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Clin Med Exam 3 (Lauren) > Lower Extremity > Flashcards

Lower Extremity Flashcards

1
Q

What age group commonly gets osteochondirtis dessicans

A

10-20yo

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2
Q

If the pt has greater trochanter pain syndrome on their right hip, which leg will they have trouble standing on?

A

Their right leg (left hip will drop)

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3
Q

What is thei treatment for greater troachanter pain syndrome?

A

Self-limiting

Heating pad

Steroid injections work very well

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4
Q

What specialized test is done for LCL injury

A

Varus stress at 0 and 30 degrees flexion

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5
Q

Should you do imaging for FAI? What type?

A

Yes, X-ray initially

Maybe CT or MRI for soft tissue

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6
Q

What is the most common location of osteochondirtis dessicans?

A

Knee (specifically the lateral portion of the medial femoral condole)

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7
Q

Is ACL tear more common in men or women?

A

Women

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8
Q

Should we do imaging to diagnose patellorfemoral pain syndrome/

A

No, not unless there is trauma or severe instability

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9
Q

Are steroid injections a good idea for patellar tendonitis? Why’?

A

No, not recommended. Because it is a direct insertion point.

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10
Q

What is the most common MOI to injure ACL

A

Non contact!

Quick position change with cutting/pivoting that causes a lateral bend

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11
Q

What is the treatment for snapping hip

A

Don’t do that

Stretching, ice, etc

NSAIDS

Steroid injection if it caused bursitis (not in kids)

Not surgery

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12
Q

Name it:
Bone overgrowth or abnormality that changes the function of the hip joint. (Either through labral tear of destruction of articular cartilage)

A

Femoroacetabular impingement

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13
Q

How can a patient prevent plantar fasciitis?

A

Improve shoes

Stretching the Achilles

Massage of the fascia (painful)

Ortho/podiatry referral for SEVERE cases so they can do steroid injections

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14
Q

Is osteochondirist dessicans a process?

A

Yes, and it can be caught at any point

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15
Q

Can pts reproduce their snapping hip on command

A

Yes

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16
Q

What causes a syndesomtic ankle sprain?

A

Dorsiflexed/rotational ankle injury

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17
Q

What can cause rupture of Achilles’ tendon?

A

Sudden pivoting or rapid acceleration. “Sensation of violent hit or pop.”

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18
Q

How will Achilles’ tendon injuries present?

A

Tendionpathy: burning pain that increases with activity

Rupture: “sensation of violent hit or pop” and pain may be absent

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19
Q

What is the treatment for patellofemoral pain syndrome

A

Ice

NSAIDS

Activity modification

PT to strengthen quads, stretch hammies, and stabilize core.

Taping or brace PRN

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20
Q

What ligaments are injured with a medial ankle sprain?

A

Deltoid ligament complex

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21
Q

How would you test for external snapping hip

A

Passive internal/external rotation while lying on side

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22
Q

Is osteochondirittis dessicans visible on x ray?

A

Yes, you will see flattening of articular surface (crater)

You can do an MRI if the x ray is inconclusive

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23
Q

What is the name for an accumulation of joint fluid in the popliteal fossa?

A

Bakers cyst

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24
Q

What constitutes a grade III knee sprain and what is the treatment?

A

Complete tear.

Treatment:
Surgery

Crutches

Brace

Aggressive PT

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25
Q

What is it:

Idiopathic osteonecrosis of subchondral bone

A

Osteochondirits Dessicans

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26
Q

What specialized test is done for MCL injury

A

Valgus stress at 0 and 30 degrees

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27
Q

Where will it hurt on a physical exam for osteochondritis dessicans?

A

Elbow: pain/guarding with passive motion.
Lateral pain with valgus stress

Knee: pain with flexion over medial condyle. Gait disturbances

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28
Q

What is knee bursitis?

A

Inflammatory disorder of the bursa

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29
Q

What is the treatment for FAI?

A

“Don’t do that”

NSAIDS

PT

Surgery for bony abnormalities

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30
Q

What are the two ways that the Achilles’ tendon can be injured?

A

Tendinopathy

Rupture

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31
Q

What is the treatment of knee bursitis?

A

Avoid precipitating factors (tilers, roofers, etc)

NSAIDS

Aspiration/steroid injections

Padding/bracing

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32
Q

What is the clinical presentation of patellofemoral pain syndrome (Runner’s knee)?

A

Anterior pain UNDER the patella

Pain with stairs

Positive theater/car ride sign

Usually crepitus, popping, feeling of instability

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33
Q

What is the treatment for ankle sprain?

A

RICE and NSAIDS

+/- short immobilization for grades 2-3

PT to prevent repeat injuries, bracing/taping

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34
Q

What is the most common knee complaint in primary care medicine?

A

Patellorfemoral pain syndrome (runners knee)

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35
Q

What is the treatment for patellar tendinitis/

A

Ice

NSAIDS

Bracing/strapping

Rest/PT

NOT steroid injections

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36
Q

Should you do imaging for an ankle sprain?

A

Only to RO fracture

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37
Q

How would you test for internal snapping hip?

A

FABER and then extend hip while in FABER position

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38
Q

What are the specialized tests for ACL injury?

A

Lachman

Anterior Drawer

Pivot shift (pt must be sedated)

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39
Q

How will Femoroacetabular impingement (FAI) present?

A

Groin/lateral hip pain that is aggravated with turning, twisting, squatting, or prolonged standing

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40
Q

What is important to do when a pt presents with IT band syndrome?

A

Evaluate for limb length discrepancy

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41
Q

What is the treatment for bakers cysts?

A

NSAID

Aspiration

Compressive brace

Surgery almost never

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42
Q

What causes external snapping hip

A

IT band over the greater troachanter

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43
Q

Does snapping hip always hurt?

A

No

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44
Q

What should you always think when you hear “catching or clicking”

A

Soft tissue tear

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45
Q

What should you be sure to do if someone presents with knee bursitis?

A

Rule out infection

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46
Q

Who is most likely to get osteochondritis dessicans in the knee?

A

Preteens

47
Q

What constitutes a grade II knee sprain and what is the treatment?

A

Partial tear

Treatment:
RICE

Brace immobilization

+/- crutches, PT, surgery

48
Q

The PCL is rarely injured, but what sport most commonly causes it to tear if it does

A

Soccer

49
Q

What causes osteochondirtis dessicans

A

We don’t know

Maybe repetitive trauma, vascular disruption, ischemia following trauma, genetic predisposition

50
Q

How does labral tear of hip present?

A

Groin pain that can radiate to lateral hip, thigh, or butt

51
Q

What specialized tests are done for patellofemoral pain syndrome/runners knee?

A

Patellar glide

Apprehension test

52
Q

Are bakers cysts painful?

A

They can be with prolonged standing or activity

53
Q

Which meniscus is more susceptible to injury? Why?

A

Medial

-greater medial forces and it is less mobile than the lateral meniscus

54
Q

What does the PCL do to provide stability to the knee

A

Prevents posterior translation of tibia

55
Q

How does the ACL provide stability to the knees

A

Prevents anterior translation of tibia***

56
Q

What causes iliotibial band syndrome

A

Overuse

Which is why its common in runners and cyclists

57
Q

What is the treatment for Achilles’ tendon injury?

A

Equinus Splinting*****

Ortho referral

Boot allowing for continued plantar flexion

58
Q

What is the most important structure for stability of the knee**

A

ACL

59
Q

What kid of injury will cause a Medial ankle sprain?

A

Eversion

60
Q

What are the two types of femoroacetabular impingement (FAI)

A

Pincer- acetabular “roof” overgrowth

Cam- femoral head too fat.. can’t slip under

(Can be a combo)

61
Q

What is the treatment for ACL tear

A

RICE

Ortho referral

Surgery maybe

Brace

PT

62
Q

How will pt present with greater trochanteric pain syndrome?

A

Very localized pain over greater trochanter that they can point to with one finger

Pain with resisted abduction

63
Q

What is the most common cause of lateral hip pain in adults?

A

Greater trochanter pain syndrome

Aka trochanteric bursitis

64
Q

Who do we give surgery to for ACL tear

A

Young people and athletes

65
Q

How do you injure your meniscus

A

Rotation force of the femur on the tibia

66
Q

Who is most likely to get patellar tendonitis (jumpers knee)?

A

Athletes involved in running, jumping and kicking sports

16-40

M>F

Excessive foot pronation (“weak ankles”) and running hills can exacerbate these symptoms

67
Q

What is it:

Anterior pain under the patella

Pain with stairs

Positive theater sign/car ride sign

Crepitus, popping, feeling unstable

A

Patellofemoral pain syndrome (Runner’s knee)

68
Q

Who commonly gets osteochondirtis dessicans in their elbow?

A

Teens, young adults

Throwing/gymnastic sports

69
Q

What is the treatment for IT band syndrome?

A

RICE

NSAIDS

PT

70
Q

What are the specialized tests for PCL tear

A

Posterior drawer sign

Sag sign

71
Q

What is it:
Joint Line pain

Inability to fully extend knee

“Locking” or “catching” when extending knee

Stairs and squatting are painful

A

Meniscus injury

72
Q

Should we do imaging on IT band syndrome?

A

No, not unless traumatic

73
Q

What is the largest and strongest knee ligament

A

PCL

74
Q

What is the specialized test for Achilles’ tendon rupture?

A

Thompson test

75
Q

What will increase the pain of plantar fasciitis?

A

ROM that strains the fascia, such as dorsiflexion of the toes or ankle

76
Q

Where in the elbow is most commonly affected by osteochondirtis dessicans

A

Capitulum

77
Q

What is the most common way to injure the MCL

A

Knee flexed, foot planted, and a lateral blow

78
Q

What shape are the menisci?

A

C-shaped

79
Q

Is imaging needed for an Achilles’ tendon injury?

A

Not always

80
Q

What is the gold standard test to diagnose a labral tear of the hip?

A

MR Arthrogram

81
Q

Are bakers cysts often asymptomatic and found incidentally?

A

Yes

82
Q

What constitutes a Grade I knee sprain and what is the treatment?

A

Mild stretch

Treatment is:
RICE

WB as tolerated

83
Q

What is the treatment for plantar fasciitis?

A

Conservative- ice, NSAIDs, rest

84
Q

What can cause Achilles’ tendon tendinopathy

A

Recent increase in training regimen

85
Q

What specialized test can be done for a syndesmotic ankle sprain?

A

Squeeze test

86
Q

How does snapping hip present?

A

Snapping/popping sensation

Might hurt

Sensation of the hip popping out of socket

87
Q

Should you do imaging for plantar fasciitis?

A

Only if you are concerned about bony abnormalities such as bone spurs

88
Q

Who most commonly gets iliotibial band syndrome?

A

Runners and cyclists

89
Q

What is one of the most common causes of foot pain?

A

Plantar fasciitis

90
Q

What causes snapping hip syndrome?

A

Muscle or tendon sliding over a bony prominence

91
Q

Is LCL sprain common?

A

No very difficult MOI

92
Q

What is the clinical presentation of iliiotibial band syndrome?

A

Gradual onset of pain on lateral knee (insertion point of IT band)

Starts as a Sharp and burning pain with activity

Develops into constant deep ache

93
Q

What is the Triad of O’Donoghue (unhappy triad)

A

ACL

MCL

Medial meniscus

94
Q

What will a patient with plantar fasciitis complain about?

A

Pain in the heel with the First Step of the day ***

95
Q

What is the clinical presentation of ankle sprain?

A

Swelling, pain, bruising, difficulty with weight bearing

96
Q

What is a syndesmotic ankle sprain?

A

A high ankle sprain

Tons of ligaments + interosseous membrane are injured

97
Q

What causes internal snapping hip?

A

Iliopsoas tendon over iliopectineal eminence of femoral head

98
Q

What specialized test can be done for a lateral ankle sprain>

A

Anterior drawer

99
Q

What is the most common location for ankle sprain, and which ligaments are torn?

A

Lateral ligament complex:

Anterior talofibular ligament

Calcaneofibular ligament

Posterior talofibular ligament

100
Q

What knee ligament do you think is injured if the pt doesn’t really complain about instability, but says “something doesn’t feel right”

A

PCL

101
Q

If a pt comes in and says “ i feel so unstable, like my knee could give out at any moment” what should you suspect

A

ACL tear

102
Q

What is the clinical presentation or osteochondritis dessicans?

A

Gradual onset of poorly localized deep pain

Popping/locking/catching in late disease due to loose fragments

Limited WB in knee lesions

Decreased ROM in elbow lesions

+/-swelling

103
Q

What is the go-to imaging modality for meniscus injury?

A

MRI

104
Q

What kind of injury will cause a lateral ankle sprain?

A

Inversion

105
Q

What is the most common ligament in the knee to be injured?

A

ACL

106
Q

What kind of imaging do we do for ACL tear?

A

MRI

X-ray maybe

107
Q

What causes patellar tendinitis?

A

Inflammation from Repetitive trauma

108
Q

Who is most at risk for snapping hip?

A

Dancers

Runners

Adolescents

(Anyone who does extreme ROM or repetitive movements)

109
Q

How do you test for FAI?

A

FADIR for impingement

FABER/figure 4 for determining ipsilateral hip pathology vs contralateral SI joint dysfunction

110
Q

Where will a pt point to their pain if they have patellar tendinitis/ jumper’s knee?

A

Just distal to the patella

111
Q

What are the different bursae in the knee that can become inflamed and which ones are the more common ones?

A

Prepatellar

Suprapatellar

Infrapatellar

Pes anserine

Prepatellar and pes anserine are the most CLASSIC presentations**

112
Q

What is a common cause of Labral tear of hip?

A

FAI

113
Q

Why do pts with greater troachnter pain syndrome have a positive trendelenberg test?

A

Due to PAIN not actually weakness

114
Q

What specialized tests do we do for meniscus injury?

A

McMurrays

Apley‘s compression/distraction

Clin Med Exam 3 (Lauren) (7 decks)

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