MSK Flashcards
(177 cards)
1
Q
hip pain and sensation of snapping around hip
A
acetabular labral tear
2
Q
achilles tendon disrders
A
tendinitis, parital and compelte tear
3
Q
what is the imaging modality of choice in achilles tendon rupture
A
US
4
Q
adhesive capsulitis alson known as
A
frozen shoulder
5
Q
adhesvice capsulittis associated with
A
frozen shoulder
6
Q
adhesive capsulitis
A
- external rotation
- active and passive affected
7
Q
phases in frozen shoulder
A
- painful freezing phase
- frozen phase non painfil
- recovery phase
whol episode typiclaly lasts 6momnths- 2years - nsaids, physio, steriod injectiosn
8
Q
ottawa ankle rules: pain in malleolar zone and
A
bony tenderness at madial/lateral malleolar zone, inability to walk 4 steps after injury or in AE
9
Q
sprain is a stretching or
A
tear of a ligament
10
Q
most common ankle sprain injury to
A
anterior inferior tibiofibular ligament- inversion injury
11
Q
mx of ankle sprain
A
RICE - rest ice, compressin and elevation
cast or crutches for short term symptomatic relief
12
Q
high ankle sprains
A
syndesmosis affected
weight bearing painful
hopkins squeeze test pos
13
Q
deltoid ligament injury is rare but if so should look out for Maisonneuve fracture of proximal fibula
A
14
Q
ix of chocie in AVN hip
A
MRI
15
Q
bakers cyst in kids
A
nromal
16
Q
bakers cyst in adults suggests
A
OA
17
Q
bakers cyst is not a true cyst but a
A
distension of gastocnemius- semimembranous bursa
18
Q
what can be a differetnial for. DVT
A
RUPTURED BAKER CYST
19
Q
proximal biceps tendon occurs when
A
biceps are lengthened eg descent of a pull up
20
Q
what tendon most affected in biceps tendon rupture
A
long tendon at shouldeer
21
Q
difficulty supinating
A
biceps tendon rupture
22
Q
ix for biceps tendon rupture
A
US first line
23
Q
what is only hting raiseed in Pagets
A
ALP
24
Q
scoring used to preduct risk of fracture in secondary bone tumours
A
Mirel
25
buckle fracture
incomplete fracture- has bulging of cortex
- splint and immobilsie
26
mx of carpal tunnel
corticosteriod injection
wrist splint
27
in surgery for carpal tunnel what structure are they dividing
flexor retinaculum
28
cauda equina msot likel to affect
L4/5, L5/S1
29
what can cuase bilateral sciatica
cauda equina
30
cervical spondylosis basically is
neck OA
31
charcot joint
joint has become badly disrupted and damged secondary to loss of sensation
- diabetics - present swollen red and warm and 75% of pts report pain
commonly has rocker bottom foot (collapsed arch in foot)
32
complication of colles fracture
acute carpal tunnel
33
raised pressure after fracture
compartment sydnrome
34
2 main fractures most at risk of compartment syndrome
supracondyalr fracture and tibial shaft
35
compartment syndrome - pressure >40 is diagnsotic and xray of this is
normal
36
mx of compartmetn syndrome
fasciotomies
37
Myoglobinuria may occur following fasciotomy and result in renal failure and for this reason these patients require aggressive IV fluids
referring to compartment sydnrome
38
de quervains tenosynovitis affects
extensor pollicis brevis and abductor pollicis longus (extend and abduc thumb)
39
pain on radial side of wrist
abduct thumb painful
finslsteins test
mx - anaglesia, steriod inejectoon, thumb splint
40
mx of discitis
Iv antibiotic therapy
41
discits should have what done
echo - assess for endocarditis
42
4th and 5th finger flexed
dupuytrens contracture- hand cannot be placed flat on table
43
cuases of dupuytrens
phenytoin, diabetes, manual labour
44
mx of dupuytrens contracture
surgery
45
importnat point for colles and smith fracture
trasnverse fracture of radius
46
opposite of colles so has a volar angulation commonly reffered to as garden spade
SMith
47
carpometacarpal of thumb - fist fight
bennet
48
biommalolar anlle fracture
potts fracture
49
bartons fracture
(colles/smiths) + radiocarpal dislocation
50
Galeazzi
radial fracture + dislcoation of radioulnar joint
51
Monteggia fractrure
ulnar fracture and discolation of radioulnar joint
52
fat embolism
tachypnoea and dyspnoea 72hrs follwoung injury
red/brown petechial rash
53
mx of fat embilism
prompot fixation of long bone fractures
54
fracture is parallel to bone
oblique
55
more than 1 fracture along a bone = segmental
>2 fragments = comminuted
56
open fractures classsifcation
Gustilo adn Anderson
57
fracture mx
immobilise
neuro status
Iv antib for open injuries
open fractures debrided
58
what is a cyst that arises from a joint or tendon sheath
ganglion - most common dorsal aspect of wrist
59
a ganglion is a
from and well circumscribed mass that transilluminates
60
mx of gnaglions
usually disappear spontaneosuly after several months
61
pain over greater trochanter
trochanteric bursitis
62
dupuytres contacture is of
palmar aponeurosis
63
dupuytrens contracture associated with
liver cirrhosis and alcoholism
64
mx of dupuytrens
fascietomy
65
formal diagnosis of carpal tunnel
electrophyscial studies
66
what doesnt cause heberdens nodes as not affect DIP
RA
67
bocuhards and heberdens suggest
OA
68
most hip dislcoations are
posteior (90%)
69
leg in psoterior hip discloation
shortened, adducted and internally rotated
70
Anterior dislocation: The affected leg is usually abducted and externally rotated. No leg shortening.
71
why do reduction in under 4hrs under GA in hip discloation
reduce risk of AVN
72
HIP dislocation vs fracture
(post)disclaotion - shortened, adducted and internally rotated
(ant) dislocation - abducted and externally rotated ( no leg shortening)
hip fracture- shortened and externally rotated
73
garden system for
hip fracture
74
if displaced hip fracture
Total hip replacement or hemiarthroplasty
75
if undisplaced intracapular
internal fixation or hemi
76
intertrochanteric frcture
dynamic hip screw
77
subtrachonteric hip fracture
intramedullary device
78
slipped uper femoral epiphysis commonly present as
knee pain - loss of internal rotation of leg in flexion
79
back pain and fever with pain on extension of hip
iliopsoas abscess
80
ix of chocie in iliopsoas abscess
CT
81
laterla knee pain in runenrs
iliotibial band syndrome
82
dasboard injuries cuase
PCL
83
what are common symptoms in menisci
locking and giving way
84
ACL rupture mx
intense physio or surgery
85
difference between ACL and meniscal tear
ACL has RAPID joint swelling, meniscalr tear has delayed joint swelluing
86
recurrent epsideos of pain and effusion are common in
meniscal tear
87
pain going downstairs tender at knee
chondromalacia patellae
88
tibial plateus opposite of what think ie varus cuases fracture of
medial plaeteau
89
best tes for ACL
Lachmans
90
meniscal tear suggested by
pain worse on straighetning knee
knee may give way
displaced meniscal tear may cuase knee lcoking
91
test for meniscal tear
Thessalys test
92
kneeling
infrapatellar/ prepatellar bursitis
93
collateral ligament injury
tenderness over the affected ligament
knee effusion
94
think what if says locking and giving
meniscal lesion
95
leriche syndrome
athermatous of iliac vessels- bum caludcation and impotence
96
back pain aching or crawling, relieved by sitting down, leaning forawrds
need MRI for dx
SPinal stenosis
97
peripheral arthritis seen in
ank spond
98
peripheral arterial disease
pain on walking relieved by rest
absent or weak foot pusles
99
facet joint cna cuase
back pain
100
first ine for back pain
NSAIDs, if over 45 alos give PPI
101
why not give paracetomol for back pain
shown to be ineffective
102
back pain
group exercise programme within NHS
103
dorsum of foot drmatome
L5
104
lateral aspect of leg and foot
S1
105
what is first line for prolapsed disc pain - Nsaids +PPI or neuropathic agents
Nsaids +PPI
106
how long with prolapsed disc pain persist then refer for MRI
4-6 weeks
107
injury to what nerve can result in Positive Trendeenburg
Superior gluteal nerve
- hip abduction
108
what nerve is commonly injured with the sciatica nerve
inferior gluteal
109
difficulty rising from seated postion
inferior gluteal nerve
110
anterior foot
deep peroneal
111
posterior leg
tibial
112
easier to walk uphill
lumbar spinal stenosis
113
neuro symptms affecting lateral cutaneous femoral nerve distribution
Meralgia paraesthetica- sensory only no motor
114
mx of meralgia paraesthetica
Injection of nerve with lcoal ansesthetic will abolish pain
115
ankle sprians can cause what fracture
5th metatarsal
116
5th metatarsal is most commonly fractured but most common metarsal stress fracture is
2nd
117
Although stress fractures may appear normal on X-ray, sometimes there is a periosteal reaction seen on 2-3 weeks later.
118
fromens test
ulnar0 paper between thumb and index finger
119
phalens test
maximal flexion - median nerve
120
cornerstone of open fractures
early debridement
121
what joints are affected less in OA
PIP
122
squaring of thumnb is charactersitc of
OA
123
hip clunk pain and inability to weight bear
posterior discolation
124
hip OA
oral analgesia and steriod injections
125
crutches normally needed how long after hip or knee replacemtn
6 weeks
126
Patients who have had a hip replacement operation should receive basic advice to minimise the risk of dislocation:
avoiding flexing the hip > 90 degrees
avoid low chairs
do not cross your legs
sleep on your back for the first 6 weeks
hromboembolism: NICE recommend patients receive low-molecular weight heparin for 4 weeks following a hip replacement
127
osteochondritis dissecans
usually knee - knee pain and swelling after exercise
painful clunk when flexing or extending knee
tenderness of medial femoral condyle
128
xray may show subchondral crescent sign or loose body
osteochondritis dissecans
129
msot common cuase of osetmyelitis if got sickle cells
salmonella
130
imaging of chocie for ostemyelitis
MRI
- fluclox for 6 weeks
131
FRAX for
10 year risk score of developing a fracture
132
frax > -- do DEXA
10%
133
> 50 with a fragility fracture dont need to do frax score can do
dexa right away
134
toddlers fracture is
oblique tibial fracture in infants
135
plastic deformity
stress on bone resulting in deformity without cortical disruption
136
greenstick
unilateral cortical breach only
137
what can cause multipe fractures
osteogenesis imperfecta
138
lack of differrentiation between cortex and medulla described as marble bone
osteopetrosis
139
straight leg raise means
extensor emchanism intact
140
Undisplaced fractures, particularly vertical fractures with an intact extensor mechanism can be managed non-operatively in a hinged knee brace for 6 weeks and patients allowed to fully weight bear.
patellar if dispalced- surgeyr
141
heel pain in adults
plantar fasciitis
rest, good shoes, insoles and heel pads may be helpful
142
pathological rib fractures can also occur due to cancer metastases: the most common cancers which predispose to these are prostate in men and breast in women
prostate one really needs to travel!
143
it is caused by two or more rib fractures along three or more consecutive ribs, usually anteriorly
flail chest
144
best diagnsotic test in rib fracture
CT!
145
what may be consdeired for pain if analgesia not doing enough for rib fracure
nerve block
146
msot common cause of shoulder problems
rotator cuff
147
rotator cuff injury
shoulder pain worse on abduction
148
rotator cuff tears
pain on abduction in first 60 degrees
impingement 0 60-120
pain on anterior acromion
149
rotator cuff think
impingement
tendonitis
tear
150
scaphoid fracture
type of wrist fracture
151
80% of blood supply to scaphiod is from
dorsal carpal branch of radial artery
152
pain in scaphoid fracture
base of thumb - tenderness over anatomical snuffbox
153
definitve ix to confirm or exlude scaphoid fracture
MRI
154
inital mx of scaphoid fracture
Futuro splint or below elbow backlab
155
if scaphoid fracture susepted by imaging inconclusive tehn repeating imaging
7-10 days later
156
scaphoid fracture if undisplaced
cast
157
if displaced or proximal scaphoid pole frractuers need
surgery
158
joint most likely to disclocate
shoulder
159
shoulder ussually disclaotes
anteiror
160
shoulder problems tink
frozen shoulder
rotator cuff impingeemtn tear
161
osteomyeltiis in tb
thoracic region
162
nipples
T4
163
anal sphicnter innervated by
S2,3,4
164
ankle plantar flexion
S1
165
most common upper limb injury in under 6s
subluxaton of radial head (pulled elbow)
166
mx of sublucxation of radial head
analesgia and supinate elbow joint while elvow if felxed to 90 degrees
167
inverted and plantar flexed foot
talipes equinovarus (clubfoot)
168
mx of club foot
ponseti method - progresive casting which starts soon after birth (correction ususally after 6-10 weeks) . achilles tenotomy required in 85% of cases
night time braces until child is 4y/o
169
trigger finger
flexed finger - initally stiffness and snapping. nodule may be felt at base of affected finger
170
mx of trigger finger
steriod injection in the majority of pts . finger spint may be applied afterwards
171
elbow flexion
musculocutaenous nerve
172
humeral midshaft fracture
radial nerve
173
medial epicondyle fracrure
ulnar
174
mastectomy
long thoracic nerve
serratus anterior
winged scapula
175
erb duchenne palsy
c5,6
176
C8 T1 - klumpke
shoulder dystocia or sudden upward jerk of hand eg trying to catch yourself if fallung from tree
associated with horner syndrome
177
