF BONE
Aching night pain ; better w/ NSAIDS —> surgery —-> ablation
MC : benign bone tumor M>F ; young adults
130
osteosarcoma [4]
KNEE ; Males ; non traumatic
Ages 15-25 y/o
Destructive sun burst appearance —> get bone bx
ALK PHOS [2-3xnml] TXM = CHEMO
131
Fibromyalgia
20-50 y/o F
Pain on trigger points in several different areas
Non progressive sxs ; but life long
TXM = moderate exercise ; CBT ; TCAs ; SSRI’s SSNRIs best analgesic = ultram/APAP
132
Gout medications 4
Thiazide
Loop diuretics
Beer
Beta blockers
133
Acute cases of gout have increased what
WBC
134
What type of crystals in out
Positive sodium urate +
Negatively birefringent
135
Must r/o what if giving CC for acute gout
Septic arthritis
136
Undersecretion vs. overproduction meds for chronic gout mgmt
Undersecretion = probenecid or uricosuric agent URI —> STOPS URATE UPTAKE, PROMOTES SECRETION
Overproduction = allopurinol/febuxostat ; XOI —> STOPS THE PRODUCTION
137
Increase what type of dietary component in gout mgmt
Dairy
138
Pseudogout affects what joint
Large joints !
Like knee and wrists
+rhomboid crystals + birefringent
139
Allopurinol or probencid in psuedogout mgmt ?
NO ; not a problem of uric acid.
Just; = acute NSAIDs // CC //
colchicine or NSAIDs = chronic
140
Juvenile idiopathic arthritis [4]
Greater 6 weeks of sxs ; less than 16 years old.
Fever ; rash that will come and go ; Oligo —-> anterior uveitis [optho x4/yr]
25% = poly articular +RF; +AntiCCP [RA] +ANA = more severe disease
TXM = NSAIDs —> DMARDS [Methotrexate]
141
Poly arteritis nodosa [4]
“Necrotizing Arteritis” ; medium sized vessels 10% CAUSE : HEP B
Libido Reticularis // skin ulcers // digital gangrene // fever // malaise
Dx : tissue bx / Angio of aneurysms ; if renal vessels —> HTN
TXM = high dose CC // HTN = ACE // Hep B = Prednisone + lamivudine + plasmaphoresis
142
Poly/dermatomyositis
20% = malignant ; can raise hand up neck and proximal muscle weakeness UE & LE
Heliotrope rash-eyelids // Gotttron papules -hands = skin rash common
Dx = muscle bx ; + ANA +ANTI-JO 1 antibodies
TXM = CC ; methotrexate ; IVIG
143
Reactive arthritis [5]
Post shigella ; salmonella ; yersenia ; campy ; chlamydia infection
Tetrad : conjunctives ; urethritis ; aseptic arthritis ; oral lesions
Keratoderma blennorhagica = feet nodules
HLA B27 + dx : joint destruction after 6 mos = permanent
TXM = NSAIDs ; PT ; less likely to develop if early TXM
144
RA [4]
Inflammatory synovial membrane pannus erodes cartilage
Boggy tissue ; symmetrical poly arthritis ; nodules on elbows
—> ulnar deviation of fingers
-Boutonnier/Swan neck deformities
-C1-2 joint prone to subluxation
60% = Sjorgens ; + RF and +Anti-CCP
Usually lasts longer than 6 weeks
TXM = Methotrexate ; NSAIDs ; etanercept ; TNF inhibitors
145
SLE [4]
Medications : procainamide ; isoniazid ; quinidine ; anti-TNF agents ; chlorpromazine; hydralazine; minocyclin]
Fever anorexia ; Arthralgia ; Raynard’s syndrome MALAR or DISCOID rash
+anti dx DNA ; + anti-smith ab
TXM = joint/skin—> hydroxuchloroquine
Minor —> NSIADs
GMN / pericarditis / hemolytic anemia —> CC
146
SE w steriods and SLE
Accelerate atherosclerosis
Osteoporosis and AVN of bone
147
Scleroderma
Diffuse fibrosis of skin and internal organs
Limited = CREST
Diffuse = skin hardening of face ; hands ; trunck ; limbs ORGANS = SEVERE
90% have Raynauds // Esoph motility —> lungs ; heart ; kidney
+AntiSCL 70 ; +Anitcentromere AB +AntiRNA polymerase Ab
TXM = rainouts = CCBs
HTN crisis —> ACE inhibitors
148
Sjorgens dysfunction TREATMENT AND ANTIBODIES
Exocrine ; + SSA [ro] + SSB [La]
+lymphs on lip bx
Anemia leukopenia eosinophilia
TXM = avoidance ; pilocarpine —> dry mouth
Topical cyclosporine —-> dry eyes
149
AC injury
Direct fall onto the shoulder ; over the handle bars
Pain at top os shoulder —> up towards the neck
+crossover test
TXM = ice sling 2-4 weeks ; grades 4-6 —> ortho surgery
150
MC bone fx in children
Clavicle
151
Most clavicle fx at the
Middle 1/3
Closer to the chest —> more concerned for organ damage medially
152
TXM of clavicle fx
Sling or fig of 8 splint [3-4 weeks]
Good ROM encouraged
153
MC injured RC muscle
Supraspinatus
154
RTC INJURY is mostly a
Chronic disorder —> inflammation causes pinching —-> tear
Pain over greater tuberosity ; lateral shoulder pain that radiates downward
+Neer and Hawkins
TXM = RICE ; steriods ; PT ; surgery
155
Biceps tendinopathy [4]
Overuse of biceps
Bicipital groove tenderness
Resisted supination of forearm pain
TXM = Rest ; sling ; NSaIDs
156
Elderly women with osteoporosis likely fx where
Proximal humerus fx
157
TXM proximal humerus fx
Mild / impacted = sling and swath 4 weeks
Dislocation / fx = surgical
158
Shoulder dislocation =
Fall on externally rotated abducted arm = trying to catch self while falling
Presents with arm ABDUCTED
Squared off
97% anterior
TXM = immediate closed reduction w post reduction X-ray
Sling swath 4 weeks ; start ROM at 2 weeks
159
Elbow joint is what type of joint
Hinge
160
Lateral epicondylitis
Tennis elbow ; overuse with supination and wrist extension
Pain on resisted wrist extension +point tenderness over lateral epicondyle
TXM = Rest ice ; NSAIDS
161
Medial epicondylitis
Golfers elbow
Point tenderness over medial epicondyle +pain on resisted wrist Flexion
TXM = stretching / REST / ice
162
Supracondylar fx think positive what on X-ray
Posterior fat pad
163
Radial head fx = fall
On an outstretched hand
Diffuse lateral elbow pain over radial head + posterior fat pad
TXM = sling 2-4 weeks
164
Colles fx
Distal radius fx
FOOSH
Silver fork deformity
TXM = closed reduction and cast 6-8 weeks
Intraarticular or comminited = surgery
165
Gamekeepers thumb
Them forced into radial deviation
Stretched ulnar collateral ligament
X-RAY r/o avulsion fx
TXM = thumb spica cast —> ORIF surgery
166
What dx test can confirm scaphoid fx best
Bone scan or MRI
167
Schapoid fx
Thumb spica cast 6-20 weeks
Repeat X-ray in 1 week
HIGH NON UNION RATE
168
Boxers fx TXM ; 4th and 5th metacarpal fx with volar angulation :
TXM = ulnar gutter splint with closed reduction
Close follow up
OR + IV abx if break in skin
169
De Quervains tenosynovitis TXM
Thumb spica splint for rest ; NSAIDs and steroid injection if non improvement
170
Trigger finger
Stenosis tenosynovitis @ flexor tendon
+snap with Flexion and extensions // pain
TXM = splinting NAIDs steriods surgery
171
Fingers of carpal tunnel compression
Them index and middle finger ; some radial aspect of ring finger
172
Thoacolumbar fx TXM
+wedge shaped or chance fx = pulled wide open
If fx is non displaced and no deficit —> brace for 6 weeks and PT
Fx or displaced with neuro deficit —> surgery
173
Monitor what 2 things for rib fx
Adequate ventilation
PNA
—consider nerve block for pain mgmt // ventilation assistance
174
AK
Chronic inflammatory disease ; starts in the pelvis SI joint
M>F ; +HLA B27 = 90% ; ESR elevated
Progresses to dec spine mobility and limited chest expansion
TXM = NSAIDs or TNF Inhibitors PT for flexibility or pt. Education
175
Thoracic outlet syndrome
Compression of brachial plexus and subcalvian artery and vein
Pain can come and go ; vague ; get an X-ray ; EMG ; Doppler of neck structures
TXM = posture exercise
Surgery = anatomic obstruction
176
Torticollis TXM
TXM = child = cervical collar
Adults = pain mgmt and PT
177
What muscle is affected by torticollis commonly
SCM +/- a mass on SCM
178
Pectus carinatum =
Pectus excavatum =
PC = protrusion of sternum
PE = extrusion of sternum
*both assoc : CHDz
179
Kyphosis [4]
Increase in dorsa curve of T spine —> collapse of vertebrae
Pain = acute Fx ; de conditioned back muscles
ANTERIOR BEND
TXM = PT for strengthening ; pain control ; surgery = kyphoplasty
180
scoliosis [4]
Idio LATERAL curve greater 10degrees
Hips/shoudler sit at diff levels
Dx : Cobb angle = greater 20 degrees
TXM = Over 20 = surgery and brace ; less 20 observe
*consider closeness to puberty*
181
TXM of LBP
Relative rest ; ice/heat ; NSAIDs ;
-PT after each episode-
Muscle relaxants ; narcotics no longer 3 days
182
Herniated disc pain is worse when
Flexion or valsava
+cross and straight leg raise
183
L4
L5
S1
Motor //
L4 —> dorsoflexion of foot
L5 —> dorsiflexion of great toe
S1 —> eversion of foot
184
L4
L5
S1
Reflex //
L4 —> knee jerk
L5 —> none
S1 —> ankle jerk
185
L4
L5
S1
// Sensory Pain
L4–> medial calf and foot
L5–> lateral calf and dorsal foot
S1 —> lateral foot and plantar foot
186
Herniated disc initial image
MRI
187
Cauda equina compression
L2 -S4 nerve root ; saddle anesthesia ; bowel bladder dysfunction
MRI
SURGICAL EMERGENCY
188
Spinal stenosis
Pt over 60 y/o male + Arthritis
Inflamed ligamentum flavum hypertrophy ; sponylolisthesis
Butt and leg pain chronic —> better when lean fwd and walk
Spaghetti legs mild LE weakness
MRI best ;
TXM = rest ; PT ; NSAIDS ; weight reduction ; nerve blocks ; surgery
189
Pt lifts heavy objects on a daily basis pain on the lateral leg and foot +SLR ; dx
Herniated disk
190
AVN
Loss of blood supply ; think : steriods or ETOH ; peds: dvd ; SCFE
Dull IR / ER pain decreased ROM
MRI best Dx
TXM = non eight bearing refer to ortho!
191
Hip fx think what kind of leg
Shortened
Then —> ER or IR
192
Hip dislocation think
MC : posterior dislocation ; knee contact with dashboard —> ACL
Posterior : short and internally rotated
TXM = immediate reduction with post reduction film
193
Tibial plateau fx think
Axial load injury = jump from high place and land
+/- weight bearing ;
X-ray —> CT ; tibial depression r/o
TXM = immobilize and non weight bearing —> surgical
194
Patellar fx
Direct blow or forced Flexion of the quadriceps muscle
Pain with knee EXTENSION
TXM = mild = immobilization
Displacement more 3mm = surgical
195
MCL vs LCL
MCL = valgus
LCL = varus
196
Associated nerve injury with LCL injury
Peroneal nerve
197
Grade 3 MCL and LCL injury TXM
= surgery ; due to buckle and insecurity of knee
198
PCL MOI commonly
Anterior tibia or dashboard injury in MVA
199
PCL nerve and artery that could be injured
Peroneal nerve
Popiliteal artery
200
Joint line pain + effusion + locking or clicking
+mcmurray and apley
201
Prepatellar bursitis
Excessive kneeling or trauma to the knee
202
3 ligaments commonly hurt in ankle injury
ATF = anterior talofibular [MC]
PTF = posterior talfobular
CF = calcaneaofibular
203
Ligament ankle injury =
Sprain
204
Ottawa ankle rules
Bone TTP along with—> distal post edge of tibia // tip of medial mall
Bone TTP along distal post edge of fibula or tip of // lateral mall
Inability to bear weight
205
Ottawa foot rules
Bone TTP at base of 5th MT
Bone TTO at navicular bone
Inability bear weight
206
MC ligament injured in ankle fx
Deltoid ligament
207
Positive Peroneal nerve damage =
Foot drop
208
Charcot mgmt
Walking correction ; wide toe box shoe
209
MC location of avulsion fx
5th base of MT
TXM = hard shoe return to activity as comfort
210
How long does it take for X-ray evidence in stress fx ; what can confirm early
X-ray
Early = MRI or bone scan
211
Large muscle groups affected think
Polymyositis
212
OGS disease of the tibial tubercle improved with what
Quad and hamstring strengthening
213
First line for AK txm
NSAIDs
214
JIA TXM of choice [severe]
CC
215
JIA mild TXM
Naproxen first
216
2 equal first line TXMs for de quarvains
Splinting and Steriod injections
217
Most sensitive pain ROM with hip intrarticualr pathology is pain with
Internal rotation
