Review Flashcards
(218 cards)
1
Q
How long does morning stiffness last for OA?
A
< 30 minutes
2
Q
How long does morning stiffness last for RA?
A
> 30 minutes
3
Q
What nodes are seen in OA?
A
Heberden’s (DIP) and Bouchard (PIP) nodes
4
Q
What is the age of onset for OA?
A
Older >65
5
Q
What is the age of onset for RA?
A
20-40
6
Q
What is the speed of onset for OA?
A
Many yrs
7
Q
What is the speed of onset for RA?
A
Rapid, weeks to months
8
Q
What joints are affected by OA?
A
Often begins unilateral and limited to one set of joints (ie fingers)
9
Q
What joints are affected by RA?
A
Symmetrical polyarticular (small (MCPs) and large joints)
10
Q
When does joint pain occurs with OA?
A
Worsens w/ usage of joint
11
Q
When does joint pain occurs with RA?
A
At rest, may improve w/ usage of joint
12
Q
Do systemic sxs occur with OA, if so what are the sxs?
A
No
13
Q
Do systemic sxs occur with RA, if so what are the sxs?
A
Yes, fatigue and malaise
14
Q
What is seen on an spine XR for RA?
A
Atlantoaxial subluxation and insatiably (c-spine)
15
Q
What is seen on an chest XR in a RA pt w/ exposure to silica dust, asbestos fibers, and other pneumoconiosis?
A
Caplan syndrome: multiple rheumatoid nodules w/ possible cavitation.
16
Q
What is seen on a hand XR in a pt with Psoriatic arthritis?
A
- Pencil in a cup deformity d/t erosion of distal end and one phalanx and expansion of the base of the proximal portion of the next phalanx
17
Q
What is seen on a spine XR in a pt w/ ankylosing spondylosis?
A
- Sacroiliitis: sclerotic changes of sacroiliac area (SI joint fusion)
- Bamboo spine
18
Q
What is seen on an XR in a pt w/gout?
A
Rat-bite erosions
19
Q
What labs are used to diagnose RA?
A
- RF
- Anti-CCP (anti-cyclic citrullinated peptides/protome antibody - ACPA)
20
Q
What is the crystal composition of gout?
A
Monosodium urate monohydrate (needle like)
21
Q
What is the crystal composition of pseudogout?
A
Calcium pyrophosphate (rhomboid like)
22
Q
What is stage 1 of gout?
A
Asymptomatic hyperuricemia
23
Q
What is stage 2 of gout?
A
Acute gouty arthritis: Podagra (big toe at the first MTP)
24
Q
What is stage 3 of gout?
A
Intercritical gout: asymptomatic period after initial attack.
25
What is stage 4 of gout?
Chronic tophaceous gout - Tophi (conglomerations of urate crystals surrounded by giant cells in an inflammatory rxn
26
Infections involving GI and GU tracts (campylobacter and chlamydia), staph areus is causes to what disease?
Reactive arthritis
27
What dx would you think of if a young male comes in complaining of decreased ROM in is back?
Ankylosing spondylosis
28
Pt comes in with a rash on their leg and joint pain. You do an XR of their hands and you see "pencil in cup". What do you diagnose pt with?
Psoriatic arthritis
29
What is the indications for Arthrocentesis?
- Painful joint effusions
- Monoarticular inflammation of joint
- Systemic rheumatoid disorder of unknown etiology
- Articular inflammation of unknown causes
- Bursal aspiration- indicated when there is a painful bursal swelling despite conserving treatment or when olecranon bursitis is aggregated by normal activities
30
What are the contraindications of Arthrocentesis?
- Total joint replacement
| - Burns, infected skin, infected subcutaneous tissue
31
What is the causes of OA?
- Degenerative condition (wear and tear of cartilage)
- Age
- Obesity
- Excessive joint loading
- Repeated microtrauma
- Macrotruama
- Genetic predisposing
32
What is the cause of RA?
- Unknown
| - may be caused by infxn or series of infxn (most likely viral), and genetically predisposition
33
What is the cause of Psoriatic Arthritis?
Genetics, +HLA-B27
34
What is the cause of Reactive arthritis?
Infections involving GI and GU tracts (campylobacter, chlamydia, staph areus)
35
What lab is + for CREST?
Anti-centromere
36
What lab is + for drug induced lupus?
Anti-histone antibodies
37
What labs are + for Sjögrens?
Ro=SS-A and La= SS-B
38
A positive HLA-B27 would make you think of which 3 disease?
- Ankylosing spondylosis
- Reactive arthritis
- Psoriatic arthritis
39
What is the COD for drug induced lupus?
Death usually related to cardiac or pulmonary complications.
- 5 yr survival w/o tx
- 10 yr survival w/treatment
40
What are the general characteristics associated with Polymyalgia rheumatica?
- Temporal arthritis
- Stiffness and subjective weakness of shoulder and hip regions after a period of inactivity
- ESR > 50
- Age >50
41
What are the SICCA sxs associated with Sjögrens?
SICCA symptoms: dry mouth (xerostomia), dry eyes (xerophthalmia)
Decreases production of saliva and tears
42
What is the MC non-sicca sx associated with Sjögrens?
Chronic fatigue
43
What are the general characteristics of Behçet disease?
- Middle eastern descent
- Relapsing uveitis
- Recurring genital ulcers
- Recurring oral ulcers
44
What are the general characteristics of Takaysau?
- Asian women
- 10-20 yrs old
- Granulomatous vasculitis of aortic arch and its major branches
- Absent peripheral pulses, discrepancies in blood pressure, arterial bruits
45
What are the general characteristics Granulomatosis with polyangiitis?
- Vasculitis involving the kidneys and upper and lower respiratory tract.
- URI sxs: purulent/bloody nasal discharge, oral ulcerations, hemoptysis, dyspnea, tracheal stenosis
- Saddle nose
46
What lab is + for Granulomatosis with polyangiitis?
c-ANCA
47
What is the MCC of death in a pt w/ Granulomatosis with polyangiitis?
Renal failure
48
What are the general characteristics of SLE?
- Malar butterfly rash
- Photosensitivity
- Discoid lesions
- Oral ulcers
- Alopecia
- Reynaud phenomenon
49
What are the general characteristics of Dermatomyositis?
- Heliotrope rash: around eyes
- Gottron papules: purplish, papular, erythematous, scaly lesion over the knuckles
- V sign: rash on face, neck and anterior chest
- Shawl sign: rash on shoulder, upper back, elbows and knees
- Increased incidence of malignancy in adults
50
What does CREST stand for?
```
C: calcinosis cutis
R: reynaud's phenomenon (1st and MC)
E: esophageal dysmotility
S: sclerodactyly (claw like appearance of hands)
T: telangiectasias
```
51
What drugs cause drug induced lupus?
- Procainamide
- Hydralazine
- Isoniazide
- Quinidine
- Carbamazepine
- Phenytoin
52
Is Takayasu large medium or small vasculitis?
Large
53
Is Behçet disease large medium or small vasculitis?
Medium
54
Is granulomatosis with polyangiitis large medium or small vasculitis?
Small
55
What are characteristic findings in a pt with SCFE?
- Risk for AVN
- Obese, adolescent male (13 yrs old)
- Limp
56
What is the Salter Harris classification?
- S: separated (physis alone)
- A: above (physis and metaphysis)
- L: below (physis and epiphysis)
- TE: through everything (physis, metaphysis, and epiphysis)
- R: cRush (physis)
57
Where is the pain located with trochanteric bursitis?
Point tenderness over bursa-pain to lateral aspect of the hip that is made worse w/ direct pressure
58
What are common sxs of trochanteric bursitis?
- Increased pain in the AM, pain at night, and difficulty laying on the affected side.
- Increased Q angle
- "Snapping" hip syndrome
- +/- warmth
59
What is the largest Sesamoid bone?
Patella w/quadriceps tendons
60
What are the types of knee XRs?
- AP
- Lateral
- Sunrise/skyline (axial patellofemoral) - imaging device at 15 degrees and knee at 115 degrees
61
What zone is a jones fx?
Zone 2
| - Fx at 5th MT at the metaphysis/diaphysis junction
62
Pt with a jones fx is at risk for what?
- Risk for nonunion
| - Surgical intervention recommended
63
What is a common presentation in a pt with RC tendonitis?
- Pain w/ raising the arm overhead
- Age: 40s
- Chronic shoulder pain for months
- Pain worse at night, difficulty sleeping on affected side
64
Where is the location of pain in a pt with RC tendonitis?
- Localized to the lateral shoulder and radiates to the deltoid muscle
- Tears generally originate in the supraspinatus tendon.
65
What ligaments are involved with an inversion ankle sprain?
- anterior talofibular ligament
- calceneofibular ligament
- posterior talofibular ligament
66
What ligaments and structure are involved with an eversion ankle sprain?
deltoid ligament
67
What are PE findings in a pt with De Quervains?
- Tenderness over the first dorsal compartment of the distal radius
- Swelling over radial styloid
- Crepitus when pt flexes and extends the thumb
- Gripping/making a fist causes pain
68
What test is used to dx De Quervains?
- Finkelstein test: Full flexion of the thumb into the palm followed by ulnar deviation of the wrist
69
What is the the tx for De Quervains?
RICE, spica splint, NSAIDs
70
What is Osgood Schlatter disease?
- Overuse injury in a growing child that results from receptive stress when quadriceps pull on the apophysis of the tibial tubercle during a time of rapid growth
71
Who is Osgood Schlatter disease seen in more commonly?
- 11-15 yr olds: more common in boys than girls
| - Pts who are active in sports
72
Pain from Osgood Schlatter disease is typically exacerbated when doing what?
Running, jumping, climbing stairs, and squatting.
73
Why should you get a comparison view in pediatric pts?
Helpful in differentiating a true fracture from a growth plate.
74
What is the MC cause of compartment syndrome?
Tibial fracture (injury to lower extremities)
75
What is the hallmark sx of compartment syndrome?
Severe leg pain out of proportion to what would be expected
76
What are PE findings of a pt with compartment syndrome?
Unwilling to flex and extend extremities
77
How many compartments in in your thigh and lower leg?
3 in thigh and 4 in lower leg
78
What is the tx for compartment syndrome?
Immediate fasciotomy within 4-6 hrs
79
What PE test are used to determine the stability of the knee and what ligament is it testing?
- Varus stress test: LCL
- Valgus stress test: MCL
- Anterior drawer test: ACL
- Posterior drawer test: PCL
- McMurrys: meniscus
- Lachmans: ACL and PCL
80
What PE test are used to determine the stability of the ankle and what ligament is it testing?
- Anterior drawer test: talofibular ligament
- Varus stress test: calcaneofibular ligament
- Thompson: Achilles tendon
- Talar tilt test: anterior talofibular ligament and calcaneofibular ligament
81
What are indications to look for a talar dome fx?
Chronic swelling and or locking of the ankle 4-5wks post injury
82
What is the MC cause of a talar dome fx?
Inversion ankle injuries
83
What structures are involved in a Lisfranc fx?
Midfoot: tarsometatarsal joint
84
What would you see on an XR in a pt with a Lisfranc fx?
- Displaced laterally
| - Widening between big toe and 2nd toe
85
A critical injury causing a Lisfranc fx involves what?
- 2nd metatarsal joint, it wedges into a slot in the cuneiforms
86
What structures are associated with a deltoid injury?
Tear to deltoid ligament usually occurs with a fracture to medial malleolus and distal tibia
87
Where does the deltoid ligament originate from?
Medial malleolus and spreads to attached to the medial border of the talus
88
What is a bimalleolar fx?
Torn deltoid ligament and fx of fib and tib
89
What deformity is a result of deltoid ligament insufficiency?
Ankle valgus deformity
90
What does the sunrise/skyline view of the knee show?
Location of the patella in the femoral groove and the thickness of the articular cartilage
91
What is the C1 dermatome?
top of head
92
What is the C2 dermatome?
temporal
93
What is the C3 dermatome?
side of jaw/neck
94
What is the C4 dermatome?
top of shoulders
95
What is the C5 dermatome?
lateral arm
96
What is the C6 dermatome?
lateral forearm, thumb, index finger
97
What is the C7 dermatome?
posterior forearm, middle finger
98
What is the C8 dermatome?
medial forearm, ring and little finger
99
What is the T1 dermatome?
medial arm
100
What are the symptoms L4-5 disc herniation?
- pain over sacroiliac joint, hip, lateral thigh and leg
- numbness lateral leg and first 3 toes
- weakness with dorsiflexion of great toe, difficulty walking on heels, foot drop may occur
- minor atrophy
101
What are the symptoms L5-S1 disc herniation?
- pain over sacroiliac joint, hip, posterolateral thigh and leg to heel
- numbness back of calf, lateral heel, foot to toe
- weakness with plantar flexion and great toe may be affected, difficulty walking on toes
- ankle jerk diminished or absent
102
What is the NEXUS criteria?
- no midline cervical tenderness
- no focal neuro deficits
- normal alertness
- no intoxication
- no painful distracting injury
103
How do you diagnose drug induced lupus?
- anti-histone antibodies - always present
| - absence of anti-dsDNA and Anti-Sm Ab
104
How do you diagnose spinal stenosis?
- degenerative narrowed spinal canal
- neurogenic claudication - back and butt pain with standing and walking
- reduced with flexed spinal positions
- can have BL leg symptoms
- pain worse walking, better sitting
105
What are the red flags for Cauda Equina?
- saddle anesthesia
- recent onset of bladder dysfunction such as urinary retention, increased frequency, or overflow incontinence
- minor trauma
- strenuous lifting, especially in the older or osteoporotic patient
- corticosteroid use
- severe or progressive neurology deficit in the lower extremity such as "foot drop" or weakening of the lower extremity muscles
- unexpected laxity of the anal sphincter, perianal/perineal sensory loss
106
What are the red flags for HNP?
-significant numbness and weakness with plantar flexion of foot (L5/S1) or dorsiflexion (L4/L5)
107
What is SCFE?
"sciffy"
| -increased in obesity
108
What is the MC age in boys for SCFE?
12-15 years
109
What is the MC age in girls for SCFE?
10-13 years
110
What are the s/s of SCFE?
limp, pain
111
What is the PE of SCFE?
decreased internal rotation, abduction, flexion
112
What is the immediate management of SCFE?
stop weight-bearing and refer immediately
113
What is the treatment for SCFE?
surgical pinning
114
What is the prognosis for SCFE?
- may interrupt blood supply (AVN)
| - damage to joint cartilage, later osteoarthritis
115
The Salter-Harris classification
```
Straight Across
Above
Lower or Below
Through
Crushed
```
116
What makes you suspicious of compartment syndrome?
- severe swelling
- orthopedic emergency (>40 mmHg)
- pain, parestesia, paralysis, pulselessness
- increased presses in closed muscle compartment
- surgical fasciotomy within 4-6 hours
117
What is the problem with scaphoid fractures?
AVN
118
What are the physical exam findings of scoliosis?
- uneven shoulders
- curve in spine
- uneven hips
119
What is the apley scratch test looking at?
rotator cuff and adhesive capsulitis
120
What is Neer's impingement sign looking at?
rotator cuff disorder
121
What is Hawkin's impingement test looking at?
rotator cuff disorder
122
What is Empty can test looking at?
supraspinatus strength
123
What are tinel's sign and phalen's test looking for?
carpel tunnel syndrome
124
What is patella balloting looking for?
assess for effusion with bulge and balloon sign
125
What is valgus laxity looking at?
MCL
126
What is varus laxity looking at?
LCL
127
What is anterior drawer and Lachman's test looking at?
ACL
128
What is posterior drawer looking at?
PCL
129
What is McMurray test looking at?
meniscus injury
130
What is Talor Tilt test looking at?
ankle instability
131
What are the intra-articular conditions?
- acute arthritis
- infectious arthritis
- reactive arthritis
- gout
- pseudogout
132
Gout
- monosodium urate monhydrate
- negatively birefringent, needle-like crystals
- monoarticualar 60%, polyarticular 40%
- warmth and erythema of 1st MTP joint (podagra)
- nodular deposits of uric acid (Tophi)
133
Developmental dysplasia
- breech delivery - increased risk of DD of hips
- do no rely on leg creases
- 25% of infants with normal hips will have asymmetric leg creases
134
What are the physical exam maneuvers of developmental dysplasia?
Barlo and Ortolani testing
| Older Infants: galeazzi sign and decreased range of motion
135
What is the pathogenesis of developmental dysplasia?
spontaneous dislocation due to lax hip ligaments - improper development of femoral head and acetabulum
136
What is the diagnostic evaluation for developmental dysplasia?
- ultrasound recommended
| - femoral head ossification starts at 4-6 months
137
What is the treatment for developmental dysplasia?
- pavlik harness (in 1st 4 months)
- casting +/- traction
- surgery (open reduction)
138
Legg-Calvé-Perthes
avascular necrosis of the femoral head
| -boys >> girls
139
What is the peak age for Legg-Calvé-Perthes to occur?
4-8 years
140
What are the s/s of Legg-Calvé-Perthes?
2-3 week history of limp, +/- aching
141
What are the PE findings of Legg-Calvé-Perthes?
limited abduction
142
What are the hip films you would get with Legg-Calvé-Perthes?
AP and frog
143
What is the treatment for Legg-Calvé-Perthes?
containment and limit weight-bearing
144
What is the treatment for club foot?
- serial casting (Ponseti) followed by bracing to prevent relapse
- may require achilles tenotomy
145
Osteosarcoma
- malignant, most high grade
| - metaphyses long bones - distal femur, proximal tibia, proximal humerus
146
Who is osteosarcoma most common to occur in?
children and adolescents
147
What are the s/s of osteosarcoma?
pain and swelling of affected are
148
What does the x-ray of osteosarcoma show?
destructive lesion, moth eaten appearance, sunburst appearance
149
What is the treatment of osteosarcoma?
- core-needle or open biopsy
- chemotherapy - preoperatively and post-operatively
- limb sparing surgery
- no role for radiation therapy
150
Osteoma
- low prevalence
- new piece of bone, usually growing on another piece of bone
- benign tumor, slow growing
151
What are the s/s of osteoma?
- vary on location
- cranial nerve or visual/hearing issues
- round, hard Smoot mass
- can be painful or not
152
What is the treatment for osteoma?
- many will disappear on their own
| - surgery with tumor removal
153
Osteoblastoma
- relatively benign, can become aggressive and malignant
| - diaphysis of long bones
154
Who do osteoblastoma most often occur in?
males
155
When do osteoblastoma most often occur?
2nd - 3rd decades of life
156
What are the s/s of osteoblastoma?
- painful, night pain
| - swelling and tenderness
157
What does the x-ray of osteoblastoma show?
- Lucent defect with various degrees of density
| - well circumscribed
158
What is the treatment of osteoblatsoma?
surgical curettage
159
What is the most common benign bone tumor?
osteochondromas
160
When do osteochondromas occur?
1st to 3rd decades
161
Osteochondromas
- 15% of all primary bone lesions
| - metaphysis of long bones, sometimes small hand/foot bones
162
What are the s/s of osteochondromas?
non painful, slow growing mass
163
What are the x-ray findings of osteochondromas?
bony protuberances usually grow away from near joint
164
What are is the treatment of osteochondromas?
usually none required
165
Chondromas
- benign cartilaginous tumor
| - small bones in hands and feet, humerus and femur
166
What are the s/s of chondromas?
- asymptomatic
- pain (dull)
- swelling
- endocondromas can cause fractures
167
What is the treatment of chondromas?
surgical removal
168
Chondroblastoma
- rare, benign bone tumor
| - epiphysis of long bones
169
Who and when do chondroblastoma occur?
males younger than 25
170
What are the s/s of chondroblastoma?
- pain (joint)
- joint stiffness
- muscle atrophy
- limp
171
What is the treatment of chondroblastoma?
curettage, bone graft, resection
172
Ewing Sarcoma
- malignant, very aggressive
- lesions below elbow and below mid-calf with no mets = 80% 5-year survival rate with treatment
- diaphysis region long bones and flat bones
173
When do Ewing sarcoma occur?
adolescence, 2nd decade of life
174
What are the s/s of Ewing sarcoma?
- pain and palpable mass
- pathologic fracture
- fever and weight loss
175
What are the x-ray finding of Ewing sarcoma?
"onion peel" periosteal reaction, soft tissue mass
176
What is the treatment for Ewing sarcoma?
- chemotherapy-systemic = mainstay
| - surgery-local resection, limb salvage
177
What are some wound complications?
- Open tibia fx worst for Osteomyelitis
- Puncture wound through sneaker- pseudomonas (get hib and tetanus vaccine)
- Puncture wound can cause septic arthritis
- Pt w/ DM has open sores = risk for osteomyelitis
178
What cancers metastasis to the bone?
prostate, breast, lung
179
T-score
- 0=0 BMD is equal to normal
| - lower score the more porous bone
180
DEXA scan
dual-energy X-ray absorptiometry
| -measures the hip, spine, and wrist
181
Z-score
- comparison to the age matched normal
- the number of SD a pts BMD differs from the average BMD of their age, sex, and ethnicity
- used for severe cases of osteoporosis
182
Osteopenia
BMD is between 1 and 2.5 SD below mean
| T-score: -1 to -2.5
183
Osteoporosis
BMD >2.5 SD below mean
| T-score: -2.5 or less
184
What are the s/s of osteoporosis?
- usually none
- progressive dorsal kyphosis
- skeletal pain: often due to fracture
185
What is the work-up for osteoporosis?
- X-ray and DEXA
| - BMP, CBC, TSH, Vit D level
186
What is the treatment for osteoporosis?
- estrogen replacement therapy
- bisphosphonates
- SERMs
- Calcium/Vitamin D
187
Osteopenia
- essentially early stages of osteoporosis
- really no sings or symptoms unless fracture occurs
- prevention is key
188
What do you do if osteopenia is caught early and want to stop progression to osteoporosis?
- exercise an nutrition
| - at this stage estrogen therapy and other specific therapies not recommended
189
What is the criteria for a septic joint?
- Labs: increased WBC, ESR, CRP
- joint aspiration: WBC >50,000 bacteria
- unable to bear weight
190
How would the pt be laying if they had a hip dislocation?
Internal rotation, adduction
191
How would the pt be laying if they had a hip fracture?
External rotation, abduction
192
What is the S/Sxs of brachial plexus?
- Burning, achy, radiating pain
- Muscle weakness/dropped shoulder
- Point tenderness
- Mechanism of injury (overly extended or compressed)
(commonly seen in football players)
193
What are the PE test fo brachial plexus?
- Spurlings
- Brachial plexus traction test
- Tinels sign
- Cervical distraction
194
Pain with a cervical strain (tendon injury) is most painful during what?
AROM
| - NO peripheral pain or paresthesia
195
Pain with a cervical sprain (whiplash) is most painful during what?
PROM and AROM
| - NO peripheral pain or paresthesia
196
Torticollis (WryNeck) is caused by a shortened SCM causes what sxs?
- Muscle spasms
| - Facet irritation
197
During PROM of the cervical spine, what should you be sure to palpate?
Intersegmental motion
198
What does vertebral artery impingement causes?
Hearing loss, vertigo, nystagmus, confusion
199
A compression force brachial plexus injury is causing what?
Pitching of nerve roots between adjacent vertebra
| - increased risk for spinal stenosis
200
A distraction force brachial plexus injury is causing what?
Tension or stretching force on nerve roots
| - MC at C5/C6
201
Where is Erbs point located?
2-3 cm above clavicle anterior to C6 transverse process
202
What is Erbs point?
Most superficial passage of brachial plexus
203
Severe cervical sprains (dislocations) will present with what?
Postural changes d/t joint disassociation
204
What is the return to play criteria?
Full pain free ROM and strength
| - need Drs approval
205
Thoracic outlet syndrome is commonly seen in what profession
Hairdressers
206
What are S/Sx of thoracic outlet syndrome?
- Tingling 4th and 5th digit
| - Ulnar and median weakness
207
What is syringomyelia?
Cyst in the spinal cord that elongates over time
208
What are S/Sxs of syringomyelia?
- Progressive arm and leg weakness
- HA and cold sensation of hands
- Loss of bladder function
- MRI: Chiari malformations
209
What is cervical spondylosis?
Degenerative disorder of the disc with ingrowth of the bone with side spurs and thickening of the ligament Flavum
210
What are S/Sx of cervical spondylosis?
- Pain
- Radiculopathy
- Limited mobility in an upright position
- paresthesia in hands and hand dexterity
211
What are PE findings that would indicate cervical spondylosis?
Loss of vibratory and position sense in feet and legs
212
Visible or palpable step-off is indicative of what?
Spondylolisthesis
213
What ROM is preserved with disc disease?
Lateral flexion is preserved where forward flexion is not
214
Single squat and rise test the quadriceps and is innervated by what nerve?
L4 nerve root
215
What test is a strong indication of nerve root compression d/t herniated disc?
Crossover straight leg test
216
Sciatica is defined as?
Pain radiating below the knee
217
Pt w/ LBP has paresthesias in the lateral foot, decreased toe-raise strength, diminished sensation lateral foot, and normal Achilles reflex. Suggestive of what dysfunction of which nerve root?
L5
218
What is felty syndrome?
RA, Splenomegaly, Neutropenia
