Lower Extremity Conditions Flashcards
What occurs with avascular necrosis at the hip?
Disruption of blood supply to the femoral head
List 4 symptoms associated with AVN at the hip.
- Hip ROM is decreased in flexion, IR and abduction
- Coxalgic gait
- Pain the groin/thigh
- Tenderness with palpation at the hip joint
What is the difference between coxa vara and coxa valga?
Coxa Vara = Angle of femoral neck with shaft of femur is < 115 degrees
Coxa Valga = Angle of femoral neck with shaft of femur is >125 degrees
Describe the difference between the 2 types of femoral acetabular impingement.
CAM = impingement of a large aspherical femoral head in a constrained acetabulum
Pincer = over-coverage of the femoral head by a prominent acetabular rim
What is the difference between patella alta and patella baja?
Alta = malalignment in which patella tracks superiorly in femoral intercondylar notch
Baja = malalignment in which patella tracks inferiorly in femoral intercondylar notch
What may occur as a result of patella alta?
May result in chronic patellar subluxation or patellar tendon rupture
Positive camel back sign (two bumps over anterior knee region instead of typical one)
What may occur as a result of patella baja?
Abnormal knee extension with abnormal cartilaginous wear
What is medial tibial stress syndrome?
Overuse injury of the posterior tibialis and/or the medial soleus, resulting in periosteal inflammation at the muscular attachments
Thought to be caused by excessive pronation
49% of all stress fractures involve the _____ and only 10% involve the _____.
49% = tibia 10% = fibula
What structures are affected by a trimalleolar fracture?
Medial malleolus
Lateral malleolus
Posterior tubercle of the distal tibia
The Ottawa ankle and foot rules indicate the need for ______.
An ankle and/or foot x-ray
What are the Ottawa ankle rules?
An ankle x-ray series is only required if there is any pain in the malleolar zone and any of these findings:
- Bone tenderness from the posterior edge or tip of the lateral malleolus extending 6cm proximally, or
- Bone tenderness from the posterior edge or tip of the medial malleolus extending 6cm proximally, or
- Inability to take 4 complete steps both immediately and in the emergency department.
What are the Ottawa foot rules?
An foot x-ray series is only required if there is pain in the midfoot zone and any of these findings:
- Bone tenderness at the base of the 5th metatarsal or,
- Bone tenderness of the navicular or,
- Inability to take 4 complete steps both immediately and in the emergency department.
What is hallux valgus?
A medial deviation of head of first metatarsal from midline of body; metatarsal and base of proximal first phalanx move medially, while distal phalanx then moves laterally
What is the normal metatarsophalangeal angle?
8-20 degrees
What is the most common complaint associated with metatarsalgia?
Pain at first and second metatarsal heads after long periods of weight bearing
What is Charcot-Marie-Tooth disease?
Peroneal muscular atrophy that affects motor and sensory nerves
Initially affects muscles in the lower leg and foot, but eventually progresses to muscles of hands and forearm
What position is the calcaneus positioned in with rearfoot varus versus valgus?
Varus = rigid inversion of the calcaneus Valgus = rigid eversion of the calcaneus
What are the Ottawa knee rules?
A knee x-ray series is only required for patients with knee injury and who have any of the following:
- Age 55 years or older, or
- Isolated patellar tenderness without other bone tenderness, or
- Tenderness of the fibular head, or
- Inability to flex knee to 90 degrees, or
- Inability to bear weight immediately after injury and in the emergency department
