MSK general points Flashcards
(131 cards)
1
Q
IgA inflammatory vasculitis causing red spots on buttocks after infection - self limiting - seen in children
A
Hinoch Scholein purpura (vasculitis)
2
Q
Pain in posterior ankle seen in older people after exercise (or athletes) - associated with overuse
A
Achilles tendonitis
3
Q
Sudden pain in posterior leg (like being kicked) - simmonds test positive
A
Achilles rupture
4
Q
Knee pain and swelling after “twisting” injury - Lachmans test +ve
A
ACL rupture
5
Q
Lower back pain & reduced movement - wall to occput test & Schober test - HLA-B27
A
Ankylosing spondylitis
6
Q
Seen in teenage girls - NSAIDs & reassurance needed
A
Anterior knee pain
7
Q
Disruption of blood supply to bone
A
Avascular necrosis (AVN)
8
Q
Pain in elbow, hip (over greater trochanter) - NSAIDs, rest, Corticosteroids
A
Bursitis
9
Q
Pain in elbow, hip (over greater trochanter) - NSAIDs, rest, Corticosteroids
A
Bursitis
10
Q
Saddle anasthesia, urinary retention, faecal incontinence - urgent MRI & surgery
A
Cauda equina syndrome
11
Q
Lack of oxygen during or shortly after birth
A
Cerebral palsy
12
Q
Malignant tumour producing cartilage
A
Chonrosarcoma
13
Q
Surgical emergency of the knee - may cause damage to popliteal artery
A
Combined knee ligament ruptures & knee dislocation
14
Q
Hip displacement in children - seen more commonly in female babies - Pavlik harness
A
Development dysplasia of the hip
15
Q
Common - usually medial - pops back in itself
A
Dislocation and subluxation of the patella
16
Q
Trisomy 21 - atlanto-axial subluxation - may cause nerve compression
A
Downs syndrome
17
Q
Trisomy 21 - atlanto-axial subluxation - may cause nerve compression
A
Downs syndrome
18
Q
Mutation of type 3 collagen - causes stretchy skin & recurrent joint dislocation - boney fixation
A
Ehlers‐Danlos syndrome
19
Q
Joint pain related to IBD - HLA-B27
A
Enteropathic arthritis
20
Q
Small vessel vasculitis - especially in the nose - P-ANCA with to EPO
A
Eosinophilic granulomatosis with polyangitis - churg-strauss
21
Q
Damage to C5,6 - medially rotated arm with waiters tip posture
A
Erb’s palsy
22
Q
Bone tumour of the neural crest cells
A
Ewing’s sarcoma
23
Q
Chronic pain syndrome - pain, depression, non restorative sleep
A
Fibromyalgia
24
Q
Failure of the medial arch
A
Flat feet
25
Outpouching of synovial fluid - leave or surgical removal
Ganglion cyst
26
Knock knees
Genu Valgus
27
Bow leg
Genu Varum
28
Large vessel vasculitis seen in >50s - granulomatous inflammation may lead to blindness
Giant cell arteritis - high dose steroids
29
Uric acid deposition in joints - red, hot, swollen & painful - -ve bifrignement crystals on aspiration - colchicine & allopuril
Gout
30
C-ANCA - PR3 - small vessel vasculitis affecting lungs - steroids
Granulmoatosis with polyangitis - Wegners
31
OA in the big toe - painful - analgesic & arthrodesis
Hallux rigidus: 1st MTPJ OA
32
Medial displacement of the big toe - conservative treatment --> surgery (bunion)
Hallux valgus
33
OA of the hip - pain on movement
| Hip replacement in suitable candidates
Hip arthritis & Total Hip Arthroplasty
34
Damage to c8 & t1 - causes paralysis of intrinsic hand muscles & horners
Klumpke’s palsy
35
Arthritis is common in this joint (OA & RA) - However replacement is often unsatisfactory
Knee arthritis & Knee replacements
36
Dash board injury uncommon in isolation - posterior sag test positive
LCL tears / ruptures
37
Benign collection of fat cells - can be removed
lipoma
38
Malignant collection of fat cells
Liposarcoma
39
Young woman with joint pain and malar rash - +ve for ANA, anti-dsDNA & anti-SM
Immunosupression & hydroxychloroquine
SLE
40
Autosomal dominant issue with fibrillin - long arms, high arched pallet, aortic insufficiency
Marfan’s syndrome
41
Skiing injury
MCL tears
42
Common cause of lower back pain - analgesia and exercise
Mechanical back pain
43
Twisting injury - joint line pain - MRI needed
Meniscal tear
44
Seen after overuse - can be hard to see on x-ray until callus forms - repeat x-ray if clinically suspicious
Metatarsal stress fractures
45
ANCA associated small vessel vasculitis
Microscopic polyangitits
46
Swelling of nerve in toe - painful - conservative treatment --> surgery
Morton's neuroma
47
OA due to cartilage wear and tear - painful - LOSS on x-ray however it is a clinical diagnosis - pain relief --> joint replacement
Osteoarthritis
48
Floating cartilage behind knee - causes pain and joint locking - NSAIDs & surgery
Osteochondritis dissecans
49
collagen disorder causing brittle bones - multiple fractures --> suspicion of NAI -- Blue sclera
Osteogenesis imperfecta
50
Benign bone tumour with sclerotic halo
osteoid osteoma
51
Weakened bones due to low vitamin d - causes low calcium absorption - replacement
Osteomalacia & rickets
52
Bone infection - systemic illness & bone pain more common in children
S.aureus
Osteomyelitis
53
Weakened bone with normal mineralisation - aysymptomatic until low impact fracture - DEXA scan
Bisphosphonates & denusomab
Osteoporosis
54
Most common primary bone tumour - localised pain and systemic symptoms
osteosarcoma
55
Thickening of the bone due to
Paget's disease
56
AVN of the femoral head in young boys - limping child presentation
Perthes disease
57
Heel pain in overweight individuals - rest & possibly corticosteroids
Plantar fasciitis
58
Neurological deficit due to infection - rare
poliomyelitis
59
Extra fingers - leave or remove
Polydactyly
60
Weakness in the shoulder & hip girdle - associated with GCA - steroids
Polymyalgia Rheumatica
61
Calcium deposition in joints - positive bifringement on aspiration - NSAIDs
Pseudogout
62
Small joint arthritis - hla-b27 associated - NSAIDs, corticosteroids & DMARDS
Psoratic arthritis
63
HLA-B27 - AI condition seen after infection - NSAIDs
Reactive arthritis
64
Smooth muscle tumour
Rhabdomyosarcoma
65
Symmetrical polyarthritis of the small joints - seen with RF & anti-CCP - das28 score & dmards
Rheumatoid arthritis
66
Compression/damage of the sciatic nerve - shooting pain down the leg - NSAIDs, physical therapy, surgery
Sciatica
67
Lateral bend in the spine - treatment dependant on Cobb angle - physio to surgery
Scoliosis
68
AI disease affecting mucous secreting glands - dry mouth & no tears - schirmer test - anti-ro & anti-la
Sjogrens syndrome
69
Knee injury - history of trauma & swelling - MRI indicated
Soft tissue injuries of the knee
70
Failure of spinal closure in utero - seen
Spina Bifida
71
Failure of spinal closure in utero - seen on checkup & AFP - oculta --> meningocele, and myelomeningocele
Spina Bifida
72
Pain on walking due to nerve compression - pain is relieved walking up hill - NSAIDs, gabapentin --> surgery
Spinal stenosis & claudication
73
Shearing of top of femur --> limping child --> surgical fixation
SUFE
74
Fingers stuck together --> surgical separation
Syndactyly
75
Collagen deposition in organs - AI disease - anti-SCL-70 & anti-topiomerase-1
Systemic sclerosis
76
Vasculitis seen in young japanese women --> pulseless disease due to intima infiltration --> corticosteroids
Takayasu arteritis
77
Normal variant in some children
| Also due to muscular dystrophy, Cerebral palsy and autism
Tip toe walking
78
Presentation of a limping child - pain after viral infection - self limiting --> is it septic?
Transient synovitis of the hip
79
Localised pain to the greater trochanter --> may be due to a tight tensor fascia lata
Trochanteric bursitis / gluteal cuff syndrome
80
Compression of the median nerve - pregnancy, hypothyroidism - NSAIDs, splint, surgery
carpal tunnel
81
Anti-jo-1 & heliptrope rash with Gottron lesions - proximal, symmetrical muscle weakness
Dermatomyositis
82
Order of muscle
Fascicle --> perimysium --> endomysium
83
Lymphocytic clustering in the perifasicular area
Dermatomyositis
84
Symmetrical, proximal muscle weakness - no skin manifestations - inflammation of endomysium
Polymyositis
85
Causes include S.aureus & salmonella - specific pain & systemic illness - MRI - antibiotics
Osteomyelitis
86
Leg pain worse on sitting - specific features dependant on where is effected
Prolapsed disc
87
Pain in the anatomical snuffbox - may not be evident on x-ray - splint and repeat
Scaphoid fracture - risk of AVN due to retrograde blood supply
88
Weakness in gluteus medius & minimus of the leg being stood on
Trendelenburg sign - test of the superior gluteal nerves
89
Female baby, High birth weight, breech position
Developmental dysplasia of the hip
90
USS in small infants - x-ray in older children
Developmental dysplasia of the hip
91
Damage to the ACL, MCL & Meniscus
unhappy triad injury
92
Loss off blood supply --> leads to pain --> MRI --> Replace
AVN
93
erythematous, raised and multilobed tumours - self resolve - topical beta-blockers
Congenital Haemangioma
94
Radial nerve, brachial tendon, brachial artery, median nerve
Cubital fossa content
95
Calcium pyrophosphate crystals - NSAIDs & steroids
Pseudogout
96
Damage in cortical bone - seen in children
Greenstick fracture
97
Fracture caused by rotational force
Spiral fracture
98
High force fracture with many shards
Communicated
99
Open fracture - risk of infection
Compound
100
Crush fracture - due to osteoporosis
Compression fracture
101
Straight line fracture
Transverse fracture
102
Pencil-in-cup X-ray appearance, sausage fingers - treat as inflammatory arthritis
Psoriatic arthritis
103
Wrist drop
Radial nerve palsy
104
Dinner fork deformity of wrist - dorsal displacement after FOOSH
Displaced Colles Fracture
105
Pain/tenderness in anatomical snuffbox - may not be seen on x-ray
scaphoid fracture
106
Walking on pebbles
RA in feet leading to subluxation of metatarsophalangeal joints
107
Arthritis, uveitis, urethritis
Reiters syndrome - reactive arthritis
108
Which fractures are at risk of AVN
```
Proximal scaphoid
Intracapsular femoral
Femoral condyles
Humeral capitellum
Proximal talus
```
109
Foot drop
Common fibular nerve injury - anterior & lateral compartments
110
Red, hot swollen joint + negative bifringement, needle shaped urate crystals
Gout
111
NSAIDs, colchine, allopurinol
Gout treatment
112
Envelope shaped/rhomboid, mildly positive birefringent Ca pyrophosphate crystals
Treat same as gout - history of hypercalcaemia
113
Positive anterior draw test
ACL Rupture - twisting injury
114
Pain in internal rotation and extension of knee at 90 degree
Lateral meniscal tear - McMurrays test
115
Painful arc - abduction between 70-120degrees
Supraspinatous damage/impingement, frozen shoulder, calcium deposits
116
Dry eyes, mouth, skin, +ve Schirmer’s test - increased risk of lymphoma
Sjogrens syndrome - anti-ro/la & RF - commonly seen with arthritis
117
Dry eyes, Mouth, vagina & bronchitis
Sicca syndrome - primary without arthritis
118
Locked knee
Bucket handle meniscal tear
119
Bamboo spine on x-ray (syndophytes), sacroillitits & questionmark posture
Ankylosing spondylitis - HLAB27 +VE - loss of lumbar lordosis
120
Shortened leg & externally related
Displaced fracture of the neck of femur
121
Shortened leg & internally rotated
Dislocated femoral head
122
Onion peel sign
Ewing's sarcoma
123
Sunburst pattern on x-ray
Osteosarcoma
124
Soap bubble appearance on x-ray
Giant cell tumour
125
Scalp tenderness & jaw claudication
Giant cell arteritis - emergency pred
126
Gowers sigh positive
Duchenne MD
127
Swollen woody calves
Duchenne or becker MD
128
Rosary bead sign
Polyarteritis nodosa
129
Light bulb sign
Posterior dislocation on xray
130
Shepherds crook deformity or femur
Fibrous dysplasia
131
Loosers zone on x-ray
Osteomalacia
