Common Elbow & Wrist Problems

Question 1

What does FOOSH stand for?

Answer 1

Fall onto out-stretched hand

Question 2

Describe an elbow dislocation

Answer 2

Children, young adults, pain/deformity/loss of function, usually posterior, can have fractures

Question 3

Outline a supracondylar fracture distal humerus

Answer 3

fracture of the distal humerus just above the epicondyles, young children, pain, swelling, bruising, no function, neurovascular compromise, un/displaced

Question 4

Describe a radial head/neck fracture

Answer 4

FOOSH, Commonest elbow fracture, Lateral pain/modest swelling/loss of range, Fat pad’ sign,

Question 5

Outline subluxation of the radial head (pulled elbow)

Answer 5

Subluxation from annular ligament, Longitudinal traction along extended arm, 2-5 yrs, Reduced move/lateral pain/‘not using it’

Question 6

What is closed reduction?

Answer 6

procedure for putting the pieces of a broken bone back into the right position without surgery

Question 7

Outline elbow osteoarthritis

Answer 7

Degenerative disease of articular cartilage, M>F 4:1 Manual workers, Symptoms relatively rare, Stiffness, loss of extension, Surgical Debridement

Question 8

What is elbow rheumatoid arthritis?

Answer 8

Systemic Autoimmune disease, Commonest inflam arthropathy, Synovial pannus -> joint destruction, Symmetric Polyarthropathy with morning stiffness

Question 9

Outline lateral elbow tendinopathy

Answer 9

Tennis elbow: Degenerative tendinopathy - Common Extensor Origin, Commonest cause of elbow pain, Beware - Radiating pain from neck or shoulder

Question 10

Describe medial elbow tendinopathy

Answer 10

Golfer’s Elbow’, degenerative tendinopathy - Common Flexor Origin, 10x less common than LET,

Question 11

What are rheumatoid nodules?

Answer 11

Extra-articular manifestation of arthritis, treatment: disease-modifying antirheumatic drugs (DMARDs)

Question 12

Describe olecranon bursitis

Answer 12

Inflam of bursa due to trauma/friction

Question 13

Outline gouty tophi

Answer 13

Disorder of nucleic acid metabolism = urate crystal deposition, treated with meds

Question 14

What is a colles fracture?

Answer 14

FOOSH, dinner fork, Dorsal displacement and angulation, shortening

Question 15

What is a smiths fracture?

Answer 15

Palmar displacement and angulation, shortening

Question 16

Describe a scaphoid fracture

Answer 16

FOOSH, Fracture in carpal bone in hand, Can be missed on x-ray, re x-ray later

Question 17

What is ulnar nerve neuropathy?

Answer 17

Cubital tunnel syndrome: compressive neuropathy of ulnar nerve at elbow, paraesthesia/numbness/weakness, hypersensitive ‘funny bone’