MSK- UE, Spine, Hip, LE

Question 1

Nickname for fracture at base of thumb

Answer 1

Bennett’s Fx

Question 2

Nickname for fracture at base of thumb that is comminuted

Answer 2

Rolando’s Fx

Question 3

Hyperextension of the thumb that leads to UCL injury is called

Answer 3

Gamekeepers thumb (aka skiers)

Question 4

Nickname for fracture at head of 5th metacarpal

Answer 4

Boxer’s Fx

Question 5

Tx boxers fracture

Answer 5

Ulna gutter

ortho consult, sometimes ORIF

Question 6

MCC paronychia

Answer 6

staph

Question 7

Main tx for paronychia

Answer 7

I&D

~abx

Question 8

what is a closed space infection of the fingertip pulp

Answer 8

felon

Question 9

Intensely painful vesicle along terminal phalanx. Patient unroofed the vesicle which helped with pain
Dx, Tx

Answer 9

Herpetic Whitlow

Acyclovir, self limited 4-6wks

Question 10

40 y/o pt presents with bump on the dorsum of the hand. It is asymptomatic except mild pain with direct pressure. It is well circumscribed and feels fluid filled. You are able to transilluminate it on exam.
Dx
Tx

Answer 10

Ganglion Cyst
can just observe, some resolve
can aspirate with 18g needle (re-occurrence common)

Question 11

pain in the anatomical snuff box

Answer 11

schaphoid fx until proven otherwise

splint and repeat films 10-14 days

Question 12

distal ulna fracture with anterior radial head dislocation

Answer 12

Monteggia fx

Question 13

proximal radial fracture with distal dislocation of radioulnar joint

Answer 13

Galaezzi fx

Question 14

24 y/o girl fell on both elbows (walking home drunk. She presents to ED with L sided decreased elbow ROM and mild swelling. Xray doesn’t demonstrate fracture but there is a sail sign

Answer 14

Likely radial head fracture

nondisplaced tx- soft splint, ICE, NSAID, early ROM

Question 15

distal radius fracture with dorsal angulation

“dinner fork” deformity

Answer 15

Colle’s fx

Question 16

distal radius fracture with palmar displacement

Answer 16

Smith’s fx

Question 17

55 y/o F presents with arm pain that is worse when picking up items that are palm down. She also has pain when turning door knobs. This affects her job as a machinist and assistant coach for her sons little league team

Answer 17

Medial epicondylitis (aka Golfers or Pitchers Elbow)

RICE, NSAIDS, Bracing
rarely ulnar nerve transposition

Question 18

medial epicondylitis is inflamm of _________

lateral epicondylitis is inflamm of______

Answer 18

flexors

extensors

Question 19

Tennis Elbow is

Answer 19

lateral epicondylitis

tender or lat elbow, pain pulling doors

Question 20

Elbow dislocation MC _____

Answer 20

posterior

Question 21

C1 (atlas) burst Fx nickname

Answer 21

Jeffersons Fx

Question 22

Fracture of C2 pedicles with anterior displacement of body nicknamed

Answer 22

Hangmans Fx

Question 23

spinous process fx

nickname and MC locations

Answer 23

Clay Shovelers Fx
usually C6 or C7
avulsion by supraspinatous ligament

Question 24

60y/o male with chronic LBP. Has hip and leg pain that is relieved by rest. He can only walk short distances before having to take a break. If he leans over his shopping cart at the market he can go a little further.

Answer 24

Spinal Stenosis

-neurogenic claudication

Question 25

MC cervical HNP

Answer 25

C6-C7 which compresses C7

Question 26

MC lumbar HNP

Answer 26

L5-S1 which compresses S1

Question 27

spurlings sign

Answer 27

pain reproduced when examiners exersts pressure down on vertex while tilting head towards symptomatic side

Question 28

lhermitte's signs

Answer 28

electrical shock like sensation radiating down spine

Question 29

diminished Achilles reflex and weakenss with plantaf flexion | which nerve being affected

Answer 29

S1

Question 30

traumatic back injury and pt has loss of motor fx, pain sensation, and temp sensation distal to lesion there is preservation of vibration, position and crude touch only

Answer 30

Anterior Cord Syndrome

Question 31

traumatic back injury and pt has decreased strength distal to lesion, UE>LE some decreased pain and temp sensation

Answer 31

Central Cord Syndrome

Question 32

osteoarthritis of spine

Answer 32

Spondylosis

Question 33

fx from interior facet, across pars, to superior facet | xray- scotty dog

Answer 33

Spondylolysis

Question 34

anterior slippage of vertebral column relative to an adjacent inferior vertebrae MC at L4-5 L5-S1

Answer 34

Spondylolisthesis

Question 35

When do you treat scoliosis

Answer 35

>20 degrees

Question 36

MC seen scoliosis curves | which do you suspect in neuro disease?

Answer 36

MC R thoracic or L lumbar | suspect neuro disease with L thoracic

Question 37

exaggerated curvature of the thoracic spine

Answer 37

kyphosis

Question 38

Back pain worse in am improves with activity radiates to buttock

Answer 38

Ankylosing spondylitis

Question 39

buzzwords for ankylosing spondylitis

Answer 39

"bamboo sign" "shiny sign" HLA-B27 hip and lbp

Question 40

1st line tx for ankylosing psondylitis

Answer 40

NSAIDS, many trials | then TNF inhib

Question 41

12 y/o boy tenderness over anterior knee worse with activity soft tissue swelling xray nonspecific changes

Answer 41

Osgood-schlatters

Question 42

Ortolanit test

Answer 42

detects DISLOCATED | hip abducted, feel reducing back into acetabulum

Question 43

Barlow test

Answer 43

detects UNSTABLE | adduction, feel "pistoning"

Question 44

MC joint injury

Answer 44

inversion ankle sprain | lateral ligament- primarily ATF

Question 45

Jones fx

Answer 45

fx base of 5th metatarsal

Question 46

wrist drop would correlate to what nerve?

Answer 46

Radial

Question 47

Thompson test

Answer 47

squeeze gastrocnemius (+)= no foot movement indicative of Achilles rupture

Question 48

MC mechanism of meniscal tear

Answer 48

axial loading with rotation

Question 49

MCL complete tear would have laxity of the knee with _____ stress

Answer 49

valgus

Question 50

patella MC dislocated what direction

Answer 50

lateral

Question 51

what test is most sensitive for ACL injury?

Answer 51

Lachmans