msk Flashcards
hip trauma + pain + leg shortened + INTernally rotated + ADducted = ?
hip dislocation
hip trauma + pain + leg shortened + EXTernally rotated + ABducted = ?
hip fx
4-10yo with weeks of painless limping, worse at end of day, loss of ABD and IR, think this
leg-calve-perthes disease/avascular necrosis
crescent sign
AVN
treatment for AVN
bracing
treatment of SCFE
ORIF
valgus stress with rotation to the knee causes ___
MCL tear
+ lachmans test
ACL tear
which meniscal tear is more common
medial
+ mcmurrays sign
meniscal tear
whats the best xray to get for patellar fx
sunrise view
pt fell on their knee while walking upstairs, think?
patellar + quad tendon rupture
palpable defect above the knee
quad tendon rupture
patellar is below
in knee dislocations (tibial-femoral dislocations), injury to ? is the biggest concern
popliteal artery**
peroneal nerve
tibial nerve
a pt has knee pain after a fall from a height, consider this
femoral condyle fx (also an emergency just like knee dislocations)
what will you see with loss of peroneal nerve function
foot drop
the exam might use this word instead of patellofemoral syndrome
chondromalacia
lateral knee pain worse with running, lateral tenderness
IT band syndrome
ottawa ankle rules
pain at lat malleolus
pain at med mallelous
can’t walk >4 steps
ottawa foot rules
midfoot pain
5th metatarsal pain
navicular pain
can’t walk >4 steps
anyone w/ a distal ankle fracture should also have this ruled out
maissoneuve fx
mgmt for an open fx
debride w/in 8 hours, give abx, reduce + immobilize
what is the MC cause of a proximal femur fx
osteoporosis
transverse fx thru the diaphysis of the 5th metatarsal
jones fx
fx at the base of the 2nd metatarsal
lis-franc
you can only do 1 test to assess for an acl tear, which is the single best one
lachman
athlete with insidious, aching pain, swelling, tenderness in midfoot area, negative xray, suspect this
3rd metatarsal fx/stress fx
pain and numbness near tarsal heads in women wearing high heels/restrictive shoes
mortons neuroma
transverse AVULSION fx at the base of the 5th metatarsal
pseudojones fx
what is a jones fx most commonly complicated by
nonunion or malunion
where are herniated discs most common
L5-S1, also L4-L5
how do you test motor fn of L5
dorsiflexion of big toe
how do you test motor fn of S1
plantar flexion
how do you test motor fn of L4
ankle dorsiflexion
where is the sensory distribution of L5
lateral thigh/leg, foot dorsum (laterally)
where is the sensory distribution of S1
posterior leg/calf, plantar surface of foot
where is the sensory distribution of L4
anterior thigh
what reflex do you lose with loss of S1
ankle jerk
what reflex do you lose with loss of L4
knee jerk
3 things that cause spinal compression fx
fall from height (kids)
osteoporosis (old)
malignancy
scoliosis is an angle > ____
10 degrees
at what degrees do you brace for scoliosis
20-40
at what degrees do you surgery for scoliosis
40+
salmonella osteomyelitis is pathognomonic for ______w
sickle cell disease
gold standard dx for osteomyelitis
bone aspiration
best imagining for osteomyelitis
mri
when is compartment syndrome most common
after fx of long bones
osteosarcoma most commonly mets to where
lungs
“onion peel” appearance on xr
ewings sarcoma
mc place for osteosarcoma
long bones
mc place for ewings sarcoma
pelvis and femur
so in GI, an asx elevated alk phos indicates PBS, but in msk it could indicate what
pagets disease
whats the other name for pagets disease that the pance might use bc it hates us
osteitis deformans
“blade of grass/flame shaped” lucency on xr
pagets dz (lucency + sclerosis)
“cotton wool appearance” on skull
pagets dz
mgmt for pagets dz
bisphosphonates
with an anterior shoulder dislocation what must you r/o
axillary nerve injury
how do you r/o axillary nerve injury
pinprick over deltoid
empty can tests what specifically
supraspinatus
hawkins tests what specifically
impingement
drop arm tests what specifically
impingement
neer test tests what specifically
impingement
lift off tests what specifically
subscapularis
medial rotation against resistance tests what
subscapularis
abduction against resistance tests what
supraspinatus
lateral rotation against resistance tests what
teres minor and infraspinatus
for proximal humerus fx you must r/o what
brachial plexus injury
for humeral SHAFT fx you must r/o what
radial nerve injury
how does radial nerve injury present
wrist drop
3 things in the thoracic outlet
brachial plexus
subclavian vein
subclavian artery
what is a + adson sign
loss of radial pulse w/ head rotated to affected side (of a thoracic outlet injury)
direct blow to forearm causes a proximal ulnar shaft with anterior radial head dislocation, this is called?
monteggia fx
foosh or direct blow causes mid-distal radial shaft fx with dislocation of distal radio-ulnar joint. this is called?
galeazzi fx
if the fx has a fancy name like monteggia or galeazzi what is the tx
ORIF they are unstable
excessive forearm pronation and wrist extension
lateral epicond
excessive forearm supination and wrist flexion
medial epicond
“dinner fork deformity” on xr
colles fracture
dorsal angulation of hand
colles fx
ventral angulation of hand
smiths fx
flexed pip, extended dip
boutonniere deform
extended pip, flexed dip
swan neck deform
