MSK Flashcards
Mcmurray test
Meniscal tear
Talar test
Ankle instability
Tinels sign
Carpal tunnel syndrome
Spurling
Cervical nerve root compression
Lachman test
Anterior cruciate ligament tear
Straight leg raising lift
Lumbar nerve root compression
Drop arm test
Rotator cuff evaluation
Finkelstein test
De Quervain’s tenosynovitis
Osgood Schlatter disease
Patellar swelling and pain.
Usually during a period of growth spurt (tanner 3) and adolescents who play or participate in sports involving running or jumping.
Repeated stress causes inflammation below the patellar tendon where it attaches to the tibia.
New bone growth can occur where the tendon pulled away from the tibia resulting in a bony lump.
Treatment:
Reduce pain and swelling with mild pain relievers (NSAIDS)
physical therapy
Avoid heavy quadriceps loading or deep knee bending. Light weight training and exercise can help symptoms.
Reactive
Multi organ system inflammatory condition. Usually caused by STI. Gonorrhea or chlamydia.
Can’t Pee (Urethritis)
Can see (conjunctivitis)
Can’t climb a tree (knee or ankle involvement)
Treatment:
Treat underlying cause (abx)
Steroids
NSAIDs
Differences between LS strain and radiculopathy
LS caused by irritation of the spine and supporting muscles most common reason for low back pain. There are no neurological abnormalities in LS strain.
LS radiculopathy is caused by neural structure damage. Pt will have altered neurological exam including abnormal straight leg raising sensory loss or alter deep tendon reflexes.
Treatment of strain: analgesics, physical therapy, heat and ice, muscle relaxers.
Treatment for radiculopathy: SAME as above. Specialty evaluation if persistent neuro deficit without resolution after 4-6 weeks of conservative therapy.
Heberden nodes
DISTAL joints of hands with osteoarthritic nodes
Bouchards nodes
PROXIMAL joints of hands have osteoarthritic nodes
Osteoarthritis
Assessment: pain, tenderness, stiffness predominately in the morning. Your strange emotion crepitus. Erythema and warmth is usually absent.
X-ray to distinguish between type of arthritis. Imaging will show narrowing of joints base changes in the bone and the presence of bone spurs or osteophytes.
Conservative treatment is recommended strengthening low impact aerobic exercises. Weight loss. NSAIDS. Intraartricular corticosteroid injection possibly.
Grade 1 sprain
Mild stretching up with microscopic tears. No joint instability on exam, can bear weight with mild pain
Grade 2 sprain
In complete tear of ligament. Mild to moderate joint instability, decreased range of motion, weight-bearing and ambulation is painful. Mild to moderate pain, swelling, tenderness and ecchymosis.
Refer to ortho for grade 2/3 sprain
Grade 3 sprain
Complete tear of ligament. Pain, swelling, tenderness, Ecchymosis. Loss of function and motion. Unable to bear weight and ambulate.
Refer to ortho for grade 2/3 sprain.
Treatment of acute gouty arthritis attack
Treatment should start within 24 hours of onset.
NSAIDs, corticosteroids, and oral colchicine are first line options
Prevention of acute gouty arthritis attack
Allopurinol or febuxostat - xanthine oxidase inhibitors- 1st line in urate lowering therapy.
Colchicine is appropriate as first line therapy with appropriate dose adjustment in CKD.
If allopurinol intolerant - a 24 hour urine collection for uric acid level would be helpful. If a patient turned out to be an under-excretor, Probenecid would be the right approach for prophylactic treatment.
