History

Question 1

Orthopaedic Symptoms

Answer 1

-Pain
-Stiffness
-Deformity
-Instability
-Swelling
-Locking
-Erythema
-Clicking
-Crunching (crepitus)

Question 2

Surgical sieve using VITAMIN C DEF

Answer 2

V Vascular
I Infective inflammatory
T Trauma
A Autoimmune
M Metabolic
I Iatrogenic
N Neoplastic
C Congenital
D Degenerative
E Endocrine environment
F Functional

Question 3

Anatomical sieve

Answer 3

-Skin
-Hai follicles and sweat glands
-Subcutaneous fat
-Fascia

-Joint
-Ligaments
=Capsule
=Synovium
=Intra-articular structures
=Articular cartilage
=Epiphysis (in children)

-Bone
=Muscle/ tendon
=Nerves and vessels
=Periosteum
=Bone

Question 4

Describe pain as a symptom

Answer 4

-Well localised:
=Skin
=Ligaments and tendons (‘sprain’ or tendinopathy)
=Dermatome -> Referred from the spine

-Poorly localised:
=Joint capsule being stretched (-> effusion)
==Transudate vs. exudate vs. (lipo)haemarthrosis

-Bone
=Fracture
=Infections and tumours -> ‘red flags

Question 5

Describe stiffness as a symptom

Answer 5

-Reduced active ROM ->
=Normally pain! Pathology affecting joint, muscle or tendon
=Neurological causes:
==Cognition
==Spinal cord
==Synapses
==LMNs
==NMJs

-Reduced passive ROM
=Any anatomical layer could be affected

Question 6

Describe swelling

Answer 6

-Exudate -> usually warm and erythematous
=Infective
=Inflammatory
=Haemarthrosis: coagulopathy / fracture

-Transudate -> usually cool and non-erythematous
=OA most common

Question 7

Describe erythema

Answer 7

-Well circumscribed
=Infective or inflammatory
=Usually of the skin

-Poorly circumscribed
=Usually the fascia or deeper
=Infective, inflammatory, or blood

Question 8

Describe clicking, crunching, and locking

Answer 8

-Intra-articular pathology
-Any intra-articular structure:
=All: (Osteo)chondral fragment: trauma or osteochondritis dessicans or Incongruent articular surfaces -> OA, others
=Shoulder: Labrum
=Hip: Labrum
=Knee: Menisci

Question 9

Describe instability

Answer 9

-Passive stabilisers
-All:
=Ligaments
=Shape of the articular surfaces
-Hip and Shoulder: Labrum
-Knee: Menisci

-Active stabilisers (extraarticular)
=Muscles and their tendons