MSK Flashcards
(43 cards)
Scaphoid fracture commonly presents with
Scaphoid fracture commonly presents with tenderness in the anatomic snuffbox dorsally, or tenderness in the scaphoid scaphoid tubercle volarly
highly specific test for SLE
Anti-dsDNA is a highly specific test for SLE
common causes of lateral knee pain in runners
Rhabdomyolysis will typically feature in the exam as
Rhabdomyolysis will typically feature in the exam as a patient who has had a fall or prolonged epileptic seizure and is found to have an acute kidney injury on admission.
rhabdomyalisis causes
- seizure
- collapse/coma (e.g. elderly patient collapses at home, found 8 hours later)
- ecstasy
- crush injury
- McArdle’s syndrome
- drugs: statins (especially if co-prescribed with clarithromycin)
rhabdomyalisis features
rhabdomyalisis management
- IV fluids to maintain good urine output
- urinary alkalinization is sometimes used
the initial imaging modality of choice for suspected Achilles tendon rupture
Ultrasound is the initial imaging modality of choice for suspected Achilles tendon rupture
classification system is used to classify neck of femur fractures
The Garden classification system is used to classify neck of femur fractures
the treatment of choice for all patients with a displaced hip fracture
Hemiarthroplasty or total hip replacement is the treatment of choice for all patients with a displaced hip fracture
the most common mechanism of ankle sprain
Inversion of the foot is the most common mechanism of ankle sprain
Trochanteric bursitis presents with
Trochanteric bursitis presents with isolated lateral hip/thigh pain with tenderness over the greater trochanter
no history of trauma
usually gradual onset over weeks
“worse at night lying on that side”
A 36-year-old woman presents with a 6 week history of a painful wrist. On examination pain over the radial aspect of the wrist is is elicited by forced adduction and flexion of the thumb.
What is the most likely diagnosis?
score used to identify patients at risk of pressure sores and its components
Waterlow score - used to identify patients at risk of pressure sores
next step management following fragility fracture
Following a fragility fracture in women ≥ 75 years, a DEXA scan is not necessary to diagnose osteoporosis and hence commence a bisphosphonate
Lateral epicondylitis features
- pain and tenderness localised to the lateral epicondyle
- pain worse on wrist extension against resistance with the elbow extended or supination of the forearm with the elbow extended
- episodes typically last between 6 months and 2 years. Patients tend to have acute pain for 6-12 weeks
Lateral epicondylitis and demographic
typically follows unaccustomed activity such as house painting or playing tennis (‘tennis elbow’). It is most common in people aged 45-55 years and typically affects the dominant arm.
Lateral epicondylitis management
advice on avoiding muscle overload
simple analgesia
steroid injection
physiotherapy
Pain on the radial side of the wrist/tenderness over the radial styloid process ?
Pain on the radial side of the wrist/tenderness over the radial styloid process ? De Quervain’s tenosynovitis
De Quervain’s tenosynovitis
Sheath containing the extensor pollicis brevis and abductor pollicis longus tendons is inflamed.
typically females aged 30 - 50 years old.
De Quervain’s tenosynovitis features
- pain on the radial side of the wrist
- tenderness over the radial styloid process
- abduction of the thumb against resistance is painful
- Finkelstein’s test: the examiner pulls the thumb of the patient in ulnar deviation and longitudinal traction. In a patient with tenosynovitis this action causes pain over the radial styloid process and along the length of extensor pollisis brevis and abductor pollicis longus
De Quervain’s tenosynovitis management
- analgesia
- steroid injection
- immobilisation with a thumb splint (spica) may be effective
- surgical treatment is sometimes required
In the emergency department, suspected scaphoid fractures should be managed with
- immobilisation using a Futuro splint or standard below-elbow backslab before specialist review
- orthopeadic review within **7 days **
A 28-year-old man presents to his general practitioner with six months of insidious onset lower back pain. The pain is worse in the morning and improves over the course of the day. There is no history of trauma, weight loss or bladder or bowel symptoms. He has no significant past medical history. He takes occasional ibuprofen, which seems to improve the pain. He works as a journalist and has travelled extensively in the last year in South Asia.
On examination, he has lower back tenderness. There are no neurological abnormalities.
Given the likely diagnosis, what is the most appropriate initial investigation to confirm a diagnosis?
Diagnosis of ankylosing spondylitis can be best supported by sacro-ilitis on a pelvic X-ray
