MSK Flashcards
What do we use the McMurray test for?
The McMurray test, also known as the McMurray circumduction test is used to evaluate individuals for tears in the meniscus of the knee.
How does JIA present?
For a diagnosis to be made the child must have had objective arthritis in the joint for at least 6 weeks. There may be stiffness on waking or after periods of inactivity. In certain sub-types the child may have a spiking fever, a salmon-coloured rash over the trunk and proximal extremities, uveitis, and rheumatoid nodules on extensor surfaces of tendons.
What is Felty syndrome?
Felty syndrome is a rare autoimmune disease that occurs in less than 1% of people with rheumatoid arthritis (RA).
How does Felty syndrome present?
Rheumatoid arthritis: An autoimmune condition that causes painful, swollen, and stiff joints
Splenomegaly: An enlarged spleen
Neutropenia: A low white blood cell count (and thrombocytopenia)
What is the flexor pollicis longus?
Muscle in the forearm and the hand which flexes the thumb
How does dislocation of the patella present?
Dislocation of the patella is most common in adolescents girls.
The patella usually dislocates laterally and there may be an associated osteochondral fracture.
Presents with knee pain and the knee is held in flexion with lateral displacement of the patella.
How does ACL injury present?
An audible pop often accompanies ACL injury.
* Within a few hours, a large haemarthrosis develops.
* In the absence of bony trauma, an immediate effusion is believed to have a 70% correlation with an ACL injury of some degree.
* The classic “terrible triad”
What does the ACL do?
Attaches the femur to the tibia
Which test do we use to dx ACL injury?
The Lachman test
How does patellar fracture present?
Pain
Overlying abrasions, ecchymosis over the anterior aspect of the knee, or both may be present.
There may be an associated haemarthrosis.
Displaced, transverse fractures result in an inability to straight leg raise (also a feature of rupture of quadriceps tendon or patellar tendon).
What is the Boutonniere deformity?
The Boutonniere deformity describes a fixed flexion deformity at the proximal interphalangeal (PIP) joint along with
hyperextension of the distal interphalangeal (DIP) joint of the finger.
What is the Z deformity?
Seen in RA
It is seen at the thumb and consists of hyperextension of the interphalangeal joint, & fixed flexion and subluxation of the metacarpophalangeal joint.
How does the back pain in ankylosing spondylitis present?
Improves with exercise - inflammatory
In which condition do you see the dinner fork deformity?
Colles’ fracture - dorsally displaced distal radius fracture
Seen in older patients who have fallen onto their outstretched hands
In which patients would you most likely see a supracondylar fracture
Children falling onto an outstretched hand
How does spinal stenosis present?
The classic presentation is radiating leg pain associated with walking that is relieved by rest (neurogenic claudication).
What is first-line for treating RA?
DMARD e.g. methotrexate
What is a Maisonneuve fracture?
The Maisonneuve fracture is a spiral fracture of the upper third of the fibula associated with a tear of the distal tibiofibular sundesmosis and the interosseous membrane usually involvina a pronation-external rotation force. There is an associated fracture of the medial malleolus or rupture of the deep deltoid ligament.
What is a March fracture?
Stress fracture of the metatarsals
Seen with excessive walking/running
What are the indications for a DEXA scan?
Patient <75y.o with a history of a low trauma fracture
Incidental x-ray finding of osteopenia or vertebral collapse or in the investigation of thoracic kyphosis or loss of height.
Postmenopausal women with a family history of a hip fracture.
Low BMI <19kg/m?
Long term steroid treatment
Oestrogen deficiency (e.g. premature menopause <45y.o. or primary hypogonadism)
How does tarsal tunnel syndrome present?
Tarsal tunnel syndrome (compression of the posterior tibial nerve as it passes underneath the flexor retinaculum behind the medial malleolus can produce the lower limb equivalent of carpal tunnel syndrome) and causes mid-foot pain.
How do scaphoid fractures present?
Clinically patients present with snuff box tenderness.
* In addition, look for tenderness over the palmar & dorsal aspect of the scaphoid, pain on compressing the thumb longitudinally and pain on gentle flexion & ulnar deviation of the wrist.
What is the function of the mental nerve?
The mental nerve is a sensory nerve which comes off the inferior alveolar nerve at about the level of the mandibular 2nd premolars, which then exits the mandible via the mental foramen supplying sensation to the chin & lower lip.
How does complex regional pain syndrome present?
It is typically characterised by segmental limb pain after a (usually) relatively minor injury to a limb but is more
severe and lasts much longer than would normally be expected given the injury.