Orthopeadics teach amk day

Question 1

sunburst appearance on X-ray

Answer 1

osteosarcoma

tissue biopsy to confirm

Question 2

what is osteosarcoma

most commonly found where

Answer 2

malignant bone tumour found at metaphysics of distal femur or proximal tibia

Question 3

symptoms fo osteosarcoma

Answer 3

dull bone pain worse at night , localised mass , soft and tissue mass and swelling

Question 4

pages disease of the bone is a metabolic bone disorder

symptoms - hearing and extra

Answer 4

constant achy bone pain
warmness
hearing loss
and heart failure

Question 5

what do results from blood show pagets

Answer 5

raised ALP
normal calcium and phonate

differentials for hbperparathryism

Question 6

management fo pagets

Answer 6

bisphosphonates e.g. IV parmidroante

Question 7

osteomyelitis is the infection of the bone usually from

Answer 7

staph aureus

Question 8

symptoms of OM

Answer 8

recent trauma or fractures due to infection getting in

bone pain at site
lump
fever and redness

Question 9

investigation fro OM - infection of bone

managemtn

Answer 9

MRI

give antibiotics
children - cefaxolin and adults fluco

Question 10

bony metastasis is when what

Answer 10

when cancers spread to the bone

most common causes are renal , trhyodi , lung , prostate, breast

Question 11

syntposm of bony metastasis

Answer 11

bone pain worse at night
anaemia

raised calcium

normally just palliative care and chemo

Question 12

chondrosarcoma is tumour and presents with painful and enlarging mass and if affects where

Answer 12

axial skeleton - ribs, shoulder and pelvis

Question 13

what does an X-ray of a chondroarcoma show

Answer 13

lytic lesions with calcification , cortical remodelling

need to remove it

Question 14

sliped upper femoral epiphysis SUFE this is where growth plate experiences some sort of fracture causing the femoral head to slip out of position

really common in boys 10-16 normally obese

symtpoms

Answer 14

limited abduction , internal rotation and flceion and present with externally rotated leg

pelvic xray - frog postion

managemnet is internal rotation - pops it back in

Question 15

perthes affects boys 4-7 and is characterised by gradual hip pain and all hip movements are limited
managed b

Answer 15

NSAIDs and bed rest

Question 16

transient synovitis of the hip 4-10 yr olds is acute onset hip pain and relived rest

upper resitpatiory tract infection relived with rest for the pain

investigations shwo

Answer 16

no findings or blood results on scan

Question 17

for septic arthritis what diagnosis should do

Answer 17

aspirate and then blood cultures

kochers criteria

mangemtn with fluclox- staph and for strep use ceftriaxone

Question 18

reactive arthritis comes after STI or campylobacter most common joint

anterior uveitis - red eye

Answer 18

knee

methotraxate

Question 19

osgood-schlatters disease

overuse syndroom in paeds population and males. normally active patients. presents as

Answer 19

warmth and tender and swelling over the tibial tuberosity - just below the knee

conservative measures for management - rests ice, physiological and NSAIDs

Question 20

if you have ligament damage what does it present as

Answer 20

swelling and pain and inability to weight bare

Question 21

test for ACL

Answer 21

anterior draw test

post draw test

Question 22

varus stress test

Answer 22

lateral

valgus is for medial

Question 23

mamagemtn for ligament damage

Answer 23

PRICER - protect , rest, ice compression , elevation and rehab

Question 24

meniscal tear presents with

Answer 24

pop sound and pain on side of knee

inability to weight bear and pain worse on flexion

Question 25

main test for meniscal tear

Answer 25

McMurray test | MRI gold standard

Question 26

chondromalaci patellae

Answer 26

anterior knee pain in teenage girls grinding of the knee when flexed worse on walking down stairs MRI and physic

Question 27

pre patellar bursitis very common n roofers and carpet layers - plumbers and gardeners - people who on their knees symtpoms

Answer 27

massive swelling warm tender clinical exma

Question 28

poster hip dislocation - dashboard car | symptoms

Answer 28

pain radiating to the knee shortened and internally rotated one closed reduction within 6 hours for manage

Question 29

femoral head injury present with groin pain and local swelling and bruising with sciatic nerve injury how to mange

Answer 29

xray | repositioning ORIF 0 expose and manipulate structures to put back in place

Question 30

neck of femur fracture common in elderly with osteoporosis | symptoms

Answer 30

hip pain worse on palpating greater trochanter shortened and external rated

Question 31

what criteria for neck of femur

Answer 31

garden criteria

Question 32

anterior hip dislocations

Answer 32

lengthened externally rotated femoral nerve injury pain radiating to the knee closed reduction within 6 hours

Question 33

neck of femur fracture - intracapsular or extracapsualr if you have dialled sub capital ( intra) you need a

Answer 33

Total hip replacement or hemiarthroplasty - weak patents so old ( half replacement essentially)

Question 34

non dispalced sub capital fracture - intracapsular what do you do

Answer 34

cannulated hip screw

Question 35

extra - intertrochanteric

Answer 35

dynamic hip screw

Question 36

subtrochnateric

Answer 36

intermudullary nail

Question 37

adhesive capultiis more common in diabetics glenohumeral joitn capsule adheres to humeral head symtpsom

Answer 37

loss of active and passive movement - freezing stage - pain worst , mvoemtn worse frozen stage- pain better , movement worse thawing stage - pain resolves and movement improves

Question 38

rotator cuff tears present as

Answer 38

loss of active movement with pain on rest and movement passive movement intact - they can't move it themselves but we can weakness on abduction

Question 39

assessment for rotator cuff tear

Answer 39

xray to exclude fractures US - to look for tear MRI - looks at tears more clearly management - depends on symptoms under 2 weeks conservative but if over 2 weeks will be surgery

Question 40

anterior glenohumeral dislocation in Rugby and poster in seizures and electrocution symtpoms

Answer 40

``` painful shoudle r reduced mobility asymmetry loss of shoulder contours antihero bulge ``` reduction immobilisation and rehab for manegmetn

Question 41

assessment for dislocations

Answer 41

x ray MRI if labral injury suspected X- ray for poster is like a light bulb sign and again MRI is labral injury suspected goes around the joint thats why if you've had one before likely to get one again