Orthopaedics 1 Flashcards by H JP

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

Features (3)

Following trauma in young people
Degenerative changes in older people

Snapping sensation
Locking
Hip/groin pain

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

Ciprofloxacin (quinolones)
High cholesterol

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Gradual onset heel pain
Worse following activity
Morning pain and stiffness

Achilles tendinopathy

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What is the Simmon’s triad?

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

USS
Ortho referral - acute

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

What chronic disease is it associated with?

Middle aged females
T2DM

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Frozen shoulder which is worse external or internal rotation?

Rx (4)
Length of time till it heals

External

NSAIDs, physio, PO steroids, intra-articular steroids

6 months to 2 years

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When do you refer to secondary care for frozen shoulder?

3 months of stiffness with no benefit of conservative measures

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Ottawa rules - ankle (3)

Ankle XR is only needed if:

Bony tenderness at lateral malleolar zone
Bony tenderness at medial malleolar zone
Inability to walk four weight bearing steps immediately after the injury and in ED

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Causes of carpal tunnel (4)

RA
Pregnancy
Lunate fracture
Oedema

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Mx carpal tunnel

Mild-moderate (3)

Severe (1)

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

Severe surgical decompression

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De Quervain’s tenosynovitis
Which age group and gender?

Females 30-50

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

Ulnar deviation of the wrist
Pain on radial styloid process

De Quervain’s tenosynovitis

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Mx De Quervain’s tenosynovitis (4)

Analgesia
Steroids
Immobilisation with a thumb splint
Surgery

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Dupuytren’s contracture
Age group gender

Older male
+ve FH

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Causes of Dupuytren’s (5)

Trauma
Manual labour
Phenytoin
Alcoholic liver disease
DM

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Dupuytren’s contracture
When do you consider surgical treatment?

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

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

Lateral epicondylitis
Wrist extension or supination with elbow extended

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

6months-2year
6-12weeks

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

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

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What is radial tunnel syndrome most commonly caused by?

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

Overuse
4-5cm distal to the lateral epicondyle

Pronation with extended elbow

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Cubital tunnel syndrome is compression of which nerve?

Ulnar nerve

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Features of cubital tunnel syndrome?
Worse when?

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

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What is olecranon bursitis?

Study These Flashcards

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

Olecranon bursitis age group and gender

Middle aged men

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

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

Pain over lateral side of hip thigh = What is caused by? Common in which age group

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

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

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

Transient synovitis Age group Associated with what?

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

Perthes disease Age group What is it Gender

Male Aged 4-8yo Avascular necrosis of femoral head

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

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

Perthe's disease XR findings (2)

widening of the joint space decreased femoral head size/ flattening

Slipped upper femoral epiphysis Age group Gender

10-15yo Obese children Male > female

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

Slipped upper femoral epiphysis

Juvenile idiopathic arthritis Age Length of symptoms Number of joints

<16yo >3 months of symptoms <4 joints

Juvenile idiopathic arthritis Type of joints Associated with Antibody

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

Commonest cause of lateral knee pain in runners Mx (2)

Iliotibial band syndrome Mx Activity modification and stretches Physio if not improving

What is intersection syndrome/ where is the pain?

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

Intersection syndrome is commonly seen in which four sports?

Skiers, tennis players, weight lifters, canoeists

Intersection syndrome Mx (3)

NSAIDs Steroid injection Physio

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

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

Meniscal tear Results from which motion? Pain worse when?

Twisting injury Straightening the knee

Meniscal tear Features (3)

Locking Give way Tenderness along joint line

Associated with kneeling

Infrapatellar bursitis (clergyman's knee)

Associated with upright kneeling

Prepatellar bursitis Housemaid's knee

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

Anterior cruciate ligament

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

Posterior cruciate ligament

Tenderness over the affected ligament Knee effusion may be seen

Collateral ligament

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

Meniscal lesion

LOAF muscles

Lumbricals Opponens pollis Abductor pollis brevis Flexor pollis brevis

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

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

Erb Duchenne palsy Nerve roots affected? Secondary to? Sx

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

Musculocutaneous nerve Nerve Motor Sensory Typical mechanism of injury

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

Axillary Nerve Motor Sensory Typical mechanism of injury

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

Radial Nerve Motor Sensory Typical mechanism of injury

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

Median nerve Nerve Motor Sensory Typical mechanism of injury

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

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

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

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

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

Trigger finger is more common in? (3) Mx

Women RA DM Steroid injection +/- finger splint

Orthopaedics 1 Flashcards

(59 cards)