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Injuries and medical problems in sport > EILP > Flashcards

EILP Flashcards

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Sports Trivia flashcards USMLE® Step 1 flashcards
1
Q

aetiology CECS

A

unknown

vascular and neurogenic theories

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2
Q

vascular theory CECS

A
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3
Q

Neurogenic theory CECS

A
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4
Q

Ix for CECS

A
  • dynamic intra-compartmental study = ONLY RELIABLE ONE
  • pre/post-exercise MRI
  • NIRS
  • microdialysis

Pressure related condition- the other Ix don’t work well

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5
Q

Types of intra-compartment pressure studies

A
  • Injection- A+E- good for acute but not chronic
  • infusion technique- barely used
  • non-infusion technique
  • Micro-tip- doesn’t use catheter so doesn’t get blocked by fluid. Can only measure anterior compartment
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6
Q

Which tracing shows CECS?

A

2nd line- baseline pressure is never that low.

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7
Q

Pedowitz diagnostic criteria for CECS

A

Baseline resting pressure >15mmhg
1 min after stopping exercise ?30mmhg
at 5 minute >20 mmhg

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8
Q

CECS conservative Tx

A

Limited efficacy

  • physio- acupuncture, trigger point release, deep massage
  • orthoses
  • botox- muscle perfuses during relaxation. By releasing muscle contraction can reverse cycle
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9
Q

Surgical Mx for CECS

A
  • superficial fasciotomy
  • fasciectomy

this is the only definitive treatment
Keep patient ACTIVE as soon as possible (if no drains)
6 weeks RTP if this is done correctly
endoscopic is the best- don’t need to cut entire leg

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10
Q

Post-op rehab for CECS by week

A
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11
Q

Sx superficial peroneal entrapment syndrome

A
  • leg pain, relieved by rest within minutes
  • non-specific anterior compartment
  • UNILATERAL (unlike CECS)
  • tightness, tenderness, ache and parasthesia near sock line
  • young, active individuals
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12
Q

Ix for Superifical peroneal nerve entrapment syndrome (aka fibular nerve)

A
  • diagnostic local anaesthetic- 0.5 chirocaine/marcaine (ask to run, when feel pain inject, then ask to run again and they feel no pain)
  • nerve conduction studies
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13
Q

Mx SPNES

A

inject ? to atrophy fascia which is trapping peroneal nerve

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14
Q

Functional popliteal artery entrapment syndrome

A
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15
Q

Functional popliteal artery entrapment syndrome- common types

A

6 types, common are type 1+2

1: medial head of gastroc is normal but popliteal artery deviates more medially
2: medial head of gastroc is located laterally but popliteal artery is normal

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16
Q

Functional popliteal artery entrapment syndrome Ix

A
  • duplex doppler USS- first line
  • funcitonal ABPI- first line
  • arteriography
  • MRI/MRA- diagnostic
  • CTA- useful to see arterial calcification
17
Q

Functional popliteal artery entrapment syndrome Mx

A

Surgery to reconstruct popliteal artery

18
Q

MTSS Hx

A
  • pain in legs some during and mostly after exercise
  • pain lasts hours-weeks after stopping
  • site of pain lower 1/3rd of medial tibia (can be ant tibia)
  • often change in intensity/duration/surface/shows etc
  • can be bilateral or unilateral
19
Q

Ix MTSS

A
  • Plain radiograph rule out sarcoma etc
  • isotope bone scan
  • PET CT
  • MRI = GOLD STANDARD
  • bloods - female triad
20
Q

MRI classification of MTSS

A

Fredericson classification system

  • grade 1 = periosteal oedema
  • grade 4 = fracture (rarely progresses to this)
21
Q

Ddx for pain in anterior compartment LL

A
  • CECS of AC

- Tibialis anterior muscle syndrome

22
Q

Ddx for pain in posterior compartment LL

A

1) Popliteal artery entrapment syndrome

  • radiculopathy
  • low lying soleus / accessory soleus
  • CECS of superificial posterior compartment
  • myofascial tears
  • myopathy
23
Q

Ddx for pain in lower 1/3rd medial tibia

A

1) MTSS

  • stress fracture
  • CECS deep posterior compartment
24
Q

Blood tests for LL pain

A
  • vit B12
  • Vit D
  • CK
25
Q

pathognomic sign for popliteal artery entrapment

A

Palpation of the popliteal and pedal pulses.

Pulse loss during both passive dorsiflexion and forced plantar flexion.

Pulse reduction can occur in individuals without abnormalities.

Injuries and medical problems in sport (17 decks)

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