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Year 2 > Msk Investigations > Flashcards

Msk Investigations Flashcards

(49 cards)

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1
Q

First line investigation when suspecting SLE

A

Urinalysis to test for renal failure

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2
Q

Investigation for Giant Cell Arteritis
(Include 1st line)

A

1st line: ultrasound
Confirm with temporal artery biopsy (although not always positive)

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3
Q

Anti ro/ anti la indicates?

A

sjorgens (60-70%)

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4
Q

1st line investigation for cauda equina symptoms (bilateral scaitic radoculopathy + incontenince)

A

Urgent MRI + pr exam

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5
Q

Pagets
(Ix and what it should show)

A

X ray- initial: well define lucency, mishapen bone
- sclerotic phase: enlarged bone, inc cortex density, coarse trabecular pattern

Isotope bone scan- shows distribution

Biochem: inc alkaline phosphatase

skull x ray showsthickened calvarium and ill defined sclerotic lucent areas throughout

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6
Q

septic arthritis investigations

A

Hot swollen acutely painful joint- assume septic arthritis til proven otherwise.

1st line: aspirate joint for microscopy, culture & sensitivity and bloods- inc CRP, blood culture if pyrexial

x ray/MRI

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7
Q

Gout
(most appropriate investigation?)

A

most appropriate: joint aspiration and CRP on admission and

to confirm diagnosis: serum urate after 2 weeks

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8
Q

Rheumatoid arthritis investigations

what to use if in diagnostic doubt?/ what is the gold standard test for RA

A

Clinical diagnosis
bloods: raised inflammatory markers
rheumatoid factor, anti CCP (more specific)
X-ray hands and feet of all suspected RA patients

MRI is gold standard!!, only use if in diagnostic doubt

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9
Q

sjorgens investigations

A

schirmers test- occular dryness

bloods:
-positive anti-Ro & anti La
-possible inc in IgG & plasma viscosity/ESR
- lymph

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10
Q

osteomyelitis investigation

A

MRI

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11
Q

Ixs for ankyosing spndylitis

what test is used if in diagnostic doubt

A

-( Spondyloarthritis cannot be reliably diagnosed or ruled out by a single test)

1st: X ray; (sacroillitis: subchondral erosions, sclerosis, squaring of lumbar vertebrae, bamboo psine etc.)

if X ray doesnt show anything but suspicion remains high do MRI

other tests:
HLA B27 gene- test for if 3 of criteria have been met

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12
Q

What confirms diagnosis of a metatarsal fracture

A

MRI or bone scan to confirm diagnosis

Xray wont show fracture for 3 weeks (until resorption at the fracture ends occurs or callus begins to appear)

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13
Q

Extension of the big toe indicates what nerve is working?

A

Deep peroneal

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14
Q

Who should be referred for dexa

A

Patients >50y with low trauma fracture “stop at one”

Patients at inc risk via risk assessment tools eg. Frax or qfactor >10% risk of fracture over 10years

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15
Q

Diagnostic test for ankylosing spondylitis

A

MRI of sacroilliac joints

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16
Q

Lateral to medial layout of femoral triangke

A

Femoral nerve, fem. Artery. Fem vein. Lymphatics.

NAV

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17
Q

Serious trauma from a car accident or fall from high place, what type of bone fracture

A

Comminuted fracture

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18
Q

Fall on an iutstretched arm associated with what type of fracture

More common in kids because…

A

Greenstick
(Partial fracture)

Kids bones are softer

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19
Q

positive phalens test indicates…

A

carpal tunnel syndrome

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20
Q

aspirate of synovial fluid in gout shows?
what are you testing when you aspirate

Study These Flashcards
A

-microscopy- needle shaped, negatively befringeent monosodium urate crystals (confirms diagnosis)
- gram stain/culture to rule out septic arthritis

21
Q

how to diagnose SLE

Study These Flashcards
A

(ANA very specific for SLE)
SLE criteria 4 or more (at least 1 lab and 1 clinical) or biopsy proven lupus nephritis + antidsdna/anti sm

22
Q

diagnostic test for osteoporosis

Study These Flashcards
A

DEXA score of <-2.5

23
Q

occult hip fracture Ix (not able to see on x ray)

24
Q

gold standard test for rib fracture

25
diagnostic test for polymyositosis/dermosyotsis
muscle biopsy: shows perivascular inflammation and muscle necrosis
26
what are the criteria to diagnose kawasaki disease
4/5 of these symptoms CRASH & Burn Conjunctivitis Rash Adenopathy (lympadenopathy) Strawberry tongue Hands/feet (peeling of hands/feet) burn: fever for 5/more days
27
criterion to diagnose atypical kawasaki disease
2/3 of the CRASH and burn symptoms and CRP> 3mg/dl ESR>40mm/hr >3 supplemental labs (eg albumin) OR abnormal echocardoigram
28
what do you have to screen for in kawasaki disease? and what tool do you use
echo to check for coronary artery aneurysms
29
initial imagiing of choice for suspected achilles tendon rupture
ultrasound
30
what is the result for schobers test in someone with ankylosing spondylitis and what does it indicate
<5cm redcuded lumbar flexion
31
vertebral tb (aka potts disease) ix
x ray and MRI
32
gold standard test for any joint pathology
MRI
33
what does the DAS 28 score take into account
Sore joint count, swollen joint count, ESR global health score.
34
Ix for SUFE and confirm diagnosis
X-ray AP and frog leg view on BOTH hips confirm diagnosis and graded by klein line (how much is intersecting the femoral head)
35
suspected psoas absecess investigation
CT abdomen
36
polymyalgia rhuematica Ix findings
inc ESR and CRP
37
if there is osteoporosis in a man what should you check
testosterone
38
first line investigation for suspected osteoporotic vertebral fracture
X-ray spine
39
scaphoid fracture ix (2)
1st line: two oblique, AP (anterior posterior) and lateral x-ray view definitive: MRI
40
can you age a bruise for non accidental injury
no can age diff fractures tho
41
septic arthritis vs rheumatoid arthritis joint aspirate findings
septic: cloudy/opaque, yellow , >90% leukocytes, usually g+ (s.A) RA: clear, viscuos, predominantly polymorphonuclear neutrophils
42
what are the ottowa rules
when to x ray for ankle fracture: if there is pain in malleoulur area and any one of the criteria below then an ankle x-ray series is indictaed -bony tenderness at posterior edge/tip of lateral malleoulus - bone tenderness at the posterior edge/tip of the medial malleoulus - inability to bear weight for 4 steps both immediatley after the injury and when examining
43
what does a positive simmonds test indicate
calcaneal tendon (achilles tendon) rupture
44
what is more reliable lachman or anterior drawer test
lachman
45
cauda equina Ixs
PR exam and urgent MRI
46
1st line imaging Ix for ACL rupture
MRI
47
acetabulum fracture imaging
CT
48
shoulder dislocation Ix
X:ray two planes> AP erect and lateral
49
first line Ix for rotator cuff tear and gold standard
1st line: ultrasound G.S: MRI

Year 2 (50 decks)

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