master document Pt 2

Question 1

Metatarsal stress fracture most common in

Answer 1

2nd metatarsal (then 3rd)

Xrays wont show for 3 weeks
Runners, dancers, soldiers
Bone scan for diagnosis

Question 2

Quinolones (ciprofloxacin), RA, gout can predispose to

Answer 2

Achilles tendonitis

Question 3

The tibialis posterior tendon inserts predominantly onto the

Answer 3

medial navicular and serves to support the medial arch of the foot

Question 5

Ape hand –

Answer 5

injury to median hand and no innervation to thenar muscles

Question 6

Sign of benediction:

Answer 6

median injury nerve, can only flex pinky and ring fingers

Question 7

Femoral triangle boundaries:

Answer 7

inguinal ligament,
lateral border of adductor longus,
medial border of sartorius, iliopsoas and pectineus,
roof is deep fascia lata

Question 8

osteotomy:

Answer 8

surgical realignment of a bone

Question 9

osteomyelitis:

Answer 9

infection of bone including compact and spongy bone and bone marrow

Question 10

Area of dead bone –

Answer 10

sequestrum

Question 11

most common cause of osteomyelitis

Answer 11

staph aureus

Question 12

osteomyelitis treatment

Answer 12

Treatment is high dose IV abx after CT guided biopsy to obtain tissue cultures

Question 13

Myositis ossificans:

Answer 13

heterotopic ossification (bone forming outside the skeleton) occurs in muscles after an injury
- Bony masses seen in soft tissue on xray

Question 14

Shoulder girdle:

Answer 14

scapula, clavicle, proximal humerus and supporting muscles

Question 15

shoulder pain young

Answer 15

instability

Question 16

shoulder pain middle aged

Answer 16

rotator cuff tear - (grey hair, cuff tear)

• Sudden jerk (sudden stop on bus) followed by pain & weakness

Usually involve supraspinatous
Confirmed by US or MRI

Question 17

shoulder pain elderly

Answer 17

glenohumeral OA

Question 18

(impingement syndrome)
- Supraspinatous passes through acromial space at 60-120 degrees

Answer 18

Tendonitis subacromial bursitis

• Acromioclavicular OA with inferior osteophyte
• A hooked acromion rotator cuff tear
• Pain in deltoid and upper arm
• NSAIDs, analgesics, physio and subacromial injections of steroid (up to 3 months)

Question 19

Adhesive capsulitis (frozen shoulder)

Answer 19

Progressive pain and stiffness, affects passive and active movement
- Age 40-60
- Resolve after 18-24 months
- Pain worse at night, worse on movement, then turns stiff after that
- Loss of external rotation
- Ass with diabetes
- Glenohumeral injections can help if it is painful

Question 20

Acute calcific tendonitis

Answer 20

Acute onset of severe shoulder pain

Calcium deposition in the supraspinatous tendon (seen on xray)

Subacromial steroid

Self limiting

Question 21

elbow

Answer 21

Humero-ulnar joint (flexion/extension) lateral

Radio-capitellar joint (supination/pronation) medial in anatomical position

Olecranon process is the bony elbow, it’s the end of the ulnar

Question 22

Cubital tunnel syndrome

Answer 22

Ulnar nerve compressed behind medial epicondyle

Numbness in ulnar 1.5 fingers

Tinel’s test positive

Question 23

Dupuytren’s contracture

Answer 23

Palmar fascia undergoes hyperplasia

Proliferative connect tissue disorder

Painless

Nodules and cords form contractures at MCP and PIP joints

Ring and little fingers, half of cases are bilateral

Question 24

Trigger finger

Answer 24

• Tendonitis of a flexor tendon
• Nodular enlargement of the affected tendon
• A1 pulley over metacarpal neck
• Clicking sensation (as nodule catches and passes under pulley)
• Middle and ring finger

Question 25

OA

Answer 25

Herbeden’s nodes DIP, Bouchard PIP, dorsal ganglion cyst(mucous cyst)

squaring of thumb