Buzzwords Flashcards
narrowing of spinal canal
spinal stenosis
numbness/paresthesias radiating to bilateral buttocks and thighs
spinal stenosis
pain worse with extension
spinal stenosis
pain better with flexion
spinal stenosis
HLA-B27 positive
Akylosing Spondylitis
Reactive Arthritis aka Reiters syndrome
Psoriatic arthritis
IBD assoc arthritis
back pain/stiffness worse in AM
ankylosing spondylitis
polymyalgia rheumatica
back pain worse with rest
ankylosing spondylitis
uveitis
ankylosing spondylitis
increased ESR
ankylosing spondylitis
Xray shows sacroiliitis
ankylosing spondylitis
bamboo spine
ankylosing spondylitis
xray shows loss of normal lumbar curvature + squaring and fusion of the vertebrae
ankylosing spondylitis
unilateral radicular back pain radiating down leg in dermatomal pattern
Herniated disc
back pain increasing with coughing
herniated disc
back pain increasing with straining
herniated disc
back pain increasing with bending
herniated disc
back pain increasing with sitting
herniated disc
back pain increasing with valsalva
herniated disc
+ straight leg raise
herniated disc
xray of spine shows loss of disc height
herniated disc
anterior thigh pain
L4 herniated disc
weak ankle dorsiflexion
L4 herniated disc
loss of knee jerk + weak knee extension
L4 herniated disc
Lateral thigh/leg hip groin paresthesias + pain
L5 herniated disc
weakness in big toe extension aka big toe dorsiflexion
L5 hern disc
walking on heels more diff than walking on toes
L5 hern disc
posterior leg/calf and gluteus pain + Plantar surfaces of foot
S1 disc hern
weakness in plantar flexion
S1 disc herniation
walking on the toes is more difficult than walking on heels
S1 disc hern
Loss of ankle jerk
S1 disc hern
pain + numbness + weakness + swelling of arm/shoulder
thoracic outlet syndrome
(+) adson sign
thoracic outlet syndrome
goose egg
olecranon bursitis
snuffbox tenderness
scaphoid or navicular fx
DIP in flexion
mallet finger
PIP in flexion and DIP in hyperextension
Boutonniere deformity
PIP in hyperextension and DIP in flexion
swan neck deformity
inability to fully extend elbow
olecranon fx or elbow dislocation or radial head fx
MC sequelae of elbow dislocation
lost of terminal extension
neuro testing maneuvers
*peace sign against resistance
ulnar nerve
**elbow dislocation to check ulnar nerve
neuro testing maneuvers
*hitchhiker/thumbs up
radial nerve
**elbow dislocation to check radial nerve
neuro testing maneuvers
*power to the people aka closed fist
median nerve
**elbow dislocation to check median nerve
neuro testing maneuvers
*OK sign
Median nerve—anterior interosseous
**elbow dislocation to check median nerve
+ posterior fat pad sign
radial head fx
+ displaced anterior fat pad sign
radial head fx
mid-distal radial shaft fx with dislocation of the distal radioulnar joint
Galeazzi fx
Fx to proximal 1/3 of ulnar shaft + dislocation of radial head
Monteggia fx
MUGR
MU= monteggia fx is ULNA fx
GR=galeazzi RADIUS fx
MonteggiA (ENDS IN A)… A is proximal: bones affected proximally
GaleaZZi=Z is distal–bones affected distally
extensor carpi radialis brevis muscle inflammation
tennis elbow aka lateral epicondylitis
pain with wrist extension against resistance
tennis elbow aka lateral epicondylitis
pain with wrist flexion against resistance with elbow flexion
medial epicondylitis aka golfers elbow
pronator teres-flexor carpi radialis muscle inflamm
medial epicondylitis aka golfers elbow
+ tinel sign
- cubital tunnel syndrome
2. Tarsal tunnel syndrome
Paresthesia and pain along the ulnar nerve distribution
-worse with elbow flexion
cubital tunnel syndrome
+) Froment sign
cubital tunnel syndrome
FOOSH with extended wrist
scaphoid (navicular) fx
MC fx carpal bone
scaphoid/navicular
anatomical snuffbox tenderness
scaphoid/navicular fx
distal radius fx with dorsal angulation
colles fx
dinner fork deformity
colles fx
XR shows dorsally displaced or angulated fx on distal radius
colles fx
MC complication from colles fx
extensor pollicis longus tendon rupture
distal radius fx with ventral angulation of distal fragment
smith’s fx
FOOSH with wrist flexed
smith’s fx
garden spade deformity
smith’s fx
wrist pain worse with passive motion
smith’s fx
and
colles fx
“piece of pie” sign
lunate dislocation
“spilled teacup” sign
lunate dislocation
whats the most serious carpal fx and why
lunate fx
-occupies 2/3 of radial articular surface
lateral angle
scoliosis
posterior and anterior angles
kyphosis and lordosis
hump back
kyphosis
indentation on lower back
lordosis
back pain not assoc with radiation to leg or neuro symps
lumbosacral sprain or strain
when you see a compression fx– what must you r/o
CA *!! esp if pt is elderly
localized back pain
compression fx
xray shows loss of vertebral height
compression fx
pars interarticular defect
spondylolysis
MC at L5-S1
spondylolysis
scotty dog
spondylolysis
lateral radiolucent defect in pars
spondylolysis
scotty dog
MC at L4-L5
Spondylolisthesis
forward slipping of a vertebra on xray
spondylothisthesis
anterolisthesis of L5 over S1 with associated spondylolysis at that level
spondylolisthesis
bad thing we must always r/o with back pain
cauda equina
back pain + decr sensation to buttocks, perineum and inner surfaces of thigh
cauda equina syndrome
back pain + new onset urinary bowel retention or incontinence
cauda equina syndrome
back pain + bilat leg radiation of pain
cauda equina syndrome
fever + spinal pain + neuro deficits
spinal infection
RF for spinal infection
> 50 YO
IVDU
immunodef
recent instrument/procedure—EX: LP
what lab test determines early diagnosis of RA
Anti-citrullinated protein antibody (ACPA)
what lab test diagnoses RA
Rheumatoid factor
aggravation of pain with prolonged rest— morning stiffness and improves with use
- inflammatory arthritis—–RA, polyarthritis
- polymyalgia rheumatica
- ankylosing spondylitis
aggrivated by motion and relieved with rest
non-inflammatory arthritis
pain, limitation of motion, swelling and/or tenderness at a joint
arthritis in general
arthritis affecting single joint
monoarticular
arthritis affected several joints
oligoarticular
arthritis affecting many joints
polyarticular
rheum dz with age of onset 20-40 YO and is MC in W>M
RA
subcutaneous rheumatoid nodule over extensor surfaces
RA
extensor surfaces—lungs, pleura, pericardum**
symmetrical involvement of the joints of hands/feet
RA–typical presentation
HLA-DRA 1 & 4
RF for RA
Boutonniere deformities of PIP
RA
Swan-neck contractures of fingers
RA
ulnar deviation of metacarpophalangeal joints
RA
- elevated RF
- (+) Anticitrullinated peptide/protein antibodies
- elevated ESR
- elevated CRP
RA
which DMARD requires eye exam every 6 MO and why
hydroxychloroquine
*risk of visual loss due to retinopahty
what must you give with methotrexate
folic acid
DIP joint affected
osteoarthritis
MCP and PIP joints affected
RA (spares DIP)
conjunctivitis + urethritis + arthritis
reactive arthritis
cant see cant pee cant climb a tree
Reactive arthritis
arthritis + conjunctivitis + urethritis after an infection
reactive arthritis