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MSK Disorders > Elbow > Flashcards

Elbow Flashcards

1
Q

What is the common mechanism for supracondular fractures of distal humerus?

A

Falling on outstretched hand with elbow hyperextended

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2
Q

How does a supracondular fracture of the distal elbow appear?

A

Extra-articular

Distal fragment displaced posteriorly

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3
Q

What are complications of supracondular distal humerus fractures?

A

Malunion
Damage to median nerve
Ischeamic contracture

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4
Q

How does ischeamic contracture occur?

A

Brachial artery damaged
Ischemia of muscles in anterior forearm
Oedema and compartment syndrome
In repair phase dead muscle replaced by fibrosis
Fibrotic tissue contracts resulting in flexion contracture

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5
Q

How does Volkmans ischeamic contracture appear?

A

Wrist flexed
Fingers extended at MCPJ and flexed at IPJ
Forearm pronated
Elbow flexed

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6
Q

How do elbow dislocations occur?

A

Fall onto outstretched hand with elbow partially flexed

Partially flexed as stability of joint here from ligaments instead of muscles

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7
Q

What is the most common type of elbow dislocation?

A

Posterior
Distal end of humerus driven though joint capsule anteriorly
Ulnar collateral ligament torn

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8
Q

What is pulled elbow?

A

Subluxation of the radial head

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9
Q

What is subluxation?

A

Partial disruption of a joint with some remaining but abnormal apposition of the articular surfaces

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10
Q

How is a pulled elbow caused?

A

Longitudinal traction with forearm pronated

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11
Q

How does pulled elbow present?

A

Reduced movement of elbow

Pain in lateral aspect of proximal forearm

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12
Q

How does pulled elbow occur?

A

In pronation as annular ligament more relaxed
Traction tears annular ligament from attachment of neck of radius
Radial head dismally though annular ligament

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13
Q

Why is pulled elbow more common in children?

A

Their annular ligament is still strengthening

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14
Q

How do radial head and neck fractures occur?

A

Fall on outstretched hand when radial head impacts on capitellum of humerus

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15
Q

How do radial head and neck fractures present?

A

Pain and loss of movement in lateral proximal part of forearm
Modest swelling
Fat pad on x-ray (effusion)

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16
Q

Why is OA of the elbow uncommon?

A

Due to well matched joint surfaces

Strong ligaments

17
Q

How does OA of the elbow present?

A

Crepitus
Locking (loose cartilage fragments)
Swelling (effusion)
Osteophytes impinging on ulnar nerve

18
Q

What is rheumatoid arthritis?

A

Autoantibodies attack synovial membranes
Inflamed synovial cells proliferate into pannus
Pannus penetrates though cartilage and bones leading to erosion and deformity

Can damge organs

19
Q

How does rheumatoid arthritis appear on x-rays?

A

Joint space narrowing
Periarticular osteopenia
Juxta-articulation bony erosions
Subluxation

20
Q

What is another name for lateral elbow tendinopathy and what is it?

A

Tennis elbow

Chronic overuse of these extensor tendons

Extensor carpi radialis brevis helps stabilise wrist but when overused is weakened and micro tears appear in tendon leading to inflammation

21
Q

How does LET present?

A

Pain at common extensor origin

Lateral epicondyle pain when extending wrist

22
Q

What is another name for medial elbow tendinopathy and what is it?

A

Golfer’s elbow

Pain at interface between pronator teres and flexor carpi radialis origins
At common flexor origin

23
Q

When is pain present in MET?

A

With resisted flexion and pronation of wrist

24
Q

What causes olecranon bursitis?

A

Repeated micro trauma (eg, leaning elbows on desk

Serous fluid accumulates and causes soft cyst

25
Q

What causes rheumatoid nodules?

A

Extra-articular manifestation of RhA

More common in smokers
Over areas that have repeated micro trauma

26
Q

What are gouty tophi?

A

Modular masses of mono sodium urate crystals deposited in soft tissues

Due to untreated gout

27
Q

Where are gouty tophi seen?

A

Olecranon bursa
Fingers
Subcutaneous tissue of elbow

28
Q

What is cubital tunnel syndrome?

A

Compression of the ulnar nerve in the cubital tunnel

29
Q

What causes cubital tunnel syndrome?

A

When the ulnar nerve passes between the tendinous arch created by the 2 heads of the flexor carpi ulnaris and becomes impinged

30
Q

How does micro trauma cause cubital tunnel syndrome and how does it present?

A

Banging elbow

Sharp pain radiating from elbow to cutaneous ulnar nerve territory

31
Q

How does compression of ulnar nerve cause cubital tunnel syndrome and how does it present?

A

Paraesthesia in cutaneous territory

Weakness in muscles supplied by ulnar nerve

MSK Disorders (9 decks)

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