MSK

Question 1

What is the most common bony tumor in children?

Answer 1

Osteosarcoma is the most common bony tumor in kids

Likes the metaphysis

Codman’s angle can be seen on x-ray

Question 2

What is the innervation for the gluteus medius?

Answer 2

the gluteus medius is innervated by the superior gluteal nerve (L4-S1)

Question 3

What is seen on imaging in a patient with ankylosing spondylitis?

Answer 3

Look for syndesmophytes on imaging.

Syndesmophytes are calcifications or ossifications in the interspinal ligaments or annulus fibrosis which eventually leads to fusion of the spine or sacroilliac joint.

Question 4

what muscle is most commonly involved in lateral epicondylitis?

Answer 4

the extensor carpi radialis brevis is commonly involved in lateral epicondylitis (tennis elbow).

*look for pain with resisted wrist extension, pain over the lateral epicondyle, and a history of lots of supination

Question 5

Muscle energy to the second rib involves which muscle?

Answer 5

muscle energy to the second rib involves activation of the posterior scalene

Question 6

What is patellofemoral pain syndrome?

Answer 6

Patellofemoral pain syndrome is knee pain caused by a overuse or misalignment.

associated with: a wide Q angle and weakness in the vastus medialis causing the patella to be pulled laterally during contraction of the quadraceps

Question 7

What is the most appropriate treatment for a statin induced myopathy?

Answer 7

stop the statin.

start the statin at a lower dose or switch statins after the pain resolves.

Question 8

Characteristics of Lambert-Eaton

Answer 8

Lambert- Eaton:

proximal muscle weakness (problems climbing stairs, getting out of bed, getting up from a chair)

weakness improves with use

antibodies against the pre-synanptic calcium channels so there is impaired ACh release into the NMJ.

Question 9

What are the characteristics of Myasthenia Gravis?

Answer 9

Myasthenia Gravis

antibodies against the nicotinic ACh post synaptic receptors in the NMJ

weakness is worse with activity

respiratory muscle weakness

facial, occular, bulbar muscles likely to be affected

Question 10

What condition is associated with Myasthenia Gravis?

Answer 10

Thymomas are associated with myasthenia gravis

Question 11

A positive cross body adduction test (grabbing the opposite shoulder with the had. AKA: scarf test)

Answer 11

A positive cross body adduction test is highly indicitive of

osteoarthritis of the acromioclavicular joing

Question 12

a pitcher with weak external rotation of the shoulder

what is the most likely injury?

Answer 12

a torn infraspinatus muscle

Question 13

what are the signs and symptoms of

bursitis in the shoulder?

Answer 13

bursitis in the shoulder commonly presents with

vague shoulder pain

pain doing overhead activities (brushing your hair)

normal strength

may awaken the patient

Question 14

what are the signs and symptoms of a

subscapularis tear?

Answer 14

a subscapularis tear will have a (+) drop arm test and

weakness in internal rotation

Question 15

Signs/Symptoms of Friedrick Ataxia

Answer 15

Friedrick Ataxia is an AR trinucleiotide repeat

symptoms usually begin between 5-15

high arches

problems with proprioception, vibration, light touch, and motor

may also have a loss of coordination, hearing and vision impairment, and slurred speech

Question 16

What cervical nerve innervates the triceps and the sensation to the middle finger?

Answer 16

C7

look for a herniation of a disk between C6-C7

Question 17

Injury to what cervical nerve would result in decreased sensation to the neck top of the shoulders?

Answer 17

Injury to the C4 (injury to C3-C4) would result in loss of sensation to the neck and the top of the shoulders

Question 18

what findings are consistant to an injury of C5?

Answer 18

Injury to C5 (segment C4-C5) is consistent with

decreased strength in the biceps

decreased sensation on the outer arm

Question 19

what findings are consistent with injury to C6

Answer 19

injury to C6 (herniation between C5-C6) leads to

decreased sensation of thumb and index finger

decreased strength in wrist extension and biceps

Question 20

tell me about trigger finger

signs and symptoms

who is at a higher risk

Answer 20

Trigger finger- aka stenosing flexor tenosynovitis

s/s: painless “catching” during flexion of the digit

episodic

if it becomes painful its on the volar aspect

nodules on the MCP joint

diabetics >45 years old

Question 21

Tell me about dupuytren contracture

Answer 21

Dupuytren contracture is a loss of extension at the MCP joint.

The flexion is fixed and chronic

nodules are in the palmar fascia