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Differential Dx > MSK UE > Flashcards

MSK UE Flashcards

1
Q

(true/false) bacterial endocarditis often presents at the shoulder

A

true

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2
Q

RTC pathologies will have a (low/high)-riding humeral head

A

high-riding

Head is pulled up due to the spastic muscles which narrows the coracoacromial space

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3
Q

How long can a surgeon wait to repair a supraspinatus tear? What can happen if they wait too long?

A

a. approx. 8-10 months

b. if the tendon is retracted too much, the surgery is less likely to connect the tendon in its original position = leads to achoring the tendon onto the humeral head which changes shoulder mechanics

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4
Q

What is a Bankhart lesion? What is the MOI?

A

a. anteroinferior glenoid labral tear with fracture of the glenoid

b. Anterior shoulder dislocation

increases the risk of shoulder dislocation and capsule damage

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5
Q

What is a hill-sachs lesion? What is the MOI?

A

a. Fracture of the posterolateral humeral head

b. posterior shoulder dislocation

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6
Q

What is a reverse hill-sachs lesion? What is the MOI?

A

a. Fracture of the anteromedial aspect of the humeral head

b. posterior dislocation

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7
Q

How long can bruising caused by bakhart lesion and/or hill-sachs lesion last?

A

10-12 months

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8
Q

What type of acromion abnormality is the worst?

A

Type 3

curved acromion that looks like the end of a field hockey stick

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9
Q

What is the surgical intervention for the supraspinatus after being damaged by the acromion?

A

SAD procedure

Subacromial decompression that removes the distal end of the acromion

4 weeks of recovery (easiest to recover from)

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10
Q

What type(s) of acromion curve(s) minimally respond to conservative intervention?

A

Types 2 and 3

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11
Q

What is the CPR for diagnostic imaging of elbow injuries?

A

NO emergent imaging if the patient has NORMAL extension, flexion, and supination

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12
Q

(true/false) It takes a short amount of time for an olecranon fracture to heal

A

FALSE

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13
Q

What are common MOIs for olecranon fractures?

A
  1. FOOSH with elbow EXT
  2. falling/direct blow to the elbow
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14
Q

What is the Sail sign? What does it suggest?

A

definition: Fat pads between the bone and muscles are fanned out due to bleeding around the joint

  • suggestive of an occult radial head fracture

occlusion is commonly hidden which is why the sail sign is helpful w/ dx

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15
Q

What are red flags indicating a possible radial head fracture?

A
  • FOOSH
  • Sail sign
  • arm being held in OPP
  • restricted/painful PRON/SUP AROM
  • radial head TTP
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16
Q

What are common medial nerve entrapment sites?

A
  • between the heads of PT
  • carpal tunnel
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17
Q

What are common ulnar nerve entrapment sites?

A
  • ulnar groove
  • between heads of FCU
  • Guyon’s canal
18
Q

What are the common radial nerve entrapment sites?

A
  • triangular interval
  • supinator

Note: pierces the supinator (deep radial nerve)

19
Q

What are red flags that can be indicative of compartment syndrome in the UE?

A
  • trauma, surgery, extreme unaccustomed activity
  • persistent forearm pain and tightness
  • tingling, burning, or numbness
  • TTP and tension of the compartment
  • pain increases with stretching
  • paresthesia, paresis, sensory deficit
  • diminished pulse and capillary refill
20
Q

What is the technical term for a “dinner fork fracture”?

A

colle’s Fx

21
Q

(true/false) Colle’s Fx and smith Fx are the same fx

A

true BUT they are distinguished between the position/movement of the wrist

22
Q

What is a smith fx?

A

Flexion fracture of the radius

23
Q

What is a colle’s fracture?

A

Extension fracture of the radius

24
Q

What are red flags that suggest scaphoid fractures?

A
  • FOOSH
  • male 15-30
  • females with osteoporosis
  • swelling and bruising around the wrist
  • TTP over anatomical snuff box/scaphoid tubercle
  • increased pain with gripping
25
Q

What portion of the scaphoid has the best blood supply when a scaphoid fracture is present?

A

distal pole

26
Q

What are red flags that indicate possible lunate fracture or dislocation?

A
  • MOI: Falling on hand or a strain
  • general wrist pain
  • pain at end range of wrist EXT
  • decreased grip strength (+ pain)
27
Q

(true/false) The lunate loses blood supply with dislocation and/or fractures

A

true

one of the worst wrist pathologies causing decreased wrist function

28
Q

What anatomically occurs with a lunate dislocation?

A

Lunate moves medially towards the scaphoid, allowing the capitate to slide down

causes decreased wrist function

29
Q

What is scapholunate separation?

A

Extensive amount of joint space between the scaphoid and lunate

“Terry Thomas Sign”

30
Q

What is a boxer’s fracture?

A

Fracture of the 4th and/or 5th metacarpal

31
Q

What is a bennett fracture?

A

Fracture at the 1st CMC joint

32
Q

What are red flags indicating possible space infection of the hand?

A
  • recent wound
  • sxs of inflammation and infection
  • digit FLX
  • uniform swelling
  • TTP over involved tendon
  • severe pain with digit hyperEXT
33
Q

Where in the hand are space infections found?

A
  • mid palmar space
  • thenar space
34
Q

What are red flags that can indicate possible long flexor tendon rupture?

A
  • laceration
  • forceful contraction
  • loss of FLX AROM at the DIP or PIP
  • possible palpable defect in the muscle involved
35
Q

What digit commonly experiences long flexor tendon ruptures?

A

4th digit

36
Q

What causes mallet finger?

A

high velocity finger flexion into a surface (“jamming your finger”)

37
Q

What are red flags for possible Raynaud’s phenomenon?

A
  • family Hx
  • women on estrogen therapy
  • cold exposure
  • underlying vascular disease
  • medication that promotes vasoconstriction
  • pallor
  • cyanosis
  • hyperemic erythema of the fingers

Medications: beta blockers, amphetamines, decongestants, caffeine

38
Q

What are red flags indicating possible CRPS?

A
  • trauma or surgery
  • severe burning/aching/boring pain out of proportion to the inciting event
  • pain not responsive to typical analgesics
  • secondary hyperalgesia/hypersensitivity
  • swollen, warm, red
  • temperature difference between extremities
39
Q

What UE pathology can resemble lymphedema but is very painful and presents with flaky and dry skin?

A

CRPS

40
Q

What are possible interventions for CRPS?

A
  • manual desensitization
  • E-stim
  • mirror therapy (graded motor imagery)
41
Q

What are the most common referral sites from systemic diseases?

A
  • mid-low back
  • chest
  • shoulder/scapula
  • pelvis
  • hip/groin

Differential Dx (13 decks)

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