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AKT > Orthopaedics 1 > Flashcards

Orthopaedics 1 Flashcards

1
Q

What is an acetabular labral tear?
Secondary to ? in young people and older people

Features (3)

A

Following trauma in young people
Degenerative changes in older people

Snapping sensation
Locking
Hip/groin pain

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2
Q

What drug can cause Achilles tendonopathy?
High ? can cause Achilles tendonopathy?

A

Ciprofloxacin (quinolones)
High cholesterol

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3
Q

Gradual onset heel pain
Worse following activity
Morning pain and stiffness

A

Achilles tendinopathy

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4
Q

What is the Simmon’s triad?

A

Patient lies prone, feet over edge
1. Look for abnormal angle i.e greater dorisflexion
2. Feel for a gap in the tendon
3. Gently squeeze calf - if it is injured it won’t move

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5
Q

Suspected rupture Ix and Mx (Achilles rupture) (1)

A

USS
Ortho referral - acute

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6
Q

Which age group is frozen shoulder/ adhesive capsulitis most common in?

What chronic disease is it associated with?

A

Middle aged females
T2DM

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7
Q

Frozen shoulder which is worse external or internal rotation?

Rx (4)
Length of time till it heals

A

External

NSAIDs, physio, PO steroids, intra-articular steroids

6 months to 2 years

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8
Q

When do you refer to secondary care for frozen shoulder?

A

3 months of stiffness with no benefit of conservative measures

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9
Q

Ottawa rules - ankle (3)

A

Ankle XR is only needed if:

  1. Bony tenderness at lateral malleolar zone
  2. Bony tenderness at medial malleolar zone
  3. Inability to walk four weight bearing steps immediately after the injury and in ED
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10
Q

Causes of carpal tunnel (4)

A

RA
Pregnancy
Lunate fracture
Oedema

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11
Q

Mx carpal tunnel

Mild-moderate (3)

Severe (1)

A

6 week trial of conservative management
- corticosteroid injections
- wrist splints
- physio

Severe surgical decompression

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12
Q

De Quervain’s tenosynovitis
Which age group and gender?

A

Females 30-50

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13
Q

What is Finkelstein’s test?
Used to check for which condition?

A

Ulnar deviation of the wrist
Pain on radial styloid process

De Quervain’s tenosynovitis

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14
Q

Mx De Quervain’s tenosynovitis (4)

A
  1. Analgesia
  2. Steroids
  3. Immobilisation with a thumb splint
  4. Surgery
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15
Q

Dupuytren’s contracture
Age group gender

A

Older male
+ve FH

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16
Q

Causes of Dupuytren’s (5)

A
  1. Trauma
  2. Manual labour
  3. Phenytoin
  4. Alcoholic liver disease
  5. DM
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17
Q

Dupuytren’s contracture
When do you consider surgical treatment?

A

Consider surgical treatment when the joins cannot be straightened/ hand cannot be placed flat on a table

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18
Q

What is tennis elbow?
Which movements make the pain worse? (2)

A

Lateral epicondylitis
Wrist extension or supination with elbow extended

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19
Q

Tennis elbow - how long does it last? How long is the acute pain?

A

6months-2year
6-12weeks

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20
Q

What is golfer’s elbow?
Which movements make the pain worse? (2)
Other features (1)

A

Medial epicondylitis
Wrist flexion and pronation
Numbness and tingling in 4th-5th finger

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21
Q

What is radial tunnel syndrome most commonly caused by?

Where is the pain?
Worse on which movements? (1)

A

Overuse
4-5cm distal to the lateral epicondyle

Pronation with extended elbow

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22
Q

Cubital tunnel syndrome is compression of which nerve?

A

Ulnar nerve

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23
Q

Features of cubital tunnel syndrome?
Worse when?

A

Tingling, numbness and weakness in 4th and 5th finger
Worse when resting on a firm surface

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24
Q

What is olecranon bursitis?

A

Swelling over posterior aspect of elbow - pain, warmth and erythema

25
Q

Olecranon bursitis age group and gender

A

Middle aged men

26
Q

Describe a ganglion
Where is it found
Which gender is it more common
Mx
When would you consider surgery?

A

Well circumscribed mass
Transilluminates
Dorsal aspect of wrist
F > M
Mx disappear sponatenously after several months
Severe symptoms or neurovascular sx

27
Q

Pain over lateral side of hip thigh =

What is caused by?
Common in which age group

A

Greater trochanteric pain syndrome
Due to repeated movement of iliotibial band and most common in aged 50-70

28
Q

Development dysplasia of the hip
Age group
Test
Signs (2)

A

Picked up at newborn examination
Ortolani and Barlow’s test
Unequal skin folds/ leg length

29
Q

Transient synovitis
Age group
Associated with what?

A

2-10yo
Acute hip pain with viral infection
Commonest cause of hip pain

30
Q

Perthes disease
Age group
What is it
Gender

A

Male
Aged 4-8yo
Avascular necrosis of femoral head

31
Q

Perthe’s disease
Features (4) - pain over what time period, unilat or bilat?

A

Hip pain develops over a few weeks
Limp
Stiffness and reduced ROM
Can be bilateral 10%

32
Q

Perthe’s disease XR findings (2)

A

widening of the joint space
decreased femoral head size/ flattening

33
Q

Slipped upper femoral epiphysis
Age group
Gender

A

10-15yo
Obese children
Male > female

34
Q

Knee or distal thigh pain
Loss of internal rotation when leg if flexed
Bilateral in 20%

A

Slipped upper femoral epiphysis

35
Q

Juvenile idiopathic arthritis
Age
Length of symptoms
Number of joints

A

<16yo
>3 months of symptoms
<4 joints

36
Q

Juvenile idiopathic arthritis
Type of joints
Associated with
Antibody

A

Medium joints eg knees, ankles, elbows
ANA +Ve
Associated with ant uveitis

37
Q

Commonest cause of lateral knee pain in runners

Mx (2)

A

Iliotibial band syndrome

Mx
Activity modification and stretches
Physio if not improving

38
Q

What is intersection syndrome/ where is the pain?

A

Pain in the distal dorsoradial forearm
5-10cm proximal of the wrist joint

39
Q

Intersection syndrome is commonly seen in which four sports?

A

Skiers, tennis players, weight lifters, canoeists

40
Q

Intersection syndrome
Mx (3)

A

NSAIDs
Steroid injection
Physio

41
Q

What is Thessaly’s test?
What is it used to test?

A

weight bearing at 20 degrees of knee flexion, patient supported by doctor, positive if pain on twisting knee

Meniscal tears

42
Q

Meniscal tear
Results from which motion?
Pain worse when?

A

Twisting injury
Straightening the knee

43
Q

Meniscal tear Features (3)

A

Locking
Give way
Tenderness along joint line

44
Q

Associated with kneeling

A

Infrapatellar bursitis (clergyman’s knee)

45
Q

Associated with upright kneeling

A

Prepatellar bursitis
Housemaid’s knee

46
Q

caused by twisting of the knee - ‘popping’ noise may have been noted
Rapid onset of knee effusion
Positive draw test

A

Anterior cruciate ligament

47
Q

May be caused by anterior force applied to the proximal tibia (e.g. knee hitting dashboard during car accident)

A

Posterior cruciate ligament

48
Q

Tenderness over the affected ligament
Knee effusion may be seen

A

Collateral ligament

49
Q

May be caused by twisting of the knee
Locking and giving-way are common feature
Tender joint line

A

Meniscal lesion

50
Q

LOAF muscles

A

Lumbricals
Opponens pollis
Abductor pollis brevis
Flexor pollis brevis

51
Q

What is Klumpke injury?
Caused by?
Associated with?
Which nerve roots affected?

A

Can be secondary to shoulder dystocia
Horner’s
C8,T1 lower trunk of brachial plexus

52
Q

Erb Duchenne palsy
Nerve roots affected?
Secondary to?
Sx

A

Upper trunk palsy, C5,C6
Shoulder dystocia
Arm hangs by the side and is internally rotated, elbow extended

53
Q

Musculocutaneous nerve
Nerve
Motor
Sensory
Typical mechanism of injury

A

C5-C7
Elbow flexion + supination (biceps)
Lateral part of forearm
Rare injury

54
Q

Axillary
Nerve
Motor
Sensory
Typical mechanism of injury

A

C5,C6
Shoulder abduction (deltoid)
Inferior region of deltoid
Humeral neck fracture

55
Q

Radial
Nerve
Motor
Sensory
Typical mechanism of injury

A

C5-C8
Extension forearm
Dorsal aspect of 1st and 2nd metacarpals
Humeral midshaft fracture
Wrist drop

56
Q

Median nerve
Nerve
Motor
Sensory
Typical mechanism of injury

A

C6,8 T1
LOAF muscles
Palmar aspect of 3.5 fingers
Carpal tunnel

57
Q

Ulnar nerve (6)
Nerve
Motor
Sensory
Typical mechanism of injury

A

C8,T1
Intrinsic hand muscles except LOAF, wrist flexion
Medial 1.5 fingers
Medial epicondyle fracture, claw hand

58
Q

Long thoracic (4)
Nerve
Motor
Sensory
Typical mechanism of injury

A

Serratus anterior
C5-C7
Blow to the ribs or mastectomy
Winged scapula

59
Q

Trigger finger is more common in? (3)
Mx

A

Women
RA
DM
Steroid injection +/- finger splint

AKT (52 decks)

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