MSK Flashcards
IBD is associated with what arthropathy?
Spondyloarthritis
Pulmonary fibrosis is associated with what arthropathy?
Rheumatoid arthritis
Lumbar stenosis pain worsens with what movement?
Lumbar extension
Herniated disc pain worsens with what movement?
Lumbar flexion, sitting
Compression fracture pain worsens with what movements?
Sitting and standing
How is mild radiculopathy diagnosed and treated?
Clinically, no need for imaging
NSAIDs, glucocorticoids if severe pain
Left diaphragm referred pain is where, and can be caused by what?
Left shoulder; contained splenic bleed
Under what cases does alk phos represent bone metastases?
Osteoblastic, not osteolytic, metastases
MM and renal cell are osteolytic
Ganglion cyst differential diagnosis
Ganglion cyst: round, rubbery, transilluminates - observation/needle aspiration/surgery
Epidermal cyst: painful, nontransilluminating, overlying punctum - use corticosteroids
RA nodule: hard, fixed, nontransilluminating
How does treatment of clavicular injury depend on which part is fractured?
Middle third: closed reduction and figure-of-eight brace
Distal third: open reduction and internal fixation
How does magnesium sulfate affect skeletal and cardiac muscle?
Skeletal muscle - decreased acetylcholine release
Cardiac muscle - prolonged conduction time
What is more typically seen in electrical, rather than thermal, burns?
Direct injury to muscle tissue –> rhabdomyolysis
Vs circumferential constrictive eschar
Which locations are high risk for malunion if stress fracture is suspected?
Fifth metatarsal, anterior tibial cortex; refer to orthopedic surgeon
Stress fracture shows how on imaging?
Hairline lucency or periosteal thickening, but would not see in first 1-2 weeks on x-ray
What does delta pressure on needle manometry correspond to with regards to compartment syndrome?
Delta pressure = diastolic BP - compartment pressure <=30 mm Hg reflects compromised perfusion pressure
When can compartment syndrome be diagnosed clinically?
High risk: e.g. those with limb revascularization
Superior pulmonary sulcus tumor would affect which nerves?
Brachial plexus –> shoulder pain
C8-T1 (ulnar) –> Weakness/atrophy of intrinsic hand muscles, pain/paresthesia of 4th/5th digits and medial arm/forearm
Paravertebral sympathetic chain/cervical ganglion –> Horner syndrome
Superior pulmonary sulcus tumor causes which lymphadenopathy and is from which cancer?
Supraclavicular
Lung adenocarcinoma or squamous cell
How can a spinal epidural abscess form?
Trauma –> hematoma
Classic triad of spinal epidural abscess
- Spinal pain –> radiculopathic pain
- Neurologic deficits
- Fever
In Peyronie disease, fibrous plaques form where?
In the tunica albuginea, reducing elasticity and expansion during erection –> pain, curvature
Peyronie disease treatment
NSAIDs for pain
Pentoxifylline - reduce fibrosis
Intralesional injections of collagenase
Surgery if refractory
Pelvic fracture signs, risks after
- Adducted, internally rotated lower extremity
- Perineal bruising
Risk for posterior urethral injury - abrupt upward motion of bladder and prostate can lead to urethral tearing at bulbomembranous junction
Also risk of bladder rupture
Posterior urethral injury signs
- Blood at urethral meatus
- Inability to void
- Perineal bruising
- High-riding prostate
Perform retrograde urethrography (X-ray with injection of contrast)