MSK Flashcards
2 COMMON locations for compartment syndrome
Anterior compartment of lower leg
Volar compartment of forearm
Don’t forget that what can be a cause of compartment syndrome
Circumferential burn
What pressure is positive for compartment syndrome
Delta pressure over 30
Muscle breakdown causes what two things
Release of myoglobin leading to myoglobinuria
Kidney dysfunction = hyperkalemia // increased phosphate // LOW CALCIUM
MC complication of compartment syndrome
Rhabdomyolysis
BMI greater than what can cause osteoarthritis
25
5 things to remember about osteoarthritis
LOSS
Loss of joint space
Osteopphytes
Subchondral cysts
Sclerosis
And
Pip-E Bouchard Nodules with Heberden Nodules at the DIP Joint
4 management options for osteoarthritis
Oral or topical NSAIDS
Topical capsaicin
Duloxetine
CC Injections
With HLA B27 think ?
Ankloysing Spondylitis
Axial spine and Sacroiliac joints
Risk factors for AK
Male under age 45
Pain is what with AK
Worse in the morning and improves with activity
Just like osteoarthritis
1 extra articulate manifestation of AK
Anterior uveitis
1 st line for AK
NSAIDs and PT
Nerve distro effected by cauda equina
L2 - S1
Post void residual volume = + for urinary retention in cauda equina
Greater 100
Lateral upper arm
Lateral forearm and thumb
Posterior forearm and middle finger
Fifth finger
Nerve Roots.
C5
C6
C7
C8
Root associated with loss of
Brachioradialis reflex
Biceps reflex
Triceps reflex
C5
C6
C7
How does the leg get its innervation
S1 the butt
L5
L4
L3 wraps around the groin
What is a positive straight leg test
Hold the knee
Raise the leg
Pain shoots from back PAST the knee
Knee extension vs. Knee Flexion roots
Extension = L3/L4 —> KICK THE FLOOR
Flexion = L5/S1 —> RIDE ONE, FLEX.
In spinal stenosis sxs improve with
Flexion
What red flag is significant from seronegative splodylarthropathy
Morning stiffness in a greater than 30 yr old adult
When is a good time to X-rays for low back pain
Persists longer than 6 weeks despite conservative treatment or if ALARM sxs
Most shoulder dislocations are
Anterior
Mechanism for posterior shoulder dislocation
Seizure or electric shock
Special tests for shoulder instability
Apprehension and O’Brien Test
What movements aggravate each RTC muscle
Supraspinatus = abduction
Infraspinatus = ER
Tree Minor = ER
Subscapularis = IR
What are good tests for shoulder impingement?
Anterior = Hawkins Kennedy
Posterior = Neers Test
Shoulder lift off and belly press test what
Internal rotation of the shoulder
Shoulder impingement gets surgery for what
Full thickness tears
2 diseases associated with frozen shoulder
Diabetes
Hypothyroidism
Movement most effected in frozen shoulder
External rotation and abduction
Lateral epicondylitis is what?
Tennis Elbow
Lateral tendonidopathy of the Extensor carpi radilais brevis
Medial epicondylitis is?
Golfers elbow
Medial tendonopathy of the pronator teres
Lateral epicondylitis vs medial epicondylitis = PAIN WITH WHAT MOTIONS?
Lateral = activities where the arm and wrist are extended
Medial = activities that involve wrist Flexion and Pronation
Pain with resisted what in LATERAL VS. MEDIAL EPICOND
LATERAL = extension
MEDIAL = Flexion
Two tests if you suspect scaphoid tenderness
Ulnar wrist deviation PAIN
Exist compression of the thumb PAIN
When do you have surgery in scaphoid fracture
Displaced fractures
Type of splint for boxer fracture
Ulnar gutter splint
Colles vs. Smith fracture
Colles = volar displacement of wrist = R/o Schaphiod injury!
Smith = distal displacement
Colles vs. Smith Fracture
Colles = volar
Smith = distal
If you are gonna do surgery on Colles or smith what is the surgery / splint
ORIF = unstable or communited
Splint = sugar tong splint
Colles = Eat something sweeet with that FORK = Sugar Tong
Mallet finger is what?
Disruption of finger extensor tendon mechanism at the DIP.
Treatment mallet finger
Maintain the DIP joint in full extension for 6-8 weeks
Mallet finger can lead to what
Swan neck deformity
DIP in Flexion
PIP in hyperextension
Skiers game keeper thumb is a disruption of what ligament
Ulnar collateral ligament avulsion fracture by forced ABDUCTION
Posterior hip dislocation is described as
Leg shortened with hip flexed ; adducted ; internally rotated
FADIR
Anterior hip dislocation is defined as
Hip extended , abducted, and externally rotated
FABER
How does the femoral head appear in anterior vs. posterior hip dislocation
Anterior = larger and medial or inferior to the acetabulum
Posterior = smaller and superimposes on the roof of the acetabulum
Time frame for closed reduction in hip dislocation
6hours
Most common type of hip fx
Intertrochaneteric
What is the story for ACL tear
Pop sensation with effusion and instability
What would a plain film show in knee ligament injury
Segond fracture
What artery is injured in PCL tear
Popliteal artery injury
MCL vs LCL stress
MCL = Valgus
LCL = VARUS
What is the story for meniscal tear
Twisting motion of a flexed knee on a planted foot
Meniscus makes you think?
Mechanical symptoms
Ankle INVERSION injury is most common and effects what ligament
Anterior talofibular ligament
Ankle eversion is uncommon and effects what ligament
Deltoid
High ankle sprain effects what location
Distal tibiofibular syndesmosis
Brief explanation of Ottawa ankle rules
Pain in the malleolar region :
-Bone tenderness posterior edge of medial mall. or lateral mall. [6cm]
-Pain in the same area when walking [ 4 steps ]
Pain in the midfoot region :
-TTP at the Navicular
-Base of 5th metatarsal pain
-Pain in the same area when walking [ 4 steps ]
Maisoneueve fracture combination ? 2 things.
1st. Medial Malleolous fracture
2nd. Spiral fracture of proximal tibia
JONES VS. PSUEDOJONES definition
Jones = transverse fracture of the proximal diaphysis of the fifth metatarsal
PSUEDOJONES = avulsion fracture of the 5th metatarsal tuberosity
Jones vs. Pseudojones management
Jones = Non weight bearing 6-8 weeks
PSUEDOJONES = walking boot 2-3 weeks
What three ligaments are involved in the lesfranc fracture
Plantar
Lesfranc
Dorsal ligament
Lesfranc management
ORIF non weight bearing cast 6-12 weeks
Non weight bearing case and repeat X-ray every 2 weeks = no dislocation
Puncture wound from nail what pathogens
Staph A
Psuedomonas = shoe de Mona’s
Most sensitive study for osteomyelitis
MRI
Osteomyelitis treatment if
Psuedomonas
GBS
MSSA
Pseudomonas = Cefepime ; Ceftazidime
GBS = Vancomycin
MSSA = nafcilin oxacilin
If something looks like septic arthritis dont forget to think about
N. Gonnorhea
Antibiotics of choice for septic arthritis
Vancomycin + Ceftriaxone
What part of the bone is effected in Ewing sarcoma
Diaphysis of long bones
Biopsy of Ewing sarcoma looks like
Small round blue cells
Psuedorossetes
What age is effected by osteosarcoma
13-16 and greater than 65
Osteosarcoma think what
Sunburst
Osteosarcoma think what
Sunburst
5 PLATE, medications that can cause gout
Pyrazinamide
Loop diuretics
ASA
Thiazides
Ethambutol
“Too much seafood on your plate”
Gout arthrocentesis shows what
Negative birefringent crystals
Psuedomonas gout shows what
Positive birefrigent crystals
Mainstay treatment gout
Indomethacin
Colchicine for ATTACKS
MX = allupurinol
Allupurinol is what type of medication and what side effects
Probenacid
Xanthine oxidase inhibitor
probenacid = urate reputake inhibitor
Hematuria
Bleeding gums
Blue/pale skin
4 disease states assoc with pseudo gout
Hyper PTH
hypothyriodism
Hemochromatosis
Thiazides diuretics
X-RAY for pseudogout shows what
Chondrocalcinosis
Shape of crystals gout vs. psuedogout
Gout = sharp
Psuedogout = rhomboids
MC primary cause of osteoporosis
Post menopause loss of estrogen
Loss of zinc / ca2+
What is the defintion of osteoporosis
Less than -2.5 with fragility fracture
Osteoporosis treatment of choice
Dronates! Bisphosphonates
Screening for osteoporosis [5]
Age over 65 women
Hx of fragility fracture
BMI less 21= LOW
Current smoker or drinker
Rheumatoid Arthritis
Medication cause of bone loss
Polymaylagia rhuematica is associated with ?
Giant Cell Arteritis
Pain in PMR is what?
Symmetric with prolonged morning stiffness greater 30 mins ; impacts ability to do daily activities.
PROXIMAL JOINTS
Lab findings associated with Reuters syndrome
HLA B27
Rheumatoid affects what joints? And what deformity is associated
MCP and PIP
Swan neck and Bouteniere deformities ; ulnar finger deviation
Lab studies positive in rheumatoid arthritis
Rheumatic factor
Anti cyclic citrullinated peptide
1st line RA and what do you also give
Methotrexate
Folic acid supplements
SLE think what meds? HIMP
Hydralazine
Isoniazid
Minocycline
Procainamide
SLE affects who?
Young women age 16-55
What is the eye involvement in SLE
Kerratoconjunctivitis sicca
SLE Lab antibodies
Anti double stranded DNA
Anti smith antibodies
SLE management
Hydroxycloroquine or chloroquine
Limited scleroderma is what?
CREST
Calcinosis
Raynauds
Esophageal dysmotitility
Telangiectasias
Lab testing in scleroderma is positive for
Diffuse = ANA -SCl-70
Limited = anticentromere antibodies
3 complications of systemic scleroderma
Interstitial lung disease
Pulmonary hypertension
Cardio renal complications
Sjorgen syndrome causes destruction of what two glands
Salivary and lacrimal [exocrine glands]
Antibodies positive in Sjogrens
Anti ss A Rho
Anti ss B LA
How to combat dryness in Sjogrens
Cholinergic agonists // artificial tears
2 complications of Sjogrens
Dental caries
MALT // lymphoid tissue lymphoma
2 things lost in osteoporosis
Bone matrix and mineral
RF : ETOH, smoking ; steroid use=2ndary
Osteopenia vs. osteoporosis
Penis = 1.0 -2.4
2.5 or more
Females = screen at 65 yrs
Males = 75 yrs
Teaching points for Bisphosphonates
Take it in the AM ; while sitting up
ADE’s = esophagitis ; Jaw necrosis ; femoral shaft fx
STOP after 3 yrs that the condition has resolved
If advanced renal dz w osteoporosis what treatment
Denosomab
Last line for osteoporosis
Raloxifene = sERM
Given to pts with increased risk of breast cancer ; to decrease hormone receptors responsible in cancer development
What is an effective analgesic after acute vertebral fx
Miacalcin nasal spray
Paget’s bone disease [4]
Osteoclastic then osteoblastic activity = weak bone formation —> CORTICAL THICKENING SKULL AND PELVIS
Highly vascular ; high ALK PHOS
Deformed ; Multiple bones involved
TXMN = IV zolendronate -single dose
Pagets of the skull
Would show mod severe cortical thickening
Compartment syndrome has pain with
Passive stretch
Osteoarthritis is a
Non inflammatory arthritis
Pain in the AM > moving makes it better
Crepitus
Heberden -DIP
Bouchard-PIP
Normal dexa scan =
-1.0 or greater
In adults osteomyelitis affects the
Spine - diabetics
Chronic osteomyelitis [4]
Weeks to months with mild incr ESR/CRP
Localized inflammation or cellulitis
X-ray —> bone destruction // CT for bone bx ; MRI best view
TXM = Lon term IV abx ; Surgical debridement
Septic arthritis is commonly what kind of spread
Hematogenous
DIG infection may have lesions where with septic arthritis
Palms and Soles of feet
Non gonnococcal arthritis TXM
Vanco + 3rd gen ceph
4-6 weeks
Gonnocoal arthritis TXM
Doxy PO + IV Ceftriaxone
Do ganglion cysts transilluminate
YES
Benign vs. Malignant bone tumor
Benign = defined sclerotic margins and SLOW growth
Malignant = permeative lesion with Lytic destruction poor margins = RAPID growth
Primary tumors that often Metz to the bone : Lettuce tomatoes pickles ketchup bacon
Prostate
Breast
Lung
Kidney
Thyroid
How can you manage bone cysts
Bx=Dx
Watch and Wait
Asp/inj w/ steriods
Curettage and bone graft
Osteoid osteoma = FULL OF BONE
Aching night pain ; better w/ NSAIDS —> surgery —-> ablation
MC : benign bone tumor M>F ; young adults
osteosarcoma [4]
KNEE ; Males ; non traumatic
Ages 15-25 y/o
Destructive sun burst appearance —> get bone bx
ALK PHOS [2-3xnml] TXM = CHEMO
Fibromyalgia
20-50 y/o F
Pain on trigger points in several different areas
Non progressive sxs ; but life long
TXM = moderate exercise ; CBT ; TCAs ; SSRI’s SSNRIs best analgesic = ultram/APAP
Gout medications 4
Thiazide
Loop diuretics
Beer
Beta blockers
Acute cases of gout have increased what
WBC
What type of crystals in out
Positive sodium urate +
Negatively birefringent
Must r/o what if giving CC for acute gout
Septic arthritis
Undersecretion vs. overproduction meds for chronic gout mgmt
Undersecretion = probenecid or uricosuric agent URI —> STOPS URATE UPTAKE, PROMOTES SECRETION
Overproduction = allopurinol/febuxostat ; XOI —> STOPS THE PRODUCTION
Increase what type of dietary component in gout mgmt
Dairy
Pseudogout affects what joint
Large joints !
Like knee and wrists
+rhomboid crystals + birefringent
Allopurinol or probencid in psuedogout mgmt ?
NO ; not a problem of uric acid.
Just; = acute NSAIDs // CC //
colchicine or NSAIDs = chronic
Juvenile idiopathic arthritis [4]
Greater 6 weeks of sxs ; less than 16 years old.
Fever ; rash that will come and go ; Oligo —-> anterior uveitis [optho x4/yr]
25% = poly articular +RF; +AntiCCP [RA] +ANA = more severe disease
TXM = NSAIDs —> DMARDS [Methotrexate]
Poly arteritis nodosa [4]
“Necrotizing Arteritis” ; medium sized vessels 10% CAUSE : HEP B
Libido Reticularis // skin ulcers // digital gangrene // fever // malaise
Dx : tissue bx / Angio of aneurysms ; if renal vessels —> HTN
TXM = high dose CC // HTN = ACE // Hep B = Prednisone + lamivudine + plasmaphoresis
Poly/dermatomyositis
20% = malignant ; can raise hand up neck and proximal muscle weakeness UE & LE
Heliotrope rash-eyelids // Gotttron papules -hands = skin rash common
Dx = muscle bx ; + ANA +ANTI-JO 1 antibodies
TXM = CC ; methotrexate ; IVIG
Reactive arthritis [5]
Post shigella ; salmonella ; yersenia ; campy ; chlamydia infection
Tetrad : conjunctives ; urethritis ; aseptic arthritis ; oral lesions
Keratoderma blennorhagica = feet nodules
HLA B27 + dx : joint destruction after 6 mos = permanent
TXM = NSAIDs ; PT ; less likely to develop if early TXM
RA [4]
Inflammatory synovial membrane pannus erodes cartilage
Boggy tissue ; symmetrical poly arthritis ; nodules on elbows
—> ulnar deviation of fingers
-Boutonnier/Swan neck deformities
-C1-2 joint prone to subluxation
60% = Sjorgens ; + RF and +Anti-CCP
Usually lasts longer than 6 weeks
TXM = Methotrexate ; NSAIDs ; etanercept ; TNF inhibitors
SLE [4]
Medications : procainamide ; isoniazid ; quinidine ; anti-TNF agents ; chlorpromazine; hydralazine; minocyclin]
Fever anorexia ; Arthralgia ; Raynard’s syndrome MALAR or DISCOID rash
+anti dx DNA ; + anti-smith ab
TXM = joint/skin—> hydroxuchloroquine
Minor —> NSIADs
GMN / pericarditis / hemolytic anemia —> CC
SE w steriods and SLE
Accelerate atherosclerosis
Osteoporosis and AVN of bone
Scleroderma
Diffuse fibrosis of skin and internal organs
Limited = CREST
Diffuse = skin hardening of face ; hands ; trunck ; limbs ORGANS = SEVERE
90% have Raynauds // Esoph motility —> lungs ; heart ; kidney
+AntiSCL 70 ; +Anitcentromere AB +AntiRNA polymerase Ab
TXM = rainouts = CCBs
HTN crisis —> ACE inhibitors
Sjorgens dysfunction TREATMENT AND ANTIBODIES
Exocrine ; + SSA [ro] + SSB [La]
+lymphs on lip bx
Anemia leukopenia eosinophilia
TXM = avoidance ; pilocarpine —> dry mouth
Topical cyclosporine —-> dry eyes
AC injury
Direct fall onto the shoulder ; over the handle bars
Pain at top os shoulder —> up towards the neck
+crossover test
TXM = ice sling 2-4 weeks ; grades 4-6 —> ortho surgery
MC bone fx in children
Clavicle
Most clavicle fx at the
Middle 1/3
Closer to the chest —> more concerned for organ damage medially
TXM of clavicle fx
Sling or fig of 8 splint [3-4 weeks]
Good ROM encouraged
MC injured RC muscle
Supraspinatus
RTC INJURY is mostly a
Chronic disorder —> inflammation causes pinching —-> tear
Pain over greater tuberosity ; lateral shoulder pain that radiates downward
+Neer and Hawkins
TXM = RICE ; steriods ; PT ; surgery
Biceps tendinopathy [4]
Overuse of biceps
Bicipital groove tenderness
Resisted supination of forearm pain
TXM = Rest ; sling ; NSaIDs
Elderly women with osteoporosis likely fx where
Proximal humerus fx
TXM proximal humerus fx
Mild / impacted = sling and swath 4 weeks
Dislocation / fx = surgical
Shoulder dislocation =
Fall on externally rotated abducted arm = trying to catch self while falling
Presents with arm ABDUCTED
Squared off
97% anterior
TXM = immediate closed reduction w post reduction X-ray
Sling swath 4 weeks ; start ROM at 2 weeks
Elbow joint is what type of joint
Hinge
Lateral epicondylitis
Tennis elbow ; overuse with supination and wrist extension
Pain on resisted wrist extension +point tenderness over lateral epicondyle
TXM = Rest ice ; NSAIDS
Medial epicondylitis
Golfers elbow
Point tenderness over medial epicondyle +pain on resisted wrist Flexion
TXM = stretching / REST / ice
Supracondylar fx think positive what on X-ray
Posterior fat pad
Radial head fx = fall
On an outstretched hand
Diffuse lateral elbow pain over radial head + posterior fat pad
TXM = sling 2-4 weeks
Colles fx
Distal radius fx
FOOSH
Silver fork deformity
TXM = closed reduction and cast 6-8 weeks
Intraarticular or comminited = surgery
Gamekeepers thumb
Them forced into radial deviation
Stretched ulnar collateral ligament
X-RAY r/o avulsion fx
TXM = thumb spica cast —> ORIF surgery
What dx test can confirm scaphoid fx best
Bone scan or MRI
Schapoid fx
Thumb spica cast 6-20 weeks
Repeat X-ray in 1 week
HIGH NON UNION RATE
Boxers fx TXM ; 4th and 5th metacarpal fx with volar angulation :
TXM = ulnar gutter splint with closed reduction
Close follow up
OR + IV abx if break in skin
De Quervains tenosynovitis TXM
Thumb spica splint for rest ; NSAIDs and steroid injection if non improvement
Trigger finger
Stenosis tenosynovitis @ flexor tendon
+snap with Flexion and extensions // pain
TXM = splinting NAIDs steriods surgery
Fingers of carpal tunnel compression
Them index and middle finger ; some radial aspect of ring finger
Thoacolumbar fx TXM
+wedge shaped or chance fx = pulled wide open
If fx is non displaced and no deficit —> brace for 6 weeks and PT
Fx or displaced with neuro deficit —> surgery
Monitor what 2 things for rib fx
Adequate ventilation
PNA
—consider nerve block for pain mgmt // ventilation assistance
AK
Chronic inflammatory disease ; starts in the pelvis SI joint
M>F ; +HLA B27 = 90% ; ESR elevated
Progresses to dec spine mobility and limited chest expansion
TXM = NSAIDs or TNF Inhibitors PT for flexibility or pt. Education
Thoracic outlet syndrome
Compression of brachial plexus and subcalvian artery and vein
Pain can come and go ; vague ; get an X-ray ; EMG ; Doppler of neck structures
TXM = posture exercise
Surgery = anatomic obstruction
Torticollis TXM
TXM = child = cervical collar
Adults = pain mgmt and PT
What muscle is affected by torticollis commonly
SCM +/- a mass on SCM
Pectus carinatum =
Pectus excavatum =
PC = protrusion of sternum
PE = extrusion of sternum
*both assoc : CHDz
Kyphosis [4]
Increase in dorsa curve of T spine —> collapse of vertebrae
Pain = acute Fx ; de conditioned back muscles
ANTERIOR BEND
TXM = PT for strengthening ; pain control ; surgery = kyphoplasty
scoliosis [4]
Idio LATERAL curve greater 10degrees
Hips/shoudler sit at diff levels
Dx : Cobb angle = greater 20 degrees
TXM = Over 20 = surgery and brace ; less 20 observe
consider closeness to puberty
TXM of LBP
Relative rest ; ice/heat ; NSAIDs ;
-PT after each episode-
Muscle relaxants ; narcotics no longer 3 days
Herniated disc pain is worse when
Flexion or valsava
+cross and straight leg raise
L4
L5
S1
Motor //
L4 —> dorsoflexion of foot
L5 —> dorsiflexion of great toe
S1 —> eversion of foot
L4
L5
S1
Reflex //
L4 —> knee jerk
L5 —> none
S1 —> ankle jerk
L4
L5
S1
// Sensory Pain
L4–> medial calf and foot
L5–> lateral calf and dorsal foot
S1 —> lateral foot and plantar foot
Herniated disc initial image
MRI
Cauda equina compression
L2 -S4 nerve root ; saddle anesthesia ; bowel bladder dysfunction
MRI
SURGICAL EMERGENCY
Spinal stenosis
Pt over 60 y/o male + Arthritis
Inflamed ligamentum flavum hypertrophy ; sponylolisthesis
Butt and leg pain chronic —> better when lean fwd and walk
Spaghetti legs mild LE weakness
MRI best ;
TXM = rest ; PT ; NSAIDS ; weight reduction ; nerve blocks ; surgery
Pt lifts heavy objects on a daily basis pain on the lateral leg and foot +SLR ; dx
Herniated disk
AVN
Loss of blood supply ; think : steriods or ETOH ; peds: dvd ; SCFE
Dull IR / ER pain decreased ROM
MRI best Dx
TXM = non eight bearing refer to ortho!
Hip fx think what kind of leg
Shortened
Then —> ER or IR
Hip dislocation think
MC : posterior dislocation ; knee contact with dashboard —> ACL
Posterior : short and internally rotated
TXM = immediate reduction with post reduction film
Tibial plateau fx think
Axial load injury = jump from high place and land
+/- weight bearing ;
X-ray —> CT ; tibial depression r/o
TXM = immobilize and non weight bearing —> surgical
Patellar fx
Direct blow or forced Flexion of the quadriceps muscle
Pain with knee EXTENSION
TXM = mild = immobilization
Displacement more 3mm = surgical
MCL vs LCL
MCL = valgus
LCL = varus
Associated nerve injury with LCL injury
Peroneal nerve
Grade 3 MCL and LCL injury TXM
= surgery ; due to buckle and insecurity of knee
PCL MOI commonly
Anterior tibia or dashboard injury in MVA
PCL nerve and artery that could be injured
Peroneal nerve
Popiliteal artery
Joint line pain + effusion + locking or clicking
+mcmurray and apley
Prepatellar bursitis
Excessive kneeling or trauma to the knee
3 ligaments commonly hurt in ankle injury
ATF = anterior talofibular [MC]
PTF = posterior talfobular
CF = calcaneaofibular
Ligament ankle injury =
Sprain
Ottawa ankle rules
Bone TTP along with—> distal post edge of tibia // tip of medial mall
Bone TTP along distal post edge of fibula or tip of // lateral mall
Inability to bear weight
Ottawa foot rules
Bone TTP at base of 5th MT
Bone TTO at navicular bone
Inability bear weight
MC ligament injured in ankle fx
Deltoid ligament
Positive Peroneal nerve damage =
Foot drop
Charcot mgmt
Walking correction ; wide toe box shoe
MC location of avulsion fx
5th base of MT
TXM = hard shoe return to activity as comfort
How long does it take for X-ray evidence in stress fx ; what can confirm early
X-ray
Early = MRI or bone scan
Large muscle groups affected think
Polymyositis
OGS disease of the tibial tubercle improved with what
Quad and hamstring strengthening
First line for AK txm
NSAIDs
JIA TXM of choice [severe]
CC
JIA mild TXM
Naproxen first
2 equal first line TXMs for de quarvains
Splinting and Steriod injections
Most sensitive pain ROM with hip intrarticualr pathology is pain with
Internal rotation
