Ortho eponyms/ word associations Flashcards
(159 cards)
1
Q
Brown tumour; osteitis fibrosa cystica
A
Hyperparathyroidism
2
Q
Gallium scan - positive with _____
A
Infections
3
Q
Arthritis with eye symptoms
A
Juvenile RA
4
Q
Still’s disease
A
Juvenile idiopathic arthritis < 3 years old
5
Q
Pauciarticular juvenile idiopathic arthritis
A
Chronic iridocyclitis (anterior uveitis)
6
Q
Ankylosing spondylitis - test
A
Schober’s test
- Assesses amount of lumbar flexion: mark ~L5 vertebrae + 10cm above + 5cm below. Pt flexes forward and distance between marks re-measured (normal >5cm increase in distance)
7
Q
Ankylosing spondylitis - DDx
A
Forestier’s disease
aka Diffuse idiopathic skeletal hyperostosis (DISH)
- Bony hardening of ligaments
8
Q
Arthritis + urogenital/bowel infection
A
Reiter’s syndrome
9
Q
Gout joint aspirate
A
Negatively birefringent crystals; monosodium urate
10
Q
Pseudogout joint aspirate
A
Positively birefringent crystals
11
Q
Achondroplasia - brain association
A
Macrocephaly
12
Q
Rickets CXR sign
A
Rickety rosary - bone necklace
13
Q
Looser’s zones
A
‘Pseudo-fractures’: incomplete stress fracture
Associated most frequently with osteomalacia and rickets
14
Q
Paget’s disease complication
A
Osteosarcoma
15
Q
Osteoporosis circumscripta [cranii]
A
Paget’s disease XR sign
- highly circumscribed (focal) lytic lesion of skull bone
16
Q
Erlenmeyer flask deformity
A
Osteopetrosis, Gaucher disease
Ends of long bones shaped like erlenmeyer flasks
17
Q
Onion skin layers
A
Ewing’s sarcoma
18
Q
Osteosarcoma XR sign
A
Codman's triangle (periosteal reaction) Sunburst appearance (breakdown of the cortex)
19
Q
Popcorn calcification
A
Chondrosarcoma XR sign
20
Q
Lytic bone mets - primary source
A
Lung, kidney, thyroid
21
Q
Sclerotic bone mets - primary source
A
Prostate, breast
22
Q
Fibrous dysplasia - associated conditions
A
McCune-Albright, Mazabrauds syndrome
23
Q
Bone abscess aka
A
Brodie’s abscess
24
Q
Gibbus
A
Tuberculosis of the spine
- structural kyphosis deformity of thoracic/ lumbar spine where one or more adjacent vertebrae become wedged
25
Mercedes Benz sign
Describes appearance of normal lateral shoulder X-ray
| If glenoid and humeral head are imperfectly overlapping -> shoulder dislocation
26
Impingement syndrome - tests
Neers, Hawkins-Kennedy, Gerber's lift-off, Jobe's empty can
27
Rotator cuff tear - test
Positive arm-drop test
28
Shoulder instability + trauma
Bankart lesion
| - lesion of anterior-inferior part of glenoid labrum, due to shoulder injury most commonly ant dislocation
29
SLAP lesion - test
O'Briens (active compression test)
- shoulder flex to 90, adducted 10-15, elbow straight
- painful elevation against resistance internally rotated, NOT externally rotated
30
Bicipital tendinitis - tests
Speed's
Yergason's
Speed's = elbow extended, forearm supinated, shoulder slightly flexed - examiner applies manual resistance in downward direction
Yergason's = elbow 90 degrees flexed then active supination and ext rotation against resistance.
Both are positive if pain is reproduced in area of bicipital tendon/ groove
31
Gilliatt-Sumner hand (wasting at base of thumb) - cause?
Neurogenic Thoracic outlet syndrome
Due to compression of lower brachial plexus. Characterised by wasting of AbPB, interrosoues and AbDM muscles PLUS normal sensation within region innervated by the median nerve. If a sensory abnormality does exist, it is usually of the medial forearm (not supplied by median n.)
32
Thoracic outlet syndrome - tests
Adson's, Wright's (hyperabduction)
33
Sprengel's shoulder - association
Klippel-Feil syndrome
('cervical vertebral fusion syndrome': rare congenital syndrome characterised by fusion of any C vertebrae)
Sprengel's deformity is a rare congenital skeletal deformity where 1 scapula sits higher than the other
34
Lateral epicondylitis - test
Cozen's test
- pain on resisted wrist extension
Maudsley's
- pain on resisted middle finger extension
35
Gunstock deformity
Cubitus varus
36
Cubital tunnel syndrome
Pressure or stretching of ulnar nerve ('funny bone')
Ligament of Osbourne (roof of cubital tunnel)
Signs
- Ulnar claw
- Ulnar escape (Wartenberg's sign: involuntary abduction of 5th finger due to unopposed action of EDM)
Tests
- Froment's test (pinch grip holding piece of paper between index finger and thumb)
- Tinel's test (over cubital tunnel)
37
Posterior interosseous nerve entrapment (arm)
Ligament ('arcade') of Frohse (also known as supinator arch: fibrous arch at superior layer of supinator muscle, under which the post interosseous nerve runs under and can become compressed)
Motor signs only (no sensory deficit) - weakness of wrist, thumb and finger extension
The post interosseous nerve is a continuation of the deep branch of the radial nerve once it penetrates the supinator muscle
38
Musculocutaneous nerve entrapment - presentation
Lateral forearm numbness
Due to compression by biceps tendon/ aponeurosis against brachialis fascia. This is quite distal, therefore only affects the lateral cutaneous branch, a purely sensory nerve for antero-lateral forearm
39
High median nerve/anterior interosseous nerve palsy
Positive O test
Hand of benediction
Median nerve trapped between two heads of pronator teres in proximal forearm
40
Carpal tunnel syndrome - tests/signs
```
Phalen's test
Tinel's test
? negative O sign
? negative hand of benediction
- for differentiated from proximal median nerve palsy
```
41
Ulnar nerve entrapment (ulnar tunnel syndrome)
```
Compression of ulnar nerve at wrist in Guyon's canal
May be pure motor, pure sensory or mixed
- Ulnar claw
- weak grasp, pinch
- pain /paraesthesia in ulnar 2 digits
```
42
Brodie Abscess
Subacute osteomyelitis
| on XR: small oval cavity surrounded by sclerotic bone
43
'Cold abscess'
Tuberculosis spread along fascial planes
44
De Quervain's tenosynovitis - test
Finkelstein's
45
Ollier's disease
Multiple enchondromata affecting long bones
46
Kienbock's disease
AVN, osteochondritis of lunate
47
RA deformities of the hand
```
Duck-bill deformity of the thumb
Ulnar deviation of the fingers
Radial deviation of carpus and metacarpals
Volar subluxation of MPJ and wrist
Boutonniere or swan-neck deformity
```
48
Hip OA - tests
Thomas' test
Trendelenburg's sign
Reduced ROM - internal rotation is first to go
49
AVN of femoral head - eponymous causes
Perthes
Tom Smith's arthritis (septic hip arthritis in infancy causing pseudoarthrosis with hip subluxation)
Caisson's disease (diver's bends)
Gaucher's disease (enzyme deficiency -> glucocerebroside accumulation)
50
Sandwich vertebral body
Osteopetrosis (dense bands involving both endplates of vertebral bodies are sharply demarcated)
51
DDH - XR sign
Broken Shenton's line
52
Meralgia paraesthetic
Entrapment of lateral cutaneous nerve as it passes inguinal ligament
Presents with numbness over anterolateral aspect of the thigh from groin to knee
53
DDH - tests
Barlow's, Ortolani's tests
Galeazzi sign
Trendelenburg (if old enough to walk)
54
Klein's line (XR)
Drawn along the top (lateral edge) of the femoral neck - normally, should continue through femoral head/ epiphysis, 20% existing above the line
If not, suggests SUFE
55
SUFE - tests/signs
Antalgic gait
Trendelenburg positive
Whitman's sign (with hip flexion, there is obligate ER)
56
Femoroacetabular impingement
```
Pincer impingement (on acetabulum)
Cam impingement (on femoral head)
70% have both
```
57
Sever's condition
Osteochondritis of Achilles' tendon insertion
| - 'traction apophysistis'
58
Kohler's condition
Osteochondritis (AVN) of navicular bone
| - self-limiting
59
Freiberg's condition
Osteochondritis (AVN) of second metatarsal head
60
Ledderhose disease
Plantar fibromatosis (benign tumour of plantar fascia, similar process to dupuytren's contractures)
> other similar processes = Garrod's pads (dorsal IPJ), Peyronie's disease (penis)
61
Fabella
Sesamoid bone in the head of gastrocnemius
62
Osgood Schlatter's disease
Osteochondrosis/traction apophysitis of tibial tuberosity
63
Discoid meniscus
Congenital condition in which lateral meniscus bilaterally D-shaped (rather than usual C-shaped)
-> more prone to injury
64
Ankle mortise XR - angle, benefit
15 degrees internal rotation; gives true view of talus in tibiotalar joint
65
Patellofemoral syndrome (chondromalacia patella) - eponymous sign
Clark's sign - inability to contract quadriceps against resistance, when the knee is held in extension
66
Blount's disease
Physeal defect resulting in abnormal growth of inner part of upper tibia
- tibia goes into varus deformity
67
Friedreich's ataxia
Also known as 'Spinocerebellar degeneration'
Progressive genetic condition with difficulty walking, lost sensation in arms and legs, and impaired speech
Associated with pes cavus feet and equinovarus deformity
68
Ligamentous laxity score
Beighton score
69
RA - foot clinical presentation
Metatarsal heads prominent in sole
| Toes clawed and dorsally dislocated
70
Congenital talipes equinovarus - eponymous treatment
Ponseti casting - repeated manipulation and adhesive strapping or PoP casting
71
Claw vs Hammer toes
Claw: proximal to distal - hyperextension MTPJ, flexion IPJs (both proximal and distal)
Hammer: proximal to distal - hyperextension MTPJ, flexion PIPJ, hyperextension DIPJ
72
Bunion
Hallux valgus deformity of MPJ of big toe
| Part congenital, part acquired. Possibly higher risk from wearing tight/ pointed shoes
73
Morton's neuroma - test
Mulder's test - compression of MT heads and dorsal pressure under MT heads reproduces the pain
[Morton's neuroma is a thickening of tissue around the digital nerve leading to the toes - most frequently bw the 3rd and 4th toes, usually in response to irritation, trauma or excessive pressure]
74
Ingrown toenail - eponymous surgery
Zadik's operation
75
Pes cavus - areas of high friction
Callosities (plantar aspect)
| Corns (dorsal aspect)
76
Bunionette
Exostosis on lateral aspect of MT5 (little toe)
| E.g. from sitting cross-legged on a hard surface
77
'Pepper pot skull'
| 'Swiss cheese' bones
Multiple myeloma
78
Levels of entrapment - straight leg raise vs femoral stretch test
SLR: L5-S1 nerve root
FST: L3-L4 nerve root
79
Lasegue's test
After straight leg raise, lower leg until pain abates, then dorsiflex ankle +/- neck flexion
Positive (pain): dural involvement and/or sciatic nerve irritation
Negative (no pain): hamstring tightness or sacroiliac pathology
80
Winking owl sign (XR)
On AP view - absent pedicle is closed eye, open eye is other pedicle, beak is spinous process
Destroyed pedicle e.g. from tumour invasion
81
Froment's sign
Test for ulnar nerve palsy
82
Spinal cord finishes at level of ?
L1-L2
83
Diffuse idiopathic skeletal hyperostosis (DISH syndrome)
Aka Forrestier's disease or ankylosing spondylitis
Spondyloarthritis characterised by ankylosis and ossification of ligaments of 4 or more vertebrae
84
Spinal tuberculosis usually localises where?
Anterior longitudinal ligament of vertebral body
85
Scheuermanns disease = ?
Idiopathic juvenile kyphosis
- crushing osteochondritis affecting the spine in adolescence
The vertebrae grow unevenly with respect to the sagittal plane (the posterior angle is often greater than the anterior) -> "wedging" shape of the vertebrae, causing kyphosis
86
Pars interarticularis fracture - XR sign
Scottie dog sign
87
Risser sign
Indirect measure of skeletal maturity, whereby the degree of ossification of the iliac apophysis by x-ray evaluation is used to judge overall skeletal development
The lower the grade, the more severe the potential for spinal scoliosis
88
What is diastematomyelia?
Bifurcation of spinal canal/cord by bony, fibrous cartilagenous band
89
What is an Arnold-Chiari malformation?
Condition present at birth where there is skull abnormalities/ hypertrophy of cerebellar tonsils that herniate into the spinal canal and may obstruct the foramen magnum
90
Congenital scoliosis associated with ?
Renal, cardiac, imperforate anus, tracheoesophageal fistula, club hand, spinal dysraphism , VATER syndrome (aka VACTERL association - a group of birth deformities that tend to co-occur: vertebral , anorectal, cardiovascular, tracheoesopagheal fistula, esophageal atresia, renal, limb)
91
Scoliosis - test
Adams forward bend test
92
Schmorl's nodes = ?
An upward and downward protrusion (pushing into) of a spinal disk's soft tissue into the bony tissue of the adjacent vertebrae
93
Which side of a greenstick fracture cracks?
Convex side
94
What is the type of fracture when bone fragments are pulled in opposite direction?
Distracted
95
Abx for open fracture?
Ampicillin + flucloxacillin
| Gentamycin/metronidazole if contaminated
96
Salter Harris II - XR sign
Thurston-Holland sign/fragment - sign depicting a triangular portion of the metaphysis remaining with the epiphysis in a physeal fracture
97
Salter Harris IV - beware the ? fracture
Triplane fracture - distal tibia fracture occurring in adolescents, that can appear as SH II and SH III in different imaging planes - combined SH IV, but need to look at multiple planes
98
Treatment of Salter Harris fractures
SH I and II - closed reduction and cast immobilisation
SH III and IV - ORIF
SH V - growth arrest almost inevitable, so no specific treatment
99
AVN XR sign
Crescent sign - subchondral lucent line
100
Reflex sympathetic dystrophy
Aka Sudeck's dystrophy, complex regional pain syndrome type 1
Chronic arm or leg pain developing after injury, surgery, stroke or heart attack
101
Complex regional pain syndrome classification
Type 1: CRPS without evidence of nerve damage in the affected limb. Secondary to injury/trauma. This accounts for about 90% of CRPS.
Type 2: CRPS with evidence of nerve damage in the affected limb.
102
Fat embolus syndrome
ARDS associated with circulation of abnormal lipid aggregations
103
Sulcus test
Pulling arm downwards may cause depression below the shoulder
Suggestive of capsular instability
104
Kocher or Stimson method
For relocation of shoulder dislocation
105
Dugas sign
Unable to put hand on opposite shoulder with elbow touching chest - loss of internal rotation
Indicative of anterior dislocation of humeral head
106
Regimental badge/patch sign
Axillary nerve damage causes loss of sensation on lateral deltoid
107
Most common complication of anterior shoulder dislocation
Axillary nerve damage
108
Associated lesions with anterior shoulder dislocation
Hill-Sachs - indentation of posterior humeral head after impaction on glenoid rim
Bankart - avulsion of capsule when shoulder dislocates, seen in 85% of all anterior dislocations
109
Anterior shoulder dislocation - reduction methods
Kocher method
Hippocratic method
Stimson Hanging arm method
110
Putti-Platt operation
Operation for reduction of anterior shoulder dislocation - anterior joint reinforced by shortening subscapularis tendon to limit external rotation
111
Posterior shoulder dislocation - XR signs
Round light-bulb appearance of humeral head on lateral view
| Reverse Hill-Sachs - divot in anterior humeral head
112
Erb's palsy
Upper brachial plexus injury, affecting C5-C6; axillary, suprascapular and musculocutaneous nerves
113
Erb's palsy - clinical sign
Waiter's tip hands
114
Klumpke's palsy
Lower brachial plexus injury, affecting C8-T1; ulnar and median nerves
115
Medication for heterotopic ossification prophylaxis
Indomethacin
116
Supracondylar fracture - XR sign
Fat pad sign (sail sign) - dark triangle posterior that may suggest blood in the joint, and demonstrates a minimal/undisplaced occult fracture
- fat pad sign anteriorly is normal
117
Tardy ulnar nerve palsy
Chronic clinical condition characterized by a delayed onset ulnar neuropathy after an injury to the elbow
- Typically, tardy ulnar nerve palsy occurs as a consequence of nonunion of pediatric lateral condyle fractures at the elbow, which eventually lead to a cubitus valgus deformity
118
Radial head fracture classification system
Mason classification
119
Essex Lopresti injury
Triad of comminuted fracture of radial head, disrupted interosseous membrane and distal radioulnar joint dislocation
120
Nightstick fracture
Isolated fracture of the ulnar shaft
121
Monteggia vs Galeazzi fractures
Monteggia: fracture of proximal ulna with dislocation of radial head
- A = proximal
Galeazzi: fracture of distal radius with dislocation of distal radioulnar joint
- Z = distal
MUGGER
- MU = Monteggia/ulna
- GR = Galeazzi/radial
122
Scaphoid test
Pain worse on radial deviation of wrist
| - indicative of scaphoid fracture
123
Colles fracture
Distal radial fracture +/- fracture of ulnar styloid
'Dinner fork deformity'
Dorsal (posterior) displacement of distal radial fragment
Complication = rupture of EPL tendon at Lister's tubercle of the radius
124
Smith fracture
Distal radius fracture - volar displacement
125
Barton fracture
Intra-articular fracture of distal radius from shearing force
126
Bennett's fracture
Fracture of thumb base (intraarticular @ CMCJ)
| Proximal base is displaced proximally and radially
127
Rolando's fracture
Three-piece intraarticular fracture of the base of the thumb
128
Gamekeeper's thumb / skier's thumb
An insufficiency of the ulnar collateral ligament (UCL) of the metacarpophalangeal (MCP) joint of the thumb
129
Scapho-lunate dissociation - XR sign
An increase in the scapholunate space on an AP radiograph of the wrist (or coronal CT)
130
Boxer's fracture
Fracture of 5th metacarpal neck
131
Pilon fracture (of the hand)
Avulsion fracture involving the base of the most distal phalanx, which may secondarily result from a more proximal dislocation
132
Straddle fracture
Pelvic fracture where direct anterior blow causes fracturing and posterior displacement of all 4 rami
133
Pelvic fracture - classification system
Tile classification
134
Pelvic open book fracture is Tile classification Type ?
Type B
135
Leg appearance in posterior vs anterior hip dislocation?
Posterior: flexed, internally rotated, adducted (shortened)
Anterior: extended, externally rotated, abducted
136
Intertrochanteric hip fracture stability determined by compromise of ?
Calcar femorale
137
Thomas splint
Splint used for femoral diaphysis fractures
138
O'Donahue's unhappy triad
ACL, ML and medial meniscus tear
139
Segond fracture
Avulsion fracture of the knee that involves the lateral aspect of the tibial plateau and is very frequently (~75% of cases) associated with disruption of the anterior cruciate ligament (ACL)
140
Lateral capsular sign (knee XR sign)
Indicative of Segond fracture, and therefore ACL disruption
141
Pellegrini-Stieda syndrome
The Pellegrini–Stieda sign is a calcification of the medial collateral ligament of the knee after trauma
Syndrome - above calcification with discomfort at MCL attachment to medial femoral condyle
142
Tibial plateau fracture classification system
Schatzker classification
143
Ankle fracture classification system
Weber classification
144
Maisonneuve fracture
Proximal fibula fracture together with unstable ankle injury
145
ATFL injury tests
Anterior drawer test
| Talar tilt test (also CFL)
146
Talar fracture classification system
Hawkins classification
147
Hawkins XR sign (ankle)
Seen on AP view
Positive if subchondral lucency of talus is present at tibiotalar joint, which suggests intact vascularity and therefore decreased risk of osteonecrosis
- Positive here is good
If subchondral sclerosis, at risk of AVN
148
Bohler's angle (XR sign)
Two lines formed from the three superior articular surfaces of the calcaneus should create an angle between 20-40 degrees - in calcaneal fracture, <20
149
Lisfranc ligament
Plantar ligament spanning articulation of medial cuneiform and second metatarsal base
150
Thomspons/Simmonds test
When patient lies prone, squeezing the calf should normally cause passive plantarflexion -> absence = positive test
Indicative of Achilles tendon rupture
151
Jones fracture
Fracture of midshaft of fifth metatarsal, from stress
152
Hangman's fracture
Fracture of C2 with bilateral pars fractures, due to extension
153
March fracture
Stress fracture of distal metatarsal bone(s)
154
Cobb's angle
Measure of scoliosis (if ≥10 degrees)
155
Frohlich syndrome
Hypopituitarism - delayed skeletal maturation, adiposity and hypogonadism
156
Lorain syndrome
Hypopituitarism - child fails to grow but normal body proportions
157
Albers-Schönberg disease / marble bones =
Osteopetrosis
158
Gaucher disease is _____
an auto rec genetic disorder in which glucocerebroside (a sphingolipid, also known as glucosylceramide) accumulates in cells and certain organs
Most common lysosomal storage disorder
159
Adson's test / Wright's test
For thoracic outlet syndrome
Adson's: patient extends neck and turns towards affected side while breathing in deeply -> this compresses interscalene space and may cause paraesthesia and obliteration of radial pulse
Wright's test: arms abducted and externally rotated -> reproduces Sx and pulse disappears on affected side
