Flashcards in Musculoskeletal Review Deck (75)
At what age should you begin ordering dexa scans for male patients? What about female patients?
70 for males, 65 for females
Give the dexa score for osteopenia? Osteoporosis?
Osteopenia = 1 to 2.4 standard deviations, osteoporosis = 2.5 standard deviations or greater.
What fracture is the #1 cause of compartment syndrome?
Tibial shaft fracture
A patient's lab work shows positive smith antibody and positive double stranded DNA antibodies. What is the most likely diagnosis?
Where are Bouchard's nodes found?
Proximal interphalangeal joint (PIP)
What will an x-ray show in acute osteomyelitis?
Nothing - it will show bone destruction in chronic osteomyelitis.
What is the best imaging to diagnose osteomyelitis?
Either a bone scan or an MRI will provide the diagnosis.
A 22 year old male patient presents with what is clearly a septic knee. You also notice lesions on his hands and feet. What is the most likely pathogen?
What would you expect the WBC count to be in the joint fluid of an infected knee?
>50,000 at a minimum and probably much higher.
A patient presents with a painless mass in her right wrist. What is the most likely diagnosis?
What is the age range for osteosarcoma? Where are they most typically found in the body?
Osteosarcoma usually occur in 15-25 year old males and are most commonly found around the knee.
You think a patient may have an osteoid osteoma due to his complaints of severe night pain. You set him up for an x-ray, but in the meantime what medication do you start him on?
If it is truly an osteoid osteoma ibuprofen will resolve his pain.
Clicking or locking of the knee indicates what diagnosis?
A 65 year old presents complaining of severe pain in his great toe that began when he woke up this morning. It is swollen, red and very tender. What is the most likely diagnosis?
Gout would be number one because of the location, but you might also think about an infection.
What uric acid level helps to confirm a diagnosis of gout?
What is the medical treatment for gout?
A pathology report comes back with positive birefringent crystals. What is the most likely diagnosis?
A patient with a history of hepatitis B presents complaning of bilateral knee pain, fever and weight loss. What is the most likely diagnosis?
You suspect a patient has polyarteritis nodosa. What is the test for a definitive diagnosis and what is the treatment?
Biopsy, high dose steroids
On physical exam you notice ulnar deviations and swan neck deformities. What is the most likely diagnosis?
A positive Neer's test indicates what diagnosis?
Rotator cuff impingement
List three medication that may cause lupus.
Procainamide, Isoniazid and Quinidine.
What test do you do for Sjogren's syndrome?
A patient with rheumatoid arthritis is heading to the OR for open reduction and internal fixation of the ankle. In addition to ankle films what other x-rays should you get?
C-spine, anesthesia will want them due to concerns about instability of C1 & C2.
What carpal bone has a high rate of nonunion and occult fracture?
What medication is used for patients with lupus?
Scleroderma limited version has five main characteristics for which the CREST acronym is often used. What are those five things?
Calcinosis, Raynaud's, Esophageal motility, Sclerodactyly, Telangiectasia
There is a sunburst appearance on x-ray. What is the most likely diagnosis?
Anatomically where are 80% of clavicle fractures located?