Miscellaneous MSK Flashcards
What% of shoulder dislocations are anterior
90%
Causes of anterior shoulder dislocation
FOOSH
Direct trauma from back
Causes of posterior shoulder dislocation (3)
Lightning
Direct trauma from front
Epileptic fit
XR feature posterior dislocation
Light bulb sign
Sx posterior shoulder dislocation
Can’t externally rotate
What is a Bankart’s lesion?
Dislocation at the weakest point of the shoulder (labrum)
ANT - head towards coracoid
POST - head away from coracoid
What is a Hill-Sachs lesioin?
Small dent posterolaterally in the humeral head if anterior
If dent anteromedially = post
What test should be performed if pt is having recurrent dislocations?
Apprehension test
What nn should be tested in shoulder injuries?
Axillary nn
What is a Charcot joint?
Rapidly progressive destructive process in joints
Features of charcot joint
Autonomic/sensory neuropathy
+ obvious deformity
Causes Charcot joint (5)
DM Tabes dorsalis (syphillis) Alcoholic neuropathy Cauda equina Leprosy
XR features Charcot joint
Osseuous destruction + collapse
Mx Charcot joint
Well fitted cast
What scoring system is used in hypermobility
Beighton score
> 4 - hypermobility
What% of the pop = hypermobile
10%
3 e.g.s of hypermobility
Ehlers Danlos (patho) Marfans (patho) Benign joint hypermobility syndrome
Synovial fluid analysis: uniform blood stained (2)
Trauma
Severe inflammation
Synovial fluid analysis: non-uniform blood stained
Traumatic aspiration
Bloods - thrombocytopenia (4)
SLE
APL
Feltys/RA
Methotrexate
Bloods - leukopenia
Lupus
Bloods - increased ALP (3)
RA
Polymyositis
Pagets bone disease
Bloods - RF +ve (3)
RA (70%)
SLE
Sjorgrens
Bloods - Anti-CCP
RA 98% specific
Bloods - ANA (4)
Rules out Lupus Positive in: RA Sjorgrens Scleroderma
Bloods - Anti-dsDNA
Specific - Lupus
Anti-sm
SLE
Anti-RO + Anti LA
Sjogrens
Anti-Jo1 + myositis =
Pulmonary fibrosis
Anti-toposiomerase + scleroderma =
Pulm/cardiac involvement
