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MSK > Lower Extremity > Flashcards

Lower Extremity Flashcards

1
Q

Aseptic Necrosis (hip) Characteristics

A
  1. loss of blood supply to trabecular bone which causes collapse of femoral head (cresent sign)
  2. children: Legg-Calve-Perthes disease
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2
Q

Aseptic Necrosis Clinical Features

A
  1. dull/throbbing ache localized to groin, lateral hip, butt
  2. pain with WB, alleviated with rest
  3. loss of rotation or ABDuction
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3
Q

Aseptic Necrosis adverse outcomes

A
  1. secondary OA
  2. femoral head collapse
  3. disability
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4
Q

Aseptic Necrosis Imaging

A
  1. MRI for early detection

2. xray (cresent sign later in disease)

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5
Q

Aseptic Necrosis Treatment

A
  1. alendronate to prevent collapse
  2. surgery: decompression, THA
  3. protected weight-bearing
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6
Q

Slipped Capital Femoral Epiphysis (SCFE) Characteristics

A
  1. weakening of epiphyseal plate of femur, results in displacement of femoral head
  2. 10-16yo
  3. boys more than girls, African-Americans more
  4. younger children: metabolic cause (hypothyroid, hypopituitary)
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7
Q

SCFE Clinical Features

A
  1. insidious hip, thigh, knee pain

2. limp

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8
Q

SCFE Imaging

A

lateral xray (frog-leg lateral view)

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9
Q

SCFE Treatment

A
  1. pinning in situ

2. crutches, avoid WB after surgery

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10
Q

Meniscal Injury Characteristics

A
  1. excessive rotational force of femur on tibia

2. medial meninscus torn more than lateral

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11
Q

Meniscal Injury Clinical Feature

A
  1. joint line pain on side of injury
  2. unable to fully extend knee (LOCKING)
  3. knee “giving way”
  4. swelling
  5. difficulty stairs/squatting
  6. Mcmurry, Apley
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12
Q

Meniscal Injury Imaging

A

MRI

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13
Q

Meniscal Injury Treatment

A
  1. activity modification
  2. NSAIDs
  3. quad strengthening
  4. Indications for arthroscopy: persistant sxs unresponsive to treatment
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14
Q

Osgood-Schlatter Characteristics

A
  1. apophysitis of tibial tubercle
  2. 8-15 yo
  3. males more than females
  4. self-limited
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15
Q

Osgood-Schlatter Clinical Features

A
  1. anterior knee pain
  2. localized pain and swelling over tibial tuberosity
  3. pain when active, relieved with rest
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16
Q

Osgood-Schlatter Imaging

A

lateral xray may show fragmentation of tibial tuberosity

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17
Q

Osgood-Schlatter Treatment

A
  1. rest for several months

2. stretching, ice, NSAIDs after exercising

18
Q

Cruciate Ligament Injury Characteristics

A
  1. ACL injured more than PCL
  2. ACL injury associated with pivot
  3. women more than men
19
Q

Cruciate Ligament Injury Clinical Features

A
  1. hear POP
  2. feel instability in knee
  3. Hemarthrosis (bleeding into joint space) within 3-4 hours
  4. Lachman test for ACL
20
Q

Cruciate Ligament Injury Imaging

A
  1. MRI

2. xray to r/o fracture

21
Q

Cruciate Ligament Injury Treatment

A
  1. PT/bracing for non-athletes

2. surgical reconstruction with autograft/allograft for patients under 40 and athletes

22
Q

Ankle Sprain/Strain Characteristics

A
  1. Inversion injury
  2. most often associated with lateral ligaments
  3. ATL (anterior tibulocalcaneal ligament)
23
Q

Ankle Sprain/Strain Clinical Features

A
  1. report hearing “pop”
  2. ecchymosis, tenderness
  3. stability tested with anterior drawed test
24
Q

Ankle Sprain/Strain Imaging

A

xray to r/o fracture

25
Q

Ankle Sprain/Strain Treatment

A
  1. RICE
  2. crutches 48-72 hours
  3. PT
26
Q

Achilles Tendonitis Characteristics

A
  1. common in runners and patients who increased fitness
  2. overuse injury, result of improper stretching/training
  3. if untreated: results in achilles rupture
27
Q

Achilles Tendonitis Clinical Feature

A
  1. pain during/after activity
  2. pain on posterior calf (2-6cm above insertion of Achilles tendon)
  3. normal ankle ROM
  4. Thompson squeeze test to r/o rupture
28
Q

Achilles Tendonitis Imaging

A
  1. xray (shows calcification)

2. MRI (r/o rupture, shows hypertrophy)

29
Q

Achilles Tendonitis Treatment

A
  1. NSAIDs
  2. PT
  3. Cortisone injection
30
Q

Bunions (Hallux Valgus) Characteristics

A
  1. most common deformity of metatarsalphalangeal (MTP) joint
  2. result of lateral deviation of proximal phalanx
  3. more common in women
31
Q

Bunion Clinical Feature

A
  1. medial eminence pain, metatarsal head pain, deformities of the toes, and inablilty of shoes to fit
32
Q

Bunion Imaging

A
  1. weight-bearing xray of foot (valgus deformity an angle greater than 15 degrees)
33
Q

Bunion Treatment

A
  1. buy shoes with wide toe box
  2. pads on medial eminence
  3. surgery for serve deformity
34
Q

Morton Neuroma Characteristics

A
  1. result of traction of interdigital nerve against the transverse metatarsal ligament causing degeneration of nerve and chronic inflammation
  2. affects 3rd web space
35
Q

Morton Neuroma Clinical Features

A
  1. pain and localized numbness with activity, relieved with rest
  2. pain localized to web space, mass often palpable
  3. squeezing forefoot will often reproduce sxs
36
Q

Morton Neuroma Diagnosis

A

clinical

37
Q

Morton Neuroma Treatment

A
  1. soft metatarsal pad and shoes with wide toe box
  2. cortisone injection
  3. surgical removal of neuroma
38
Q

Plantar Fasciitis Characteristics

A
  1. common in runners and overweight patients

2. cause by microscopic tears in plantar fascia

39
Q

Plantar Fasciitis Clinical Features

A
  1. pain with first few steps in the morning
  2. heel pain at night
  3. inflexible achilles tendon
40
Q

Plantar Fasciitis Treatment

A
  1. 6-12 months conservative treatment (PT)
  2. steroid injections
  3. surgery for severe cases

MSK (9 decks)

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