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Diff Di > Lower extremity complaint > Flashcards

Lower extremity complaint Flashcards

1
Q

pt has patellofemoral arthralgia and/or patellar tracking disorders

A

athlete with anterior knee pain

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2
Q

knee pain in elderly pts

A

osteoarthritis

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3
Q

young athlete with tibial tuberosity pain

A

Osgood Schlatter’s disease

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4
Q

pt with complaint of knee instability

A

chronic ACL damage

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5
Q

pt with painful locking of knee

A

meniscus tear

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6
Q

history of hyperextension injury at the knee

A

ACL tear or patellar dislocation

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7
Q

history of hyperflexion injury at the knee

A

PCL tear and/or ACL tear

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8
Q

history of sudden deceleration in knee

A

ACL tear

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9
Q

history of Valgus force injury in knee

A

MCL tear

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10
Q

history of Valgus force with rotation in knee

A

ACL, MCL, and menisci

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11
Q

history of blow to a flexed knee

A

contusion, patellar fracture, or PCL tear

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12
Q

tests for ACL

A

Lachman’s, anterior drawer, pivot shift test

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13
Q

tests for meniscus

A

McMurray’s, Apley’s compression and distraction

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14
Q

collateral ligament tests

A

varus and valgus stress tests

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15
Q

tests for patellofemoral disorders

A

compression, stability, and tracking

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16
Q

Ottawa knee rules for acute trauma

A 
pt is over 55
isolated tenderness at patella
isolated tenderness at fibula head
pt is unable to flex the knee 90 degrees
pt is unable to bear weight immediately after injury
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17
Q

pt reports sudden onset of knee pain following hyperextension injury, or sudden stopping or cutting, or after being hit from the side of the knee; may hear pop, joint swelling may appear, and pt is unable to bear weight

A

ACL tear

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18
Q

usually consists of anterior cruciate ligament tear, medial collateral ligament tear, and medial meniscal tear

A

O’Donoghue’s triad

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19
Q

xrays may show Segond’s fracture, potential tibial spine fracture, or head of fibula fracture

A

ACL tear

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20
Q

ACL should be this color on MRI

A

black

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21
Q

young athlete complains of knee pain following a blow to the front of his tibia with the knee in a flexed position or by forced hyperflexion

A

PCL injury

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22
Q

tests for PCL

A

posterior drawer test

SAG sign

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23
Q

refers to a characteristic linear fragment arising from the lateral margin of the lateral tibial plateau

A

Segond’s fracture

24
Q

Segond’s fracture is associated with the disruption of

A

ACL

25
Q

knee pain following a rotational injury and involves flexion and internal rotation of the tibia; swelling in the knee over a few hours; episodes of knee locking; knee gives away

A

meniscus tears

26
Q

most meniscus injuries are due to

A

compression and rotation

27
Q

on MRI the defect extends to the articular surface of the posterior horn

A

meniscus tear

28
Q

young athlete complains of pain and swelling at the tibial tuberosity

A

osgood-schlatter’s disease

29
Q

with osgood-schlatter’s disease, the apophysis may undergo an inflammatory reaction that is called

A

a traction apophysis

30
Q

stiffness and knee pain that is worse with prolonged sitting or walking; varus deformity may be apparent

A

DJD

31
Q

on xray may show decreased joint space predominantly involving the medial compartment with osteophytes, cystic changes, subchondral sclerosis and misalignment

A

DJD

32
Q

young pt with insidious onset of anterior knee pain with a limp, occasionally the knee locks and swells, is a defect in the osteochondral bone and articular cartilage that usually affects the lateral portion of the medial femoral condyle

A

osteochondritis desiccans

33
Q

occurs only on the convex surfaces of bone and is the most common cause of an intra-articular loose body

A

osteochondritis desiccans

34
Q

FBI sign means

A

fracture

35
Q

in older pts, calf pain should always suggest possibility of

A

deep vein thrombosis

36
Q

pt has complaints of leg pain that occurs with walking and relief with rest

A

claudication

37
Q

type of claudication that is secondary to spinal stenosis with compression of nerves and/or blood supply to the nerves causing leg symptoms that are related to exertion

A

neurogenic claudication

38
Q

distinction between vascular and neurogenic claudication is due to

A

posture

39
Q

pts with this claudication are more likely to be able to walk or ride a bicycle further before the onset of leg pain in a flexed position

A

neurogenic

40
Q

claudication that involves stenosis of peripheral blood vessels compromising the blood supply to the muscles

A

vascular

41
Q

smoking is a major risk factor for this type of claudication

A

vascular

42
Q

older pts complain of leg pain after walking for a few minutes then must stop and rest before continuing; relief from rest is almost immediate

A

intermittent claudication

43
Q

possible issues with the first toe

A

Hallux valgus/rigidus, gout, sesamoiditis

44
Q

possible issues with metatarsals

A

Morton’s neuroma, netatarsalgia, stress fractures

45
Q

possible issues with ankle

A

inversion and eversion sprains

46
Q

possible issues with achilles tendon/heel

A

tendinitis, bursitis

47
Q

pain on bottom of foot, dropped metatarsal heads, could be from direct trauma after jumping and landing on toes

A

metatarsalgia

48
Q

pain on bottom of foot, insidious onset, pt may have less pain when barefoot, transverse compression may increase the pain, occasionally a mass may be palpated

A

Morton’s neuroma

49
Q

constant pain of the forefoot especially with weight bearing, history of prolonged walking or running, tender to touch and pain with transverse compression

A

stress fracture

50
Q

ankle pain and swelling following a twisting injury

A

ankle sprain

51
Q

most ankle sprains involve these ligaments in sequence:

A

anterior talofibular ligament, calcaneofibular ligament, posterior talofibular ligament

52
Q

eversion ankle sprains often damage this ligament

A

deltoid ligament

53
Q

type of ankle sprain that has pain in malleolar region and tenderness at either malleolus or inability to bear weight immediately after

A

plantar flexion inversion

54
Q

tests for ankle sprains

A

anterior drawer test, varus and valgus stress test

55
Q

one of the impingement syndromes involving the ankle, classically described in ballet dancers

A

Os trigonum syndrome or PAI

56
Q

when measured, the angle of the calcaneus should not be less than this many degrees

A

28 degrees

57
Q

transverse fracture at the base of the 5th metatarsal

A

Jones/Dancer’s fracture

Diff Di (8 decks)

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