Msk Flashcards
Normal elbow carrying angle?
Increased in ?
5-10 degrees
Turners syndrome
Foot features of rheumatoid arthritis
Hallux/ hindfoot valgus
Toe crowding
Flattened arches
Causes of inability to fully extend elbow
Synovitis, osteoarthritis , trauma , soft tissue conditions
Finger findings of rheumatoid arthritis
Ulnar deviation of phalanges and MCP joints
Z deformity of thumb
Causes of sausage shaped fingers
Psoriatic arthritis
Also present in Reiters disease
Nail deformities in psoriasis
Pitting, onycholysis, hyper keratosis, ridging, discolouration
Where is the scar from a hip replacement
Lateral aspect
Dislocated hip held how?
Adducted and flexed
Fractured neck of femur held how ?
Leg shortened and externally rotated
Most comfortable way to hold painful hip with synovitis
Slight flexion, abduction and external rotation
What is apparent leg length
Causes of discrepancies
Umbilicus to medial malleolus
True shortening or tilting of pelvis
What is trendelenburgs test for?
How is it done?
What happens in a positive test? Cause?
Tests hip abductees
Ask the patient to stand on one leg
Non weight bearing side sags (instead of rises)
L5 lesion, proximal myopathy, hip joint disease
What is indicated if sideways flexion is more limited than forward
Ankylosing spond
Difficulty walking on toes
Difficulty walking on heals
S1 lesion
L4/5
Weak quadriceps suggests
L4 root damage
Weakness of muscles of foot an ankle suggest
L5 root damage
Weakness of calf suggest
S1 root damage
Loss of lumbar lordosis characteristic of
Ankylosing spond
Side effects of steroids
BECLOMETHASONE Buffalo hump Easy bruising Cataracts Larger appetite Obesity Moon face Euphoria Thin arms and legs Hypertension, hyperglycaemia A vascular necrosis of femoral head Skin thinning Osteoporosis Negative nitrogen balance Emotional liability
Rheumatic fever criteria
Major JONES Joints (migratory) O (heart shaped) carditis (murmur) Nodules - subcutaneous on extensor surfaces Erythema marginatum (pink rings on trunk and inner surface of limbs) Sydenham's chorea (uncoordinated jerking affecting face hands and feet) Minor PEACE PR interval (prolonged) ESR elevated Arthralgia CRP elevated Elevated temperature
Need 2 major (or 1 and 2 minor) plus evidence of recent infection
What is genu recurvatum
Knee hyperextension
What do cafe au lait spots suggest
Neurofibromatosis
Sacral dimple with hairy patch may indicate
Spina bifida occulta
What is spondylolisthesis
How is it felt
Forward displacement of vertebrae usually after a fracture
Palpable step
Eg of cause of tenderness over sacroiliac joints
Ankylosing spond
Test used to give a quantitative measure or lumbar spine flexion
Schobers test
Draw lines
Femoral nerve roots
L2-4
Pitting / nail ridges seen in
Psoriasis
Onycholysis seen in
Psoriasis, fungal nail, hyperthyroidism
What is onychogryphosis ?
Seen in?
Hypertrophic nails that resemble claws
Post traumatic, peripheral vascular disease
What is sclerodactyly
Thickening and tethering of skin over fingers
What is dactylitis ?
Seen in ?
Sausage fingers
Psoriatic arthritis, ankylosing spond, IBD
What is a boutonnière deformity
First joint bent towards palm and last away
When do you see squaring of 1st carpalmetacarpal joint?
Osteoarthritis
What nerve supply’s sensation to the anatomical snuff box
Radial
What does increased stepping height indicate
Foot drop
Pelvic tilt indicates
Hip abductor weakness
Causes of popliteal swellings
Bakers cyst
Popliteal aneurysm
To finish gals
Perfom focused examination joints with suspected pathology
Associations with dupuytrens
Familial, T2DM, liver cirrhosis
Finger abduction done by
Ulnar
Wrist / finger extension
Radial nerve
Thumb abduction
Median nerve
Things to finish a knee exam
Neuro vascular examination of lower limbs
Examine the joint above and below
Request further imaging if suspected X-ray / MRI
Putting hands behind head tests
External rotation
Pitting hands up back tests
Internal rotation
Pain on resisted external rotation suggests
Infraspinatus, teres minor tendonitis / torn
Abduct shoulder from neutral position pain
Supraspinatus
Painful arc indicates
Supraspinatus
Lift off test is for
Subscapularis
To finish shoulder exam
Perform full neuro vascular exam
Examine spine and elbow
Request further imaging if required X-ray / MRI
Apparent vs true leg length
Apparent - umbilicus to medial maleolus
True - ASIS to medial maleolus
Causes of hyper lumbar lordosis
Obesity
Tight lower back muscles
Abnormal hair growth on back
Spina bifida
Sciatic stretch test- positive results suggests
Sciatic nerve root impingement
Usual cause of sciatic nerve root impingement
Prolapsed disk
Finish spine exam
Full neuro vascular examination of all limbs
Take plain radiographs of spine if indicated
Perform further imaging if indicated MRI / CT
