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Ortho-Rheum > Soft Tissue Injuries > Flashcards

Soft Tissue Injuries Flashcards

1
Q

inflammation of the thin, fluid-filled sacs around the elbow that act as cushions between bones and soft tissue

A

olecranon bursitis

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2
Q

type of olecranon bursitis typically caused by repeated trauma or leaning on the elbow for a long time

A

inflammatory bursitis (aseptic)

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3
Q

type of olecranon bursitis caused by a skin break due to scrape or bite

A

infectious

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4
Q

a patient presents with red, hot, swollen, tender elbow, decreased ROM, elbow warm to touch, without pain with axial load. Dx?

A

olecranon bursitis

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5
Q

how is olecranon bursitis diagnosed?

A

H&P

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6
Q

what is the treatment for inflammatory olecranon bursitis? (4)

A

NSAIDs
RICE
elbow pads
+/- aspiration/steroid injections

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7
Q

what is the treatment for infectious olecranon bursitis? (2)

A

empiric antibiotics
+/- I&D

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8
Q

what is the treatment for infectious olecranon bursitis that does not improve with abx and I&D?

A

surgical bursectomy

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9
Q

what are the usual organisms in infectious olecranon bursitis? (2)

A

staph
strep

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10
Q

defined as a chronic tendinosis

A

epicondylitis

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11
Q

also known as tennis elbow; causes tendinosis and inflammation of the extensor carpi radialis brevis muscle

A

lateral epicondylitis

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12
Q

lateral epicondylitis occurs d/t overuse injury at the origin of what?

A

common extensor tendon

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13
Q

a patient presents with pain with resisted wrist extension, pain with gripping, pain with passive wrist flexion, and TTP over extensor carpi radialis brevis with resisted wrist extension and elbow in full extension. Dx?

A

lateral epicondylitis

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14
Q

also known as golfer’s elbow; injury d/t overuse of the flexor-pronator mass

A

medial epicondylitis

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15
Q

medial epicondylitis involves what?

A

all common flexor tendons, except palmaris longus

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16
Q

a patient presents with medial elbow pain, pain with gripping, and tenderness with gripping or resisted wrist flexion and pronation. Dx?

A

medial epicondylitis

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17
Q

how to diagnose lateral and medial epicondylitis?

A

H&P

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18
Q

what is the treatment for lateral and medial epicondylitis? (5)

A

NSAIDs
RICE
physical therapy
bracing
steroid injections for inflammation

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19
Q

when can surgery be considered for lateral and medial epicondylitis?

A

after 6 months of failed conservative treatment

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20
Q

peripheral compressive neuropathy of the ulnar nerve within the medial elbow

A

cubital tunnel syndrome

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21
Q

what is the 2nd most common compression neuropathy of the upper extremity?

A

cubital tunnel syndrome

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22
Q

where is the most common site of compression in cubital tunnel syndrome?

A

between the 2 heads of flexor carpi ulnaris and aponeurosis

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23
Q

a patient presents with paresthesia of the small finger, ulnar half of the ring finger, and ulnar dorsal of the hand. it is worse with full elbow flexion and at night while sleeping. Dx?

A

cubital tunnel syndrome

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24
Q

what will be seen in physical exam of a patient with cubital tunnel syndrome? (2)

A

loss of adductor pollicis (pinky)
positive tinel’s test

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25
Q

what is the non-op treatment for cubital tunnel syndrome? (2)

A

NSAIDs
nighttime extension splinting in 45 degrees

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26
Q

what is the op treatment for cubital tunnel syndrome when conservative tx fails and when patient is having weakness?

A

ulnar nerve decompression

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27
Q

peripheral compression neuropathy of the median nerve at the level of the wrist

A

carpal tunnel syndrome

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28
Q

what is the most common compression neuropathy of the upper extremity?

A

carpal tunnel syndrome

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29
Q

a patient presents with pain and numbness in thumb, index, middle finger, and radial side of ring finger; they have weakness with grip and pain is worse at night while sleeping. Dx?

A

carpal tunnel syndrome

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30
Q

what will be seen in physical exam of a patient with carpal tunnel syndrome? (3)

A

thenar atrophy
positive phalen test (wrist flexion)
positive tinel’s test

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31
Q

what is the non-op treatment for carpal tunnel syndrome? (3)

A

NSAIDs
nighttime splinting
+/- steroid injections

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32
Q

what is the op treatment for carpal tunnel syndrome when non-op fails or when patient has weakness?

A

carpal tunnel release

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33
Q

mucin-filled synovial cyst; most commonly on the hand/wrist

A

ganglion cyst

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34
Q

where is a ganglion cyst most common?

A

dorsal carpal of wrist

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35
Q

how do ganglion cysts usually present?

A

asymptomatic

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36
Q

what is the non-op treatment for a ganglion cyst?

A

bracing

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37
Q

what is the 2nd line treatment for a ganglion cyst?

A

aspiration

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38
Q

why is aspiration of a ganglion cyst on the volar aspect avoided?

A

radial artery

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39
Q

what is the op treatment for a ganglion cyst if severe symptoms or neurovascular manifestations?

A

surgical resection

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40
Q

mechanical impingement of a flexor tendon on the hand; thickens and forms a nodule that catches on the flexor tendon sheath

A

trigger finger

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41
Q

trigger finger is most common in which 2 fingers?

A

ring finger
long finger

42
Q

a patient presents with finger pain at the A1 pulley, has clicking, and the finger is locked in flexed position at the PIP joint. Dx?

A

trigger finger

43
Q

where does a patient have tenderness if they have trigger finger?

A

MCP joint

44
Q

what is the non-op treatment for trigger finger? (3)

A

NSAIDs
splinting
steroid injections

45
Q

what is the operative treatment for a trigger finger?

A

surgical release of A1 pulley

46
Q

thickening and contraction of the palmer fascia that leads to flexion of the fingers making it difficult to extend

A

dupuytren’s contracture

47
Q

which fingers are most commonly affected by dupuytren’s contracture?

A

ring finger
small finger

48
Q

a patient presents with their finger held in flexion, is unable to extend it, has decreased ROM, and painful fascia; a nodular band of thick tissue is seen along the palm of the hand which is TTP. Dx?

A

dupuytren’s contracture

49
Q

which joint is most affected by dupuytren’s contracture?

A

MCP joint

50
Q

what is the non-op treatment for dupuytren’s contracture?

A

hand therapy
steroid injections + clostridial injections by hand surgeon

51
Q

what is the op treatment for dupuytren’s contracture?

A

palmar fasciectomy

52
Q

a thumb collateral ligament injury caused by radially-directed force, causing hyper-abduction of the thumb’s MCP joint

A

gamekeeper’s thumb (Ulnar Collateral Ligament Injury)

53
Q

a patient presents with pain at the ulnar side of the thumb’s MCP joint, increased pain with pinch/grasp. Dx?

A

gamekeepers thumb (Ulnar Collateral Ligament Injury)

54
Q

what imaging diagnoses a gamekeeper’s thumb?

A

thumb xrays +/- stress views

54
Q

what exam showing radial instability in 20 degrees indicates an injury to the ulnar collateral ligament of the thumb?

A

radial-ulnar stress exam

55
Q

what is the non-op treatment for a grade 1-2 partial gamekeeper’s thumb?

A

thumb spica splint

56
Q

what is the treatment for a grade 3 gamekeeper’s thumb?

A

UCL repair

57
Q

what is the treatment for a chronic gamekeeper’s thumb?

A

UCL reconstruction with tendon graft

58
Q

inflammation of the 1st dorsal compartment, involving the extensor pollicis brevis and abductor pollicis longus at the base of the thumb

A

De Quervain’s tenosynovitis

59
Q

a patient presents with pain on the radial side of the wrist that is worse with gripping, they have tenderness over the 1st dorsal compartment at the radial styloid, and has resisted radial deviation. Dx?

A

De Quervain’s tenosynovitis

60
Q

what test causes pain when grasping the thumb in closed fingers with ulnar deviation?

A

finkelstein test

61
Q

what is the non-op treatment for De Quervain’s tenosynovitis (3)

A

thumb spica splint
NSAIDs
steroid injections

62
Q

what is the op treatment for De Quervain’s tenosynovitis?

A

surgical release of 1st dorsal compartment

63
Q

common cause of hip pain in which impingement occurs in the bursa, causing it to become irritated or inflamed

A

trochanteric hip bursitis

64
Q

where does trochanteric hip bursitis occur?

A

deep to IT band and superficial to abductor muscles

65
Q

a patient presents with pain to lateral side of their hip, has point tenderness, but has normal ROM. Dx?

A

trochanteric hip bursitis

66
Q

what is the treatment for trochanteric hip bursitis? (3)

A

RICE / heat
anti-inflammatories
physical therapy

67
Q

what can be used to treat trochanteric hip bursitis if the patient cannot do physical therapy?

A

steroid injections

68
Q

swelling and inflammation of the anterior knee bursa associated with pain during kneeling

A

prepatellar bursitis

69
Q

a patient presents with pain and swelling over their anterior knee, is warm to touch, decreased ROM, and tender to touch. Dx?

A

prepatellar bursitis

70
Q

what should be done during diagnosis of prepatellar bursitis? (2)

A

aspiration w/ gram stain + culture
xray to r/o foreign body

71
Q

what is the most common organism in prepatellar bursitis?

A

staph aureus

72
Q

what is the non-op treatment for prepatellar bursitis? (3)

A

RICE
NSAIDs
aspiration

73
Q

what is the op treatment for prepatellar bursitis if it is septic?

A

I&D

74
Q

a patient presents with pain/lump in the back of the knee with swelling in the knee or lower leg. they have a normal knee exam but have decreased ROM with flexion. Dx?

A

popliteal (baker’s) cyst

75
Q

what 3 imaging can be used to diagnose popliteal (baker’s) cyst?

A

knee xray
ultrasound (determines size)
MRI (shows inflammation)

76
Q

what is the non-op treatment for a popliteal (baker’s) cyst? (4)

A

RICE
NSAIDs
steroid injections
aspiration

77
Q

what is the op treatment for popliteal (baker’s) cyst?

A

surgery with arthroscopy

78
Q

a patient presents with sharp pain and redness in the leg/calf, has bruising along their ankle. Dx?

A

baker’s cyst rupture

79
Q

what is the treatment for a baker’s cyst rupture?

A

self-limiting

80
Q

what is a complication of baker’s cyst rupture?

A

compartment syndrome

81
Q

which ligament is most commonly involved in an ankle sprain?

A

anterior talofibular ligament

82
Q

what 2 tests can be used to assess a possible ankle sprain?

A

squeeze test
external rotation stress test

83
Q

what imaging should be done for an ankle sprain?

A

3 view xray

84
Q

what is the treatment for an ankle sprain? (4)

A

RICE
anti-inflammatories
ankle brace or walking boot
physical therapy

85
Q

caused d/t limited blood supply, prone to injury within the hypo vascular zone and occurs 4-6 cm above the calcaneal insertion

A

Achilles tendon rupture

86
Q

a patient has a loss of resting foot tone, weakness to plantarflexion, and has a positive thompson test. Dx?

A

achilles tendon rupture

87
Q

what should always be done for a patient with an achilles tendon rupture?

A

refer to ortho

88
Q

which patients should have non-op treatment of an achilles tendon rupture? (3)

A

sedentary patient
elderly
co-morbidities

89
Q

what type of achilles tendon rupture can receive op treatment?

A

acute rupture < 6 weeks

90
Q

compressive neuropathy of the foot causing pain d/t compression of the interdigital nerve

A

interdigital neuroma (morton’s neuroma)

91
Q

what ligament is responsible for interdigital neuroma?

A

transverse intermetatarsal ligament

92
Q

which webspaces are most commonly affected by interdigital neuroma?

A

3rd and 4th webspace

93
Q

a patient presents with pain to forefoot that is worse with tight shoes, has TTP between metatarsal heads, and a mulder’s click when compressing the metatarsal heads. Dx?

A

interdigital neuroma (morton’s neuroma)

94
Q

what imaging is most helpful when diagnosing interdigital neuroma? what will it show?

A

ultrasound
oval hypoechoic mass

95
Q

what is the non-op treatment for an interdigital neuroma?

A

change in shoe wear
steroid injections

96
Q

what is the op treatment for interdigital neuroma?

A

neurectomy

97
Q

inflammation of the aponeurosis of the calcaneus origin with pain along the plantarmedial heel

A

plantar fasciitis

98
Q

a patient reports pain with 1st step out of bed that is relieved with walking, and is worse at the end of the day. they are tender over the medial side of the plantar heel and dorsiflexion of the great toe increases pain. Dx?

A

plantar fasciitis

99
Q

what may present in an xray of plantar fasciits?

A

plantar heel spur

100
Q

what is the treatment for plantar fasciits? (4)

A

stretching
heel cushion inserts
night splints
walking boot

101
Q

what is the last treatment option for plantar fasciitis since it can cause fat pad atrophy?

A

steroid injections

Ortho-Rheum (27 decks)

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