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Clin Med I > Lower Extremity X3 > Flashcards

Lower Extremity X3 Flashcards

1
Q

Femoroacetabular impigement

A

Bown overgrowth of abnormailty in development whcih changes function of the hip joint
- can cause secndary problems > labral tear or OA
Pincer (acetabulum) and Cam(neck of femur) type

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2
Q

Femoroacetabular impigement present

A

Groin pain +- lat hip pain

  • described as sharp stabbing or deep dull ache
  • aggravate with turning, teisting, prolonged standing or squatting
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3
Q

Femoroacetabular impigement tests

A

FADIR- impingment specifcally
FABER- “figure four”
- also can show SI disfunction so ask where do you have pain
Imaging: X ray and CT if needed

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4
Q

Femoroacetabular impigement tx

A
  • Decreaseing aggrvating activities
  • NSAIDs
  • PT
  • surgery maybe
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5
Q

Trochanteric Pain syndrome

A

repetitive overload tendinopath

  • lateral hip pain with localized pain to greater tochanter
  • pain increase with prresure and increase with repetative motion
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6
Q

Trochanteric pain syndrome dx

A

TTP over greater trochanter
- pain with resisted abduction
Trendelenburg sign

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7
Q

Trochanteric pain synrome Tx

A

NSAIDs
heat
adjust positioning
injection

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8
Q

Labral Tear Present

A

Dull or ahrp groin pain

  • may radiate to lat hip or ant thigh or but
  • insidious onset vs. acute trauma
  • catching or clicking that causes pain
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9
Q

Labral Tear Dx

A

ROM and strength testing
-FADIR and FABER
Imaging: X ray MRI or ***MR arthrogram- test of choice

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10
Q

Snapping Hip Syndrome

A

Snapping or poppin sensation in hip with walking, getting up
Cause: muscle or tendom sliding over bony prominence
External: IT band over greater troch
Internal: Iliopsoas over iliopectineal eminence

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11
Q

Snappin Hip Syndrome pres

A

Snapping or popping sensation

  • may or may not be painful
  • Pseudosubluxation
  • difficulty with stairs, running
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12
Q

Snapping Hip Syndrome Dx

A

Physical exam: snapping is reproducible
external: passive IR ER rotation of hip while laying on side
Interal: FABER then extend hip

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13
Q

Snapping hip

A

NSAID, avoidance of specific activities +/- corticosteroid inj
PT
surgery rarely indicated

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14
Q

MCL sprain MOI

A

knee flexion and foot planted and a lateral inpact causing valgus and rotation
- usually in combo with triad of Donnoghue

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15
Q

Unhappy triad

A

ACL, MCL, Medical meniscus

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16
Q

ACL injury MOI

A
  • quick position change with cutting/pivoting

c- contact: direct blow causing hyperextention

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17
Q

ACL present

A

feeling pop + immediate pain and swelling+ report feeling very very unstable
Present: joint effusion, gaurding, often able to bear weight , laxity

18
Q

ACL test/ Dx

A

Lachman, ANterior drawer, Pivot shift

MRI! but X ray may be considered for bony involvment

19
Q

ACL Tx

A 
RICE
refer to ortho 
conservative vs surgical 
- surgery for younger pt or athletes 
- brace or PT rehabilitation
20
Q

PCL MOI

A

Prevents post translation
MOI
- high evergy trauma MVA
- can be in sports but least likely in athlets

21
Q

PCL presentation

Special test

A 
variable
- grossly instable 
- may be very subtle finding 
- mild to moderate knee effusion/hemarthrosis 
Test: posterior testing
22
Q

Menisci MOI

A

Increases stability and shock absorption

  • during rotational force
  • medial is more suspecptible to injury
23
Q

Meniscus Present

A

joint line pain
inability to full etend knee and described as locking or catching
- walking down stairs and squatting is diff or painful

24
Q

Meniscu Dx

A

McMurray, Apley Gring
Image: MRI
Tx: conservative vs surgical

25
Q

Knee sprain grade c tx

A

I- rice WB as tolerated
II- patrial tear
rice, brace immobilixation +/- crutches maybe surgery
III: complete tear
surgical repair, crutches, brace, aggressive PT

26
Q

Patellofemoral Pain Syndrome cause/pres

A

“runner knee”
Anterior pain under patella
- pain worse with going up and down stairs
- postive theatre sign or long car ride
- common crepitus, popping, feeling of joint instability

27
Q

Runners knee test

A

Patellar glide and apprehension test
Dx: history and physical exam
Tx: Ice, NSAIDs, PT
- strengthen hip abductors and quads, stretching, core stability

28
Q

Bakers Cyst

A

Accumulation of joint fluid of the popliteal fossa

Clin present: often asymptomatic or found incidentaly, pain and swelling with prolonged standing or activity

29
Q

Bakers cysts tx

A

NSAID
aspiration/injection
compressive neoprene brace
surgery rarely indicated

30
Q

Patellar tendonitis

A

jumpers knee
tendon inflamattion typically involved in running often after skeletal maturity
- seen with pronation or running hills

31
Q

Patellar tendonitis tx

A

Conserv: Ice, NSAID, bracing, strapping, act modification and PT

32
Q

Iliotibial band syndrome present

A

Overuse injury Gradual onset of localized pain
- initially sharp burning and will develope a deep ache
Exam: localized tenderness
evaluate LLD
Tx: RICE, NSAIDS, PT

33
Q

Knee Bursitis

A

Inflam or the bursa

prepattelar, suprpatellar,infrapatellar, pes anserine

34
Q

Knee bursitis pres/tx

A

pain swelling
R/O infection
Tx: avoid preipitating factors, NSAID, asapiration/steroid injection

35
Q

Osterochondritis Dissecans

A 
Presentation
gradual onset of poorly localized deep pain
- decrease ROM in elbow but not knee
may have sweeling, popping locking
need X ray or MRI
36
Q

Osterochondritis Dissecans tx

A

1-III avoidance of activitu and immobilication may be required +- pt
IV- surgery

37
Q

Ankle Sprain lateral

A

Lateral- most common
lateral ligament complex
anterior talofibular ligament, calcaeofibular ligament and post talofibular lig
Dx: anterior draw

38
Q

Ankle sprain dx

A

radiographs to rule out fracture
tx: RICE and NSAIDs
+/- short immobilize grade 2/3
PT to prevent future injuries

39
Q

Achilled Tendon issues present

A

tedinopathy- maybe new repative training or buring pain

Rupture: sudden pivoting or rapid acceleration sunden pop with severe pain

40
Q

Achilles tendon exam

A 
palpate along tendon for pain edenma 
palpate both plantar and dorsal flexon 
Special: thompon test 
Tx: ortho referal
immobilization, equinus splinting , boot to keep in felxed position

Clin Med I (14 decks)

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