MSK Flashcards
TIBIAL STRESS FRACTURE
- Present as point tenderness at fracture site. - Cannot do hopping test.
- Xrays may be negative for up to 6 weeks. MRI if high risk.
- Treat with rest, minimize weight bearing and ortho consult if HR. Pneumatic compression device can be used.
QUADRICEP AND PATELLAR TENDON RUPTURE
Quadricep is above the patella and patellar is the connection between tibia and femur. Disruption of this complex will present with inability to extend.
SUBACROMIAL IMPINGEMENT SYNDROME
Causes subacromial tendon to be squeezed between humeral head and acromion.
- Hard to differentiate between these but rotator cuff will have some weakness
- Neers (hand up) and Hawkins (Chicken) positive
- Treatment is NSAIDs, rehab, steroid injection
PES ARSENIS PAIN SYNDROME
Pes arsenus is a point around medial knee where satorius, gracilis and semitendinosis attach. It presents with medial knee pain. Valgus stress test is negative and rules not MCL tear. Supportive is Tx.
PATELLOFEMORAL PAIN SYNDROME
Common in adolescent girls. Pain present with running, squatting and presents with anterior knee pain.
Treatment is RICE and supportive
OSGOOD SCHLATTER
Common in males 10-15 years. Point tenderness at tibial tuberosity (Apophysitis)
Tx: Supportive post activity and icing. Can do as tolerated.
SACRO-ILIAC JOINT DYSFUNCTION
posterior hip pain with low back pain. FABER test will positive
PYRIFORMIS MUSCLE PAIN
Log roll test positive but will present with posterior pain too
FIFTH METATARSAL FRACTURE TX
Non-displaced can be treated with compressive bandage and as tolerated weight bearing
Displaced: <3mm needs short boot and >3mm needs ortho ref
Tuberosity avulsion Fx can be treated with compression bandage.
WHICH FRACTURES REQUIRE CT IMAGING?
Displaced radial and tibial plateau fractures
SUPRACONDYLAR FX
FOOSH. 5-7y olds.
Ant interosseous nerve (OK), radial, median affected
Tx: ND- Long arm splint (humerus) x 3 weeks, repeat XR in 1 wk
D- Refer
BUCKLE/TORUS FX
- Common wrist fx in kids.
- Stress makes bone bulge out but not break all the way
- Usually FOOSH.
- Just put a splint/brace x 3 wks
CLAVICLE FX Treatment
- If ND: Just treat with a sling or figure 8 sling
- If comminuted, displaced or shortening in Adults= Sx
MOST COMMONLY AFFECTED NERVE IN RADIAL FX
Median
SCAPHOID FX TX
ND: Thumb splint
D: need Ref
BOXER FX
4th/5th metacarpal.
Tx: Immobilize with ulnar/volar splint, ace wrap or short arm cast.
If angulation >40, refer
JERSEY FINGER
Ruptured flexor digitorum. Cannot flex. Usually ring finger. Need surgery
MALLET FINGER
Ruptured extensor digitorum. Cannot extend. Need splint for 8wks.
BOUTINNIERE DEFORMITY
Injury to PIP joint. Causes: locked finger, RA
Tx: Splint in extension then night splinting
MALLEOLAR FX
Medial or lateral, short boot with protected WB
Post: No WB for 4-6wks
PATELLAR FX
Direct blow. Focal patellar tenderness. Inability to extend.
Tx: knee immobilizer or Sx if displaced.
LATERAL EPICONDYLITIS
Lateral epicondyle tenderness and pain with wrist movement.
SEVERS DISEASE TX
Calcaneal stress fracture
Stretching exercises, NSAIDs, heel cups
MOTOR NEUROMA
Numbness and pain between 3rd and 4th metatarsals.
SEPTIC ARTHRITIS IMAGING MODALITY
Ultrasound
HIP MSK
Ant: Labral
Lateral: Greater trochanteric syndrome
Posterior: iliosacral
OTTAWA ANKLE RULES
Malleolar tenderness AND
- Post malleolar tenderness OR
- Inability to bear weight
OTTAWA FOOT RULES
Midfoot tenderness AND
- Navicular (Medial) or 5th Met (Lateral) tenderness OR
- Inability to bear weight
OTTAWA KNEE RULES
- > 55 y
- Patellar tenderness or fibular head tenderness
- Inability to walk
- Cant flex knee 90 degrees
ILIOTIBIAL SYNDROME
Lateral knee and hip pain. Common in cyclists.
Tx is supportive.
LITTLE LEAGUE SHOULDER
Can get xray which will show sclerosis/demineralization
Tx: Stop playing
CUBITAL TUNNEL SYNDROME
Compresses Ulnar nerve. Innervation affected and motor (Finger abduction affected)
TENNIS ELBOW
Lateral epicondylitis.
Occurs in adults
Epicondyle tenderness and weak grip strength
Tx: Dont overuse. Counterforce brace for 6 weeks
LEGG CALVE PERTHES
B>G and in kids.
Caused by temporary interruption of blood supply
Usually supportive treatment
Presenting with limp and hip pain
TARSAL TUNNEL SYNDROME
- kinda like plantar fasciitis
- medial ankle pain and parasthesia
- Positive tinel sign (tapping over and reproducing symptoms)
BEST TEST FOR MENISCAL TEARS
Thessaly. Stand on one leg and rotate internally and externall
KNEE SOFT TISSUE FEATURES
- Meniscus: Small effusion, inability to extend
- Collaterals: Valgus/Varus instability
- Cruciate: pop sensation and large effusion
TUFT FRACTURES
Distal phalynx fractures. Just need splinting.
