MSK Q's Flashcards
(20 cards)
carpal tunnel syndrome
*compression of the median nerve
*first 3 fingers paresthesia pain
*as disease progresses can have motor symptoms
dermatomyositis
*proximal muscle weakness UL=LL
*heliotrop rash
*erythema v shape on chest and shawl pattern on back
* assoc with high risk of malignancy
*raised creatinine phosphokinase
*anti MI2
rotator cuff tear
- occurs after a fall
*common in >40
*pain and weakness in abduction and ext rotation of shoulder
*MRI investigation of choice
achilles tendinopathy
- c/o ankle pain, swelling and tenderness
*follows abrupt increase in exercise
*can also be cause by fluroquinolones
*tenderness 2-6cm proximal to insertion into calcaneus
*mgx:- eccentric calf strengthening exercises - steroids not recommended
septic bursitis
- can follow cellulitis, abrasion, penetrating traumatic injury, bursal injection or aspiration
- worsening pain and fever
- investigation of choice:- aspiration
vertebral compression fracture
- common risk in postmenopausal women and men over 65
- assoc risk decreased bone density and osteoporosis
*occurs after minor trauma, pain not relieved by rest
*midline pain and tenderness - investigation of choice :- X-ray. DXA guides mgx
acute glenohumeral dislocation
aka shoulder dislocation
* is simple dislocation with no other damage –: closed reduction
*if complicated by recurrent dislocations, extensive soft tissue damage or fracture –> open surgical repair
* common compilation :- humeral neck fracture –> risk of avascular necrosis
disseminated gonococcal infection
*can present with purulent monoarthritis and fever OR
* tenosynovitis, dermatitis, migratory polyarthralgia
*synovial fluid usually negative for crystals +organisms
*diagnosis :- NAAT from synovial fluid and other mucosal sites
Paget’s disease of the bone
*bone pain and deformity affecting bones of skull, long bones and spine
*can lead to CN impingement –> vertigo, sensorineural deafness
*ALP raised
*imaging;–> thickening of cortical and trabecular bone
*mgx:–> bisphosphonates
Neck of femur fracture
- risk:- >65, osteoporosis, frailty
*Xray:- shortening of the neck and disruption of cortical contour
*mgx:- open reduction and fixation or arthroplasty
osteoarthritis
*chronic pain worse with activity and weight bearing
*XRay:- loss of joint space, osteophytes
Ottowa ankle rules
*pain in the malleolar region +
pain in medial or lateral malleolus
pain in
unable to wt bear
plantar fasciitis
*heel pain worse with activity, standing or walking for a long time
*worse in the morning
*seen in middle aged obese pts
*o/e tenderness on toe dorsiflexion on plantar facia insertion into calcaneus
risk of using succinycholine in pts with burns, trauma, stroke
*severe hyperkalaemia leading to cardiac arrhythmias
vertebral metastatases presentation
*back pain worse with activity no relief with rest, worse at night
*focal spinal tenderness
*recent or current hx of malignancy
phantom limb pain
*common post-amputation complication
*neurpapthic pain in the absent limb +/- triggers like urination/defecation
*mutli-modal therapy for the pain
assessment of blunt chest injury
*if haemodynamically unstable or stable but hx of high impact injury or obvious injury —> FAST + ECG,+CXR
* if abnormality found —> CT chest
osteitis fibrosa cystica
*complication of 1o hyperparathyroidism
*xray –> lytic lesions and cortical thickening
Charcot joint
*repetitive joint and bone trauma due to impaired sensation and proprioception
*seen in diabetics
*XR:- osseous absorption, foot disorganisation and mid foot arch collapse
mgx of OA knee
*weight loss
*moderate exercise
*topical / oral NSAIDs
*quad strengthening exercises
