Knee and Musculoskeletal Conditions Flashcards
Describe how the unhappy triad occurs
Common injury in contact sports due to lateral force impacting the knee when foot is planted on the ground
What is damaged in the unhappy triad
ACL, MCL and medial meniscus (attached to MCL)
*lateral meniscus more common w ACL + MCL injury
Presentation of unhappy triad
Acute pain and signs of joint instability
What is prepatellar bursitis
Inflammation of the prepatellar bursa in front of the kneecap
Causes of prepatellar bursitis
Repeated trauma or pressure from excessive kneeling (also called “housemaid’s knee”
What is a popliteal cyst & what is it related to?
Aka Baker’s cyst
Popliteal fluid collection in gastrocnemius-semimembraneous bursa commonly communicating w the synovial space
Related to chronic joint disease (eg OA, RA)
What is costochondritis
Inflammation of costochondral or costosternal junctions, may be due to minor trauma
Common in younger females
Presentation of costochondritis
Presents with pleuritic chest pain and focal tenderness to palpation
May mimic myocardial infarction, pleuritis, or pulmonary embolism
Tx of costochondritis
Analgesics, stretch therapy
What is De Quervain tenosynovitis
Noninflammatory thickening of abductor pollicis longus and extensor pollicis brevis tendons = pain/tenderness at radial styloid
Test for De Quervain tenosynovitis
Positive Finkelstein test (pain at radial styloid with active or passive stretch of thumb tendons)
Who is at risk for De Quervain tenosynovitis
New mothers (lifting baby), golfers, racquet sport players, “thumb” texters
What + cause of Duputryen contracture
Caused by fibroblastic proliferation and thickening of superficial palmar fascia
Typically involves the fascia at the base of the ring and little fingers
Who is Duputryen contracture commonly seen in
Males >50 years of N European descent
What is a ganglion cyst
Fluid-filled swelling overlying joint or tendon sheath, most commonly at dorsal side of wrist
Arises from herniation of dense connective tissue
Resolves spontaneously
What is iliotibial band syndrome
Overuse injury of lateral knee that occurs primarily in runners
Pain develops 2° to friction of iliotibial band against lateral femoral epicondyle
What is limb compartment syndrome
Increased pressure wi fascial compartment of a limb = venous outflow obstruction & arteriolar collapse = anoxia, necrosis, rhabdomyolysis that can lead to acute tubular necrosis
Causes of limb compartment syndrome
Significant long bone fractures (eg, tibia), reperfusion injury, animal venoms
Presentation of limb compartment syndrome
Severe pain and tense, swollen compartments with passive stretch of muscles in the affected compartment
5 Ps: pain, pallor, paresthesia, pulselessness, paralysis
What are the late signs of irreversible muscle and nerve damage
Increased serum creatine kinase and motor deficits
Cause of medial tibial stress syndrome and what is it
Aka shin splints
Common cause of shin pain and diffuse tenderness in runners and military recruits
Caused by bone resorption that outpaces bone formation in tibial cortex
What is plantar fascitis
Inflammation of plantar aponeurosis characterized by heel pain (worse with first steps in the morning or after period of inactivity) and tenderness
Associations in plantar fascitis
Obesity, prolonged standing or jumping (eg, dancers, runners), and flat feet
What often coexists w plantar fascitis
Heel spurs
What is temporomandibular disorders
Group of disorders that involve the temporomandibular joint (TMJ) and muscles of mastication
Associations of temporomandibular disorders
TMJ trauma, poor head and neck posture, abnormal trigeminal nerve pain processing, psychological factors
Presentation of temporomandibular disorders
Dull, constant unilateral facial pain that worsens with jaw movement, otalgia, headache, TMJ dysfunction (eg, limited range of motion)
What is radial head subluxation, common in, caused by?
Aka nursemaid’s elbow
Common elbow injury in children < 5 years
Sudden pull on the arm = immature annular ligament slips over head of radius
How is the injured arm in radial head subluxation presented
Slightly flexed and pronated position
What is Osgood-Schlatter disease and who does it occur in
Aka traction apophysitis
Overuse injury caused by repetitive strain and chronic avulsion of the secondary ossification center of the prox tibial tubercle
Occurs in adolescents after growth spurt and common in running and jumping athletes
Presentation of Osgood-Schlatter disease
Progressive anterior knee pain
What is patellofemoral syndrome, exacerbation?
Overuse injury seen in young, female athletes as anterior knee pain
Exacerbated by prolonged sitting or weight-bearing on a flexed knee
What is developmental dysplasia of the hip
Abnormal acetabulum development in newborns resulting in hip instability/dislocation
Risk factor for developmental dysplasia of the hip
Breech presentation
Tests for developmental dysplasia of the hip
Orotlani & Barlow maneuvers (manipulation of newborn hip reveals a “clunk”)
Confirmed w US (x-ray doesn’t show until 4-6 months)
What is Perthes disease
Idiopathic AVN of femoral head
Presentation of Perthes disease
Between 5-7 years (common in males) w insidious onset of hip pain that may cause the child to limp
Initial x-ray is often normal
What is slipped capital femoral epiphysis, how it happens, diagnosis
Seen in obese young adolescents with hip/knee pain and altered gait
Increased axial force on femoral head = epiphysis displaces
Dx via x-ray
