MSK Flashcards
Weak external rotation (shoulder)
adhesive capsulitis
Antiphospholipid syndrome
APTT
PT
Plts
APTT prolonged
PT normal
Plts low (sometimes)
Gottrons papules
roughened red plaques on extensor surfaces
associated with dermatomyosytis
De Quervain’s tenosynovitis clinical test
Finkelstein test positive ie. she has pain over her radial styloid on forced abduction/flexion of the thumb.
Hydroxychloroquine SE
visual acquity
Rheumatoid arthritis most specific test
anti CCP (anti cyclic citrullinated peptide)
knee meniscal tears Fx
knee locking, giving way
ankylosing spondylitis Mx
1st - NSAIDs/ exercise
2nd - DMARD (sulfasalazine)
3rd - Anti TNF (etanercept)
Gout chronic Mx
1st - Allopurinol + Colchicine/ NSAID cover
2nd - Febuxostat (xanthine oxidase inhibitor)
3rd - uricase
Ottawa rules for Ankle X ray
lateral malleolar pain
medial malleolar pain
unable to weight bear at time of injury and on assessment
Rheumatoid arthritis X ray findings
Early x-ray findings
loss of joint space
juxta-articular osteoporosis
soft-tissue swelling
Late x-ray findings
periarticular erosions
subluxation
cubital tunnel syndrome
compression of ulnar nerve - tingling of 4/5th fingers
carpal tunnel syndrome
compression of median nerve - tingling of thumb, index, middle finger
weak thumb abduction
thenar eminence wasting
antiphospholipid syndrome clotting profile
prolonged APTT
low platelets
antiphospholipid syndrome Mx
primary thromboprophylaxis: aspirin
secondary thromboprophylaxis: lifelong warfarin (INR 2-3); if recurrent despite warfarin, then INR 3-4
Ankylosing spondylitis associations (6)
Apical fibrosis
Anterior uveitis
Aortic regurgitation
Achilles tendonitis
AV node block
Amyloidosis
hydroxychloroquine SE (1)
retinopathy
Femeroacetablur impingement Fx
anterior groin pain in active young adults
phenytoin SE
dupuytrens contracture
Intertrochanteric (extracapsular) non displaced proximal femoral fracture Mx
dynamic hip screw
Displaced femoral fracture Mx
hemiarthroplasty or total hip replacement (if patient is active)
Lateral epicondylitis (tennis elbow) Fx
worse on resisted wrist extension/suppination whilst elbow extended
Sjogrens disease antibody
Anti-Ro
Perthes disease Fx
male, age 4-8yrs
progressive hip pain
XR hip - widening joint space, flattened femoral head
osteoporosis + steroid (Pred >7.5mg for 3 months) Mx
> 65 - start bisphosphonate
<65 - DEXA scan (T-1.5 start bisphosphonate)
psoriatic arthritis Fx
symmetrical polyarthritis (although can be asymmetrical)
arthritis mutilans (severe deformity of hands/ “telescoping fingers”)
Nails - pitting, oncholysis
Dactylitis - finger swelling “sausage”
Tenosynovitis
psoriatic arthritis XR finding
pencil in cup
Radial tunnel syndrome Fx
pain distal to lateral epicondyle
worse on elbow extension/forearm pronation
paget’s disease Mx
bisphosphonate (alendronate)
osteoarthritis Mx
1st - paracetamol + topical NSAIDs
2nd - oral NSAIDs, opioids, capsaicin cream and intra-articular corticosteroids
Radial nerve (C5-8) motor function
motor - extension (forearm, wrist, fingers, thumb)
sensory - dorsal aspect between thumb and index
injury - humeral shaft fracture, palsy leads to wrist drop
Axillary nerve (C5,6) motor, sensory function
motor - shoulder abduction (deltoid)
sensory - deltoid
MOI - humeral neck fracture
methotrexate and trimethoprim interaction leads to
myelosuppression - pancytopenia
people with aspirin allergy can not take
sulfasalazine
drug induced lupus antibody
antihistone antibody
causes of drug induced lupus (2)
procainamide
hydralazine
posterior hip dislocation Fx
high energy impact
shortened, internally rotated leg
neck of femur fracture Fx
low impact, elderly patients
shortened, externally rotated leg
pseudogout XR findings
chondrocalcinosis (calcification of articular edge)
Subacromial impingement Fx
presents with a painful arc of abduction
ACL Ix
Lachman test positive
MRI (gold standard)
scaphoid fracture Fx
snuff box tenderness
pain compressing thumb longitudinally
pain on flexion and ulnar deviation of wrist
Colles fracture Fx
dorsally displaced distal radius fracture
MOA - fall on outstretched hand
“dinner fork” derformity
Smiths fracture Fx
MOA - fall on flexed hand/ direct impact to wrist (opposite of colles)
type of distal radius fracture
Bartons fracture
intraarticular distal radius fracture
Similar to Colles and Smiths but intraarticular
Bennetts fracture
intraarticular fracture of base of first metacarpal (thumb)
Fx - force abduction of first metacarpal (thumb)
Rolando fracture
comminuted first metacarpal fracture
MOA - flexed first metacarpal (thumb) eg fist fight
Ottawa Knee x ray rules
Knee injury PLUS any of the below
>55yo
tenderness of patella
tenderness of head of fibula
inability to flex 90 degrees
inability to weight bear immediately and in ED
developmental dysplasia of hip Ix
ultrasound
shoulder dislocation nerve damaged
axillary nerve - numbness over deltoid
Limited cutaneous systemic sclerosis (CREST syndrome) antibody
anti-nuclear antibody
anti centromere
