DUMS ortho Flashcards
<p>What type of tumour has causes a bony outgrowth with a cartilaginous cap and what symptoms does it have?</p>
<p>Osteochrondroma
Local pain</p>
<p>What is the chance of malignancy in an osteochrondroma?</p>
<p>1%</p>
<p>Where is an enchondroma found?</p>
<p>Intramedullary (usually metaphyseal) </p>
<p>How does an enchondroma present?</p>
<p>Usually asymptomatic (may cause pathological fracture),
| Incidental finding on X-ray (lucent lesion) </p>
<p>How is an enchondroma treated?</p>
<p>Curettage and bone graft</p>
<p>What are the 2 types of bone cyst and how do they present?</p>
<p>Simple: fluid filled (asymptomatic)
| Aneurysmal: blood filled (pain and weakness)</p>
<p>How is a bone cyst managed?</p>
<p>Curettage and bone graft</p>
<p>How does an osteoid osteoma appear?</p>
<p>Small nub of bone surround by intense sclerotic halo </p>
<p>How does an osteoid osetoma present?</p>
<p>Intense constant pain, worse at night (due to inflammatory response) </p>
<p>How is an osteoid osteoma diagnosed and managed?</p>
<p>X-ray
NSAIDs to relieve pain
CT guided radiofrequency ablation </p>
<p>What is the most common malignant bone tumour and who does it present in?</p>
<p>Osteosarcoma Young patients (usually around knee)</p>
<p>What tumour presents with fever and inflammatory makers (similar to osteomyelitis) in young patients </p>
<p>Ewings sarcoma </p>
<p>What disease presents with multiple fragility fractures in childhood, loss of hearing and blue sclera?</p>
<p>Osteogenesis imperfecta (brittle bone)</p>
<p>What is dwarfism referred to as and what facial features are seen?</p>
<p>Skeletal dysplasia
| Prominent forehead and wide nose </p>
<p>What gene is mutated in marfans syndrome?</p>
<p>Fibrillin gene </p>
<p>What is Gowers sign associated with?</p>
<p>Duchenne muscular dystrophy (due to proximal leg weakness)</p>
<p>What is the genetic defect in Muscular dystrophy and how is it diagnosed?</p>
<p>Dystrophin gene (assoc with ca)
| Raised serum creatinine phosphokinase + abnormal muscle biopsy </p>
<p>What is DDH and how is it investigated?</p>
<p>Developmental dysplasia of the hip
USS
Present with shortened limb</p>
<p>What group does transient synovitis commonly present in and how is it managed?</p>
<p>Young boys after viral infection
| Rest and NSAIDs</p>
<p>What is Perthes disease?</p>
<p>Idiopathic inflammation of femoral head, loss of blood supply, necrosis and abnormal growth</p>
<p>How does Perthes disease present?</p>
<p>Pain and limp in active boys </p>
<p>What is SUFE and who does it present in?</p>
<p>Slipped upper femoral epiphysis (growth plate can't cope with weight)
Overweight children</p>
<p>What is club foot and how is it managed?</p>
<p>Congenital deformity of talus, calcaneus and navicular joint
Splintage + gradual correction in 4-6 week blocks</p>
<p>Where are rotator cuff tendons impinged during a painful arc?</p>
<p>Subacromial space </p>
<p>What muscle is most commonly injured in a rotator cuff tear and how is it managed?</p>
<p>Supraspinatous
| Surgery or physio</p>
<p>What is adhesive capsulitis and how is it managed?</p>
<p>Frozen shoulder
| Self-resolving over 18-24 months (+steroids)</p>
<p>What is a Bankart repair used for?</p>
<p>Recurrent shoulder dislocations</p>
<p>What nerve is affected in carpal tunnel and cubital tunnel syndrome?</p>
<p>Carpal tunnel: median
| Cubital tunnel: ulnar</p>
<p>What causes the pain in tennis and golfers elbow and how is it managed?</p>
<p>Micro-tears in the tendons
| Rest, NSAIDs and steroids </p>
<p>What causes Dupuytren's contracture? What groups of people is it more common in?</p>
<p>Proliferation of type 3 collagen fibres (proliferative connective tissue disorder)
Alcoholics, diabetics</p>
<p>How is Dupuytren's managed?</p>
<p>Fasciectomy (surgical release of collagen fibres) if greater than 30 degrees </p>
<p>What causes trigger finger?</p>
<p>Tendonitis of a flexor tendon to a finger (enlarges and catches on the fascia - causes a clicking sensation)</p>
<p>How is trigger finger managed?</p>
<p>Injection of steroid around the tendon to relieve symptoms
Surgery</p>
<p>What is a ganglion cyst?</p>
<p>Mucinous filled cyst by a tendon or synovial joint (mostly cosmetic issues)</p>
<p>How is a ganglion cyst investigated and managed?</p>
<p>Transillumiation to ensure not pathological Needle aspiration (temporary relief, common reoccurrence) Surgical excision (only if causing severe discomfort)</p>
<p>What is trochanteric bursitis and what causes it?</p>
<p>Inflammation of the bursa over the greater trochanter (hip) -> self-limiting
Caused by overuse (athletes)</p>
<p>What direction does the shoulder most commonly dislocate?</p>
<p>Anterior (95%)</p>
<p>In a shoulder dislocation which nerve and artery are at most risk of compression?</p>
<p>Axillary nerve (numbness of lateral aspect)
| Axillary artery</p>
<p>What nerves and arteries are at risk in a humeral shaft fracture?</p>
<p>Radial nerve
| Brachial artery</p>
<p>What is a nightstick fracture?</p>
<p>Isolated fracture of the ulna (usually defensive injury)</p>
<p>What is a Monteggia and a Galeazzi fracture dislocation?</p>
<p>Monteggia: ulnar fracture, dislocation of radial head at elbow
Galeazzi: radial fracture, dislocation of the ulna at the wrist</p>
<p>What is a FOOSH?</p>
<p>Fall onto outstretched hand</p>
<p>What is a Colles' fracture?</p>
<p>Distal radial fracture
FOOSH
Causes dorsal displacement of hand (dinner fork)</p>
<p>What is the opposite of a Colles' fracture?</p>
<p>Smiths fracture
Distal radial fracture,
Causes volar displacement (requires ORIF, highly unstable)</p>
<p>What X-rays must be taken for a scaphoid fracture? How long until repeat scan if unclear?</p>
<p>AP, Lateral, 2 x oblique
| 6 weeks </p>
<p>What is the risk with a scaphoid fracture?</p>
<p>Avascular necrosis (due to retrograde blood supply)</p>
<p>How does a hip fracture appear and where should this be managed?</p>
<p>Shortened + externally rotated
| A&amp;E (medial emergency)</p>
<p>What type of hip fracture is higher risk and why is this?</p>
<p>Intracapsular, retrograde blood supply so risk of avascular necrosis to femoral head </p>
<p>How should an intracapsular vs extra capsular hip fracture be managed?</p>
<p>Intra; hemi-arthroplasty (longer lasting, lesser mobility) or total hip replacement
Extra; dynamic hip screw (internal fixation)</p>
<p>What bone in the body takes the longest to heal if fractured and what is its definitive management?</p>
<p>Tibia Internal fixation (intermedullary nail)</p>
<p>What is the salter-harris classification of fractures used for?</p>
<p>Paediatric physeal fractures</p>
<p>What Salter-Harris fractures require intervention and why is this?</p>
<p>Salter-Harris III + IV
| High risk of growth arrest as splits the physis</p>
<p>What occurs during a Salter-Harris V injury?</p>
<p>Compression injury to physis causing growth arrest (cannot be diagnosed on initial X-ray)</p>
