AP Ankle And Foot Flashcards
Pott’s fracture
Fracture of distal fibula with ligamentous disruption
Distal fibula and tibia fx
Bimalleolar fracture
Fx of distal fibula, distal tibia, and posterior aspect of tibia
Need to see AP and Lat
Trimalleolar fx
Fractured talar dome (half moon shape)
Osteochondritis of the talus
Fx of calcaneus
Calcaneal fx
Fracture of the 2nd/3rd/4th metatarsal
Stress/march fx
Fracture at the base of the 5th metatarsal
Jones/dancer’s
Attachment of peroneus brevis
Fracture of distal 5th phalanx
Bedroom fx
Avulsion of the calcaneus
Heel spur
Heel spur caused by
Reiter’s disease
Plantar fascitis
Conditions affecting joints in the foot and hand
RA OA PA Gout Scleroderma SLE
RA name in children
Still’s disease
Autoimmune caused inflammatory arthritis
RA
MCPs always involved DIPS NOT INVOLVED Symmetrical distribution BILATERAL uniform loss of joint space Localized periarticular osteoporosis Rat bite erosions
RA
Haygarth’s nodes
MCP
Haygarth’s nodes, swan neck and boutinneire deformity, ulnar and deviation (lanois deformity)
RA
Labs RA
\+RA latex \+FANA \+ESR \+CRP Normocytic normochromic anemia
M/c RA
Women >50
MTP/MCP is most common joint
Never hits the DIP
RA case management
Refer to rheumatologist
Decreased joint space with sclerosis
OA
Gull wing appearance
EOA
Inflammatory arthritis
Males 20-50
PA
Silver scaly lesions on extensors
Pitted nails
Cocktail sausage digits
PA
Increase in joint space
Joint space bigger and darker
Distribution pattern
PA
Periarticular erosions Mouse ear deformity Pencil in cup deformity Ray sign Auspitz sign Balancing pagota sign
PA
Labs PA
-Rheumatoid
+HLA B27
Looks like RA but affects DIP
PA
Inborn inability to metabolize proteins
Males >40
Due to overproduction of uric acid
Deposition uric acid crystals
Gout
Gout
Metabolic arthritide
Foods high in purines Red meats Red wines Aged cheeses Beer Pork
Gout
Usually mono-articular with the m/c site at the MTP of the big toe (podagra)
Gout
Extremely painful, red, hot, and swollen joint
Gout
Overhanging margin
Juxta-articular erosions
Gout
Labs gout
Increased uric acid
+ESR
Gout
Special tests gout
Joint aspiration
Pharmacology gout
Acute-colchicine
Chronic allopurinol
Gout
Only arthritide that destroys from outside-in
Gout
Scleroderma aka
Progressive systemic sclerosis
Inflammatory arthritis
Females 30-50
Associated with erosions of the distal tufts of the phalanges called auto amputation/osteo-acrolysis
Scleroderma
CREST syndrome
Calcinosis Raynaud’s Esophageal dysfunction Sclerodactyly Teleganctasia
CREST syndrome found in
Scleroderma
Labs scleroderma
+(F)ANA
+RA latex (30%)
Females
Sunlight precipitates a skin rash (malar/butterfly rash)
SLE
Oral ulcers
Discoid lesions
Alopecia
Raynaud’s phenomenon
SLE
Can cause ulnar deviation of the phalanges with no joint destruction (Lanois deformity)
SLE
Look exactly like RA deformity but no joint destruction
Lanois deformity
Place hands on table can stretch them out to normal
SLE
Labs SLE
\+ANA \+LE prep \+FANA \+RA latex \+ESR Leukopenia Thrombocytopenia
Case management SLE
Co-manage with rheumatologist
M/c condition affecting MTPs is
RA
PA does not cause
Lanois deformity
Swelling/nodes of MCP/MTP
Haygarth’s nodes
Swelling/nodes of PIPs
Bouchards nodes
Swelling/nodes of DIPS
Heberdens nodes
Either OA, PA, or Gout
DIPS
OA whiter
PA darker loss of joint space
Gout monoarticulation overhang
Lateral ankle/foot film
Check each bone for fx
Check for calcneal spur
Check for AVN’s