FARR MSK Flashcards
Back pain that is exacerbated by standing and walking and relieved with sitting and hyperflexion of the hips.
Spinal stenosis.
Joints in the hand affected in rheumatoid arthritis.
MCP and PIP joints; DIP joints are spared.
Joint pain and stiffness that worsen over the course of the day and are relieved by rest.
Osteoarthritis.
Genetic disorder associated with multiple fractures and commonly mistaken for child abuse.
Osteogenesis imperfecta.
Hip and back pain along with stiffness that improves with activity over the course of the day and worsens at rest. Diagnostic test?
Suspect ankylosing spondylitis. Check HLA-B27.
Arthritis, conjunctivitis, and urethritis in young men. Associated organisms?
Reactive (Reiter’s) arthritis. Associated with Campylobacter, Shigella, Salmonella, Chlamydia, and Ureaplasma.
A 55-year-old man has sudden, excruciating first MTP joint pain after a night of drinking red wine. Diagnosis, workup, and chronic treatment?
Gout. Needle-shaped, negatively birefringent crystals are seen on joint fluid aspirate. Chronic treatment with allopurinol or probenecid.
Rhomboid-shaped, positively birefringent crystals on joint fluid aspirate.
Pseudogout.
An elderly woman presents with pain and stiffness of the shoulders and hips; she cannot lift her arms above her head. Labs show anemia and ↑ ESR.
Polymyalgia rheumatica.
An active 13-year-old boy has anterior knee pain. Diagnosis?
Osgood-Schlatter disease.
Bone is fractured in a fall on an outstretched hand.
Distal radius (Colles’ fracture).
Complication of scaphoid fracture.
Avascular necrosis.
Signs suggesting radial nerve damage with humeral fracture
Wrist drop, loss of thumb abduction.
A young child presents with proximal muscle weakness, waddling gait, and pronounced calf muscles.
Duchenne muscular dystrophy.
A first-born female who was born in breech position is found to have asymmetric skin folds on her newborn exam. Diagnosis? Treatment?
Developmental dysplasia of the hip. If severe, consider a Pavlik harness to maintain abduction.
An 11-year-old obese African-American boy presents with sudden onset of limp. Diagnosis? Workup?
Slipped capital femoral epiphysis. AP and frog-leg lateral view.
The most common 1° malignant tumor of bone.
Multiple myeloma.
Herniated disc Symptoms improve with
flexion at the hips and bending forward.
The most common benign bone tumor is
osteochondroma.
Codman’s triangle
(periosteal new bone formation at the diaphyseal end of the lesion)
“onion skinning,” which is classic for
Ewing’s sarcoma.
Polymyositis is
a progressive, systemic connective tissue disease characterized by immune-mediated striated muscle inflammation. Dermatomyositis presents with symptoms of polymyositis plus cutaneous involvement, although the pathogenesis is different. Most often affect patients 50–70 years of age; the male-to-female ratio is 1:2. African-Americans are affected more often than Caucasians.
CREST syndrome:
Calcinosis
Raynaud’s phenomenon Esophageal dysmotility Sclerodactyly Telangiectasias
Criteria for SLE—
DOPAMINE RASH
Discoid rash Oral ulcers Photosensitivity Arthritis
Malar rash Immunologic criteria Neurologic symptoms
(lupus cerebritis,
seizures) Elevated ESR Renal disease
ANA
SLE TREATMENT
I NSAIDs for mild joint symptoms.
I Corticosteroids for acute exacerbations.
I Corticosteroids, hydroxychloroquine, cyclophosphamide, and azathioprine
for progressive or refractory cases.
Duchenne Muscular Dystrophy (DMD)
An X-linked recessive disorder resulting from a deficiency of dystrophin, a cytoskeletal protein. Onset is usually at 3–5 years of age.
Differential diagnosis of pediatric limp—
STARTSS HOTT
Septic joint Tumor Avascular necrosis (Legg-Calvé-Perthes) Rheumatoid arthritis/JIA Tuberculosis Sickle cell disease SCFE Henoch-Schönlein purpura Osteomyelitis Trauma Toxic synovitis
