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MSK (mine) > lower limb > Flashcards

lower limb Flashcards

1
Q

what is hallux valgus

A

deformity of the great toe due to medial deviation of 1st metatarsal and lateral deviation of toe

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2
Q

what are the symptoms of hallux valgus

A

pain
rubbing may lead to bunion
ulceration

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3
Q

what is the treatment of hallux valgus

A

prevention of bunions

surgery

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4
Q

what is hallux rigidus

A

OA of 1st MTP joint

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5
Q

what are the types of hallux rigidus, what causes them

A 
primary = degenerative
secondary = osteochonadral injury
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6
Q

what is the treatment of hallux rigidus

A

stiff soled shoes
removal of oestophytes = cheilectomy
arthrodesis = fusion of joint

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7
Q

what is morton’s neuroma

A

repeated trauma to plantar interdigital nerves overlying inter-metatarsal ligaments causes inflammation leading to the formation of a neuroma

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8
Q

what are the symptoms of morton’s neuroma

A

burning/tingling pain radiating to affected toes
loss of sensation web space
compression of metatarsal head results in click

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9
Q

what is the investigation of morton’s neuroma

A

US

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10
Q

what is the treatment of morton’s neuroma

A

offloading insoles
steroid/anaesthetic injections
excision

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11
Q

where do metatarsal stress fractures commonly occur

A

2nd metatarsal = most common

3rd metatarsal

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12
Q

what is the investigation of metatarsal stress fractures

A

bone scan

X-ray = after 3 weeks

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13
Q

why can you not x-ray a metatarsal stress fractures before 3 weeks

A

reabsorption at fracture end and callus formation takes 3 weeks

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14
Q

what is the classical history of an achilles rupture

A

sudden deceleration with resisted calf muscle contraction that caused sudden pain

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15
Q

who commonly gets achilles rupture

A

middle aged or elderly people

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16
Q

what are the causes of achilles rupture

A

repetitive strain = sport
degenerative
tendonitis

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17
Q

what can commonly cause tendonitis

A

RA
gout
ciprofloxacin

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18
Q

what are the symptoms of achilles rupture

A

pain at the achilles tendon or its site of insertion
difficulty weight bearing
palpable gap in tendon
+ve simmond’s test

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19
Q

what is simmond’s test

A

no plantar flexion of foot when calf is squeezed

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20
Q

what is the treatment of achilles rupture

A

rest
physio
cast

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21
Q

what treatment should not been given in achilles rupture

A

steroid injections

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22
Q

what is Plantar fasciitis

A

inflammation of the sole of the foot especially around the heel

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23
Q

what causes Plantar fasciitis

A

repetitive stress/overload

degenerative condition

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24
Q

what are the symptoms of Plantar fasciitis

A

pain on walking in the instep of the foot

localised tenderness

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25
Q

what is the treatment of Plantar fasciitis

A

rest
stretching
gel filed heel pad
steroid injections

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26
Q

where does the Tibialis posterior tendon insert, what is its role

A

medial navicular

supports the medial arch of the foot

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27
Q

what is the treatment of Tibialis posterior tendon rupture

A

splint

surgery

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28
Q

what is pes cavus

A

abnormally high arch of the foot

29
Q

what are the causes of pes cavus

A

idiopathic
polio
cerebral palsy
spinal cord tethering in spina bifida

30
Q

what are the symptoms of pes cavus

A

claw toes
pain
usually asymptomatic

31
Q

what is the treatment of pes cavus

A

supple = soft tissue release and tendon transfer

rigid = calcaneal osteotomy

32
Q

what causes claw toes

A

hyperextension at the MTPJ and PIPJ

33
Q

what causes hammer toes

A

hyperextension at the DIPJ

34
Q

what are the symptoms of claw and hammer toes

A

pain
corns
skin breakdown

35
Q

injury to the hip will produce pain where

A

groin which may radiate to the knee or buttock

36
Q

what is the first movement that is lost in hip injury

A

internal rotation

37
Q

what is a positive trendelenburg sign

A

when standing on one leg the pelvis drops on the side opposite to the standing leg

38
Q

what is femoracetabular impingement syndrome

A

abnormal femoral neck and/or acetabular results in contact of the femoral neck on the edge of the acetabulum during movement damaging the labarum and cartilage

39
Q

what are the types of femoracetabular impingement syndrome, what causes them

A 
CAM = femoral deformity 
pincer = acetabular deformity 
mixed = femoral and acetabular deformity
40
Q

who commonly gets CAM femoracetabular impingement syndrome

A

young, athletic males

maybe be related to previous SUFE

41
Q

who commonly gets pincer femoracetabular impingement syndrome

A

females

42
Q

what are the symptoms of femoracetabular impingement syndrome

A

activity related pain in groin particularly on flexion and rotation
difficulty sitting
“c-sign”

43
Q

what is the investigations of femoracetabular impingement syndrome

A

X-ray
CT
MRI = damage to labarum + bony oedema

44
Q

what is the treatment of femoracetabular impingement syndrome

A

asymptomatic = observation
symptomatic = surgery to remove deformity
elderly/secondary OA = arthroplasty

45
Q

what is avascular necrosis, who is commonly affected

A

ischaemic necrosis of bone usually affecting adults

46
Q

what does avascular necrosis cause

A

necrosis of a segment of bone causing patchy sclerosis before subchondral collapse and irregularity of the articular surface

47
Q

where is the most common site for avascular necrosis to occur

A

hip

48
Q

what are the causes of avascular necrosis

A

primary = idiopathic

secondary - anything that causes clots or venous stasis

49
Q

what are the causes of secondary avascular necrosis

A

trauma secondary to fracture
alcohol
steroid injection

50
Q

what are the symptoms of avascular necrosis

A

insidious onset of groin pain
pain worsened by stairs or impact
normal exam
80% are bilateral

51
Q

what are the investigations of avascular necrosis

A

1st line = MRI

2nd line x-ray

52
Q

what would be seen on a x-ray of avascular necrosis

A

“hanging rope sign”
patchy sclerosis
femoral head collapse

53
Q

what causes the “hanging rope sign” in avascular necrosis

A

lytic zone formed by granulation tissue from attempted repair

54
Q

what is the treatment of avascular necrosis

A

pre-collapse = drilling to decompress bone

pst-collapse = joint replacement (THR)

55
Q

what is idiopathic transient osteonecrosis of the hip

A

local hyperaemia and impaired venous return with marrow oedema and intermediary pressure

56
Q

what are the symptoms of idiopathic transient osteonecrosis of the hip

A

progressive groin pain
difficulty weight bearing
usually unilateral

57
Q

who is commonly affected by idiopathic transient osteonecrosis of the hip

A

middle aged men

women in the late stages of pregnancy

58
Q

what are the investigations of idiopathic transient osteonecrosis of the hip

A

Xray
MRI = gold standard
bone scan

59
Q

what would you seen on the X-ray of idiopathic transient osteonecrosis of the hip

A

decreased bone density
thinning of cortices
persevered joint space

60
Q

what is the treatment of idiopathic transient osteonecrosis of the hip

A

will resolve itself in 6-9months

protected weight bearing

61
Q

what is gluteal cuff syndrome

A

inflammation of the trochanteric bursa

62
Q

what is gluteal cuff syndrome also known as

A

trochanteric bursitis

63
Q

who is commonly affected by gluteal cuff syndrome

A

females due to hip shape
elderly people = degeneration
young runners

64
Q

what covers the trochanteric bursa

A

IT (iliotibial) band

65
Q

what are the symptoms of gluteal cuff syndrome

A

pain/tenderness in lateral hip = region of greater trochanter
pain when greater trochanter is palpated and on resisted abduction

66
Q

what are the investigations of gluteal cuff syndrome, what do they show

A 
x-ray = normal 
MRI = shows the diseases but is not usually needed
67
Q

what is the treatment of gluteal cuff syndrome

A

physio
anti-inflammatory drugs
steroid injections

68
Q

who is commonly affected by proximal fracture of the femur

A

old women

69
Q

what are the causes of proximal fracture of the femur

A

young adults = high impact trauma

elderly = weakness

MSK (mine) (17 decks)

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