MSK Flashcards
classic signs of hip fracture?
shortened and externally rotated leg
Dynamic hip screw
weight bearing status post op
immediate post op weight bearing
knee pain
> twisting injury
knee gives way
meniscal tear
pain worse on straightening the knee
ACL stops the ____ from sliding ____?
anterior cruciate ligament stops the tibia from sliding forward
1st line for IX ACL tears
MRI scan
> RICE
osgood schlatter disease
growth of tibial tuberosity
pain in anterior aspect pf knee
pain exarcebated with physical activity
dynamic hip screw or intramedullary nail?
inter trochanteric fractures prefer DHS
pain analgesia in NOF
iliofascial nerve block
radiculopathy follows?
dermatomal distribution
C8
achilles tendonitis mx?
rest, NSAIDS
> 7 days
refer to physio
Lumbar spinal stenosis?
central canal narrowed by tumour/ disc prolapse / similar degenerative changes
positional element ; better on sitting
Simmonds triad
palpation of tendon
examine angle of decline at rest
calf squeeze
suspected osteoporotic vertebral fracture 1st line investigation
xray spine
common complication of colles fracture resulting in weakness of index finger flexion?
median nerve injury
radial nerve injury affects?
extension of digits
all proximal pole fractures require?
surgical screw fixation
scaphoid fractures
when is urgent surgical fixation required?
displaced S frcatures
proximal scaphoid pole fractures
undisplaced scaphoid fractures?
cast 6-8 weeks
initial management of suspected / confirmed scaphoid fracture?
immobilsation with a futuro splint
refer to ortho with further imaging 7-10 days later
how to manage ankle fractures?
urgent closed reduction
ottawa ankle rules?
xrays only needed
1- pain in malleolar
2- tender over distal tibia
3- Bone tenderness over distal fibula
osteomyelitis investigation?
MRI of affected area
> swelling
infection
fever
when does surgery precede xray for ankle fracture?
evidence of neurovascular compromise
> parasthesia
reduced sensation
prolonged capillary refill
bouchards nodes are?
bony enlargements of PIP joint
scaphoid fracture signs?
maximal tenderness over the anatomical snuffbox
pain elicited on telescoping of the tumb
pain on ulnar deviation
Red flags for lower back pain?
<20, >50
history of previous malignancy
night pain
history of trauma
systemically unwell
most common mechanism for ankle sprain?
inversion of the foot
s1 nerve root compression
sensory loss lateral aspect of foot
weakness in plantar flexion
reduced ankle reflex
+ sciatic nerve stretch test
initial improvement of cellulitis with antibiotics but persistent discharge and tenderness suggests?
abscess formation
> surgical drainage
what back pain requires specialist review?
thoracic > lumbar > neck
colles fracture?
dorsally displaced distal radius
dinner fork deform
sickle cell and osteomyelitis?
non typhi salmonella
prolapsed disc features?
leg pain
worse on back
> worse when sitting
Mx of prolapse disc?
analgesia
physiotherapy
exercises
> 6 weeks
then refer for MRI
de quervains tenosynovitis?
inflammation of the tendon on lateral aspect of the wrist and thumb
finkelsteins test?
de quervains tenosynovitis
pull thumb of the patient in ulnar deviation
and flexion of thumb
most common reason THR is revised?
aseptic loosening
scaphoid fracture most common neurovascular structure to be involved?
dorsal carpal branch of the radial artery
L3 nerve compression?
sensory loss over anterior thigh
weak quadriceps
reduced knee reflex
Weber A fractures
management?
minimally displaced
stable
may weight bear / CAM boot
patella fractures
direct injury?
undisplaced crack / comminuted fracture
intact extensor mechanism
which patella fractures can be managed non op?
undisplaced
vertical (transverse)
intact extensory mechanism
iliotibial band syndrome?
knee pain in runners
lateral knee pain
L4 nerve root compression
sensory loss anterior aspect of the knee
medial malleolus
weak knee extesnion
hip adduction
reduced knee reflex
nerve most likely to get injured in knee arthroplasty?
common peroneal nerve
Osteosarcoma
mesenchymal tissue
bone
bone destruction
ensure pt seen by specialist in 48 hours
rib fracture management?
conservative
appropriate analgesia
> NSAIDs
>Opioids
>intercostal nerve blocks
what is cubital tunnel syndrome?
compression of the ulnar nerv and can present with tingling/numbness of 4th/5th finger
Baker’s cyst?
asymptomatic fluctuant swelling behind the knee
> popliteal cyst
what is a popliteal cyst?
distension of the gastrocnemius-semimembranous bursa
biceps tendon rupture
2 tendons
long > glenoid
short > coracoid process
popeye deformity?
rupture of the proximal tendon causes this
muslce > bulge in the arm
anterior shoulder dislocation?
external rotation and abduction of the upper limb
what is the phalens test?
carpal tunnel syndrome
reverse prayer sign
30-60 s
what are oslers nodes
what can cause it?
tender
purple/red raised lesions with a pale centre
endocarditis
>immune complex deposition
> SLE
>gonorrhoea
> typhoid
what is the triad of fat embolism?
respiratory
neurological
petechial rash
rotator cuff injuries
subacromial impingment
calcific tendonitis
cuff tear
arthropathy
