EM - Ortho Flashcards
etiologies of low back pain
-injury to paravertebral spinal muscles
-intervertebral disk
management of low back pain
-reassurance and education
-NSAIDs and tylenol
MC MOI of cervical strain
whiplash
presentation of cervical strain
diffuse and nonradicular pain at the base of the skull
diagnosis of cervical strain
-cervical xray normal
management of cervical strain
-soft cervical collar
-NSAIDs
MOI of olecranon bursitis
direct blow
Presentation of olecranon bursitis
pain and swelling of bursa
diagnosis of bursitis
aspiration of fluid
management of bursitis
-mild: NSAIDs
-severe: aspirate, compression bandage
treatment of septic bursitis
mild: bactrim
severe: IV vanc
s/s of rotator cuff tendonitits
-aching and soreness with repetitive activity
-pain with ADLs
-positive empty can, neers, and hawkins
-tender to palpation
diagnosis of rotator cuff tendonitis
-US
-MRI
management of rotator cuff tendonitis
rest and PT
Etiologies of cauda equina syndrome
-disk herniation
-spinal stenosis
-spinal trauma
-neoplasm
-infection
s/s of cauda equina syndrome
-bowel and bladder incontinance
-low back pain
-saddle anesthesia
-radiculopathy
-weak anal tone
diagnosis of cauda equina
emergent MRI with contrast
treatment of cauda equina syndrome
urgent neuro consult
presentation of costochondritis
pain and tenderness on the breastbone, pain in multiple ribs that is reproducible
diagnosis of costochondritis
clinical
Treatment of costochondritis
NSAIDs
MOI of anterior shoulder dislocation
blow to abducted, internally rotated and extended arm
s/s of anterior shoulder dislocation
-slight abduction
-external rotation
-prominent acromion
MOI of posterior shoulder dislocation
blow to anterior portion of the shoulder
s/s of posterior shoulder dislocation
-adducted and internally rotated
-inability to externally rotate
-prominent coracoid process
MOI of inferior shoulder dislocation
axial loading with the arm fully abducted or forceful hyperabduction of the arm
presentation of inferior shoulder dislocation
arm held above head, pronated with the inability to adduct
arm held above head, pronated with the inability to adduct
-anterior: apprehension
-posterior: jerk
-inferior: sulcus
complications of shoulder instability
-axillary nerve damage
-hill-sachs lesion
-disruption of labrum
management of anterior shoulder dislocation
-stimson technique
-longitudinal traction
management of inferior shoulder instability
axial traction
management of posterior shoulder instability
traction-countertraction
Types of AC injuries
-type 1: sprain
-type 2: AC ligament is torn, but CC joint is intact
-type 3: all ligaments are torn
presentation of AC injury
-pain with abduction
-tenderness over joint
treatment of AC injuries
-grade 1-3: ice, rest, and NSAIDs + sling
-grade 4: surgery
s/s of gout
-swollen, red joint
-mc at night
diagnosis of gout
-joint fluid analysis
-rat bite on xray
treatment of gout
-low purine diet
-NSAIDs
-Colchicine
-Allopurinol
-corticosteroids for acute attack
gout vs pseudogout
Gout - negatively birefringent; Crystals are NEEDLE shaped and yellow when parallel to the light
Pseudogout - weakly positive birefringent; Crystals are RHOMBOID shaped and blue when parallel to the light
treatment of pseudogout
NSAIDs
s/s of herniated nucleus pulposus
-abrupt and severe
-pain and numbness
-shooting or stabbing pain into the buttock and down the leg
-positive SLR
indications for MRI for herniated NP
-symptoms for more than 4 weeks
-significant neuro deficit
-progressive neuro changes
-intolerable pain
management of herniated NP
-NSAIDs
-steroids
-rest
mc location of osteomyelitis
metaphysis of long bones
S/S of osteomyelitis
-gradual onset of dull pain
-tender, warm, erythema, and swelling
diagnosis of osteomyelitis
-blood cultures
-CT
management of osteomyelitis-
antibiotics
-debridement
mc location for compartment syndrome
lower leg
s/s of compartment syndrome
-severe pain out of proportion to injury
-6 Ps
diagnosis of compartment syndrome
stryker kit
treatment of compartment syndrome
-if over 45: fasciotomy
-admit
s/s of septic arthritis
-pain, swelling, heat over joint
-fever and chills
diagnosis of septic arthritis
joint fluid analysis
treatment of septic arthritis
-rocephin + vanc
-drainage of fluid
