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NPTE > MSK Advanced Differential Diagnosis > Flashcards

MSK Advanced Differential Diagnosis Flashcards

1
Q

Subacromial impingement

A

Ant/lat pain
Pain at night

Painful arc 60-120 deg

Special tests:
Neer
Hawkins
Yocum
Jobe (empty can)

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2
Q

Rotator cuff tear

A

Age >40 (overuse) or traumatic MOI

Ant/post/sup shoulder pain w/ loss of strength

Pain during sleep, worst at night

Weakness and atrophy

Special tests:
ER lag
Drop arm
Hornblower’s
IR lag
Lift off
Belly press
Bear hug

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3
Q

SLAP - labrum tear

A

Traumatic MOI

Deep anterior shoulder pain

Click/clunk/locking
Pain w/ throwing, biceps loading

Special tests:
Biceps load
Active O’Brien
Clunk

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4
Q

AC Joint Injury

A

Trauma that displaces the shoulder girdle inferiorly or heavy weightlifting

Pain at sup shoulder

Painful arc 170-180
Pain w/ horizontal add

Step deformity

Special tests:
horizontal adduction
Paxinos sign
AC sheer

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5
Q

Bicipital tendinitis

A

DDx against adhesive capsulitis

Age 20-40
Common in throwers
Anterior shoulder pain
Agg w/ overhead mvmts
Limited active ER is when arm is at 90 abd

Pain on combined passive shoulder and elbow extension

Special tests:
Speed’s
Yergason’s

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6
Q

Adhesive capsulitis

A

DDx against biceps tendinitis

Age 35-70
Common in pts w/ thyroid abnormalities and diabetes

Poorly localized shoulder/upper arm pain

Agg w/ all A/PROM shoulder mvmts

All motions limited especially ER (ER > ABD > IR)

Capsular end feel

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7
Q

Lateral epicondylitis

A

Lateral aspect of elbow pain

Extensor carpi radialis brevis involved - activities involving repeated wrist ext/grasping increases pain (gradual overuse)

Special tests:
Cozen’s
Mills
Maudsley

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8
Q

Medial epicondylitis

A

Anteromedial aspect of elbow pain

Pronator teres + flexor carpi radialis involved - activities involving repeated wrist flexion increases pain (gradual overuse)

Special test:
medial epicondylitis test

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9
Q

Olecranon bursitis

A

Student’s elbow

Posterior aspect of elbow pain and swelling

Inflammation of olecranon bursa - contact w/ posterior elbow aggs

Pain w. full elbow flexion/extension

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10
Q

De Quervain’s tenosynovitis

A

Tenderness over lateral wrist and thumb

Abductor pollicis longus and extensor pollicis brevis (APL, EPB) affected

Severe pain w/ ulnar deviation and thumb flexion and add

Special tests:
Finkelstein’s

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11
Q

Carpal tunnel syndrome

A

n/t in median n. distribution of hand

repetitive aactivities and sustained positioning of wrist aggravates pain

thenar muscle atrophy seen in later stages

night pain

special tests:
phalen’s
tinel’s

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12
Q

Colle’s fracture

A

MOI FOOSH

Dorsal displacement of distal fragment of radius

Dinner fork deformity

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13
Q

Smith fracture

A

MOI fall on flexed wrist

Volar displacement of distal fragment of radius

Garden spade deformity

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14
Q

TMJ mouth opening

A

Depression of mandible
35-55 mm
Lateral pterygoid

“La” = opening

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15
Q

TMJ mouth closing

A

Elevation of mandible

Temporalis
Masseter
Medial Pterygoid

“MMT” > “mmm” > closed mouth

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16
Q

TMJ hypomobility

A

Decreased mouth opening and deviation to the same side

17
Q

TMJ hypermobility

A

Increased mouth opening and deviation to opposite side

18
Q

TMJ disc displacement with reduction

A

Clicking heard
No deviation
No difficulty with mouth opening

19
Q

TMJ synovitis

A

Pain, swelling
Limited opening
No deviation

20
Q

TMJ capsulitis

A

Pain
Limited opening
Deviation to same side

21
Q

Iliotibial band syndrome

A

Age 25-55 years

Pain over lateral aspect of thigh and lateral aspect of knee

Snapping sensation over the greater trochanter as IT band passes

Pain w/ active knee ext to flexion

Tenderness over lat epi of femur and lateral aspect of knee

Special test:
Noble compression

22
Q

Piriformis syndrome

A

Age 25-55

Pain over butt, posterior thigh, back of leg

Pain may radiate down leg mimicking radicular sxs

TTP sciatic notch

Pain w/ active ER, passive IR

Special test
FAIR

23
Q

Avascular necrosis of hip

A

Age 30-50
Males > females

Often bilat, can be unilat

Dull aching/throbbing in groin/lat hip/butt

Pain inc w/ activity

Dec ROM in capsular pattern
FABIR especially limited

24
Q

Osteoarthritis of hip

A

Age > 50
Females > males

Can be unilat/bilat

Anterior thigh and anteromedial thigh pain which increases with weight bearing

Progressive pain and morning stiffness < 60 min

Most limited and painful - IR < 20, reproduced by passive rotation of hip

25
Q

Anterior cruciate ligament

A

Primary restraint for anterior translation and medial rotation of tibia on femur

MOI:
hyperextension + valgus force + planted foot

Sxs:
deep pain, strong pop heard at injury, instability while descending stairs

Special tests:
Lachman’s
Anterior drawer
Pivot shift

26
Q

Posterior cruciate ligament

A

Primary restrain for posterior translation and medial rotation of the tibia on the femur

MOI:
hyperflexion/dashboard injury

sxs:
deep pain, instability, mild pop heard at injury

special test:
posterior drawer
posterior sag sign

27
Q

Patellofemoral pain syndrome

A

Runner’s knee

Age < 50
Female > male

Anterior knee pain, lateral patellar tracking

Agg w/ prolonged sitting, stairs, kneeling

pain at end range knee flexion w/ PROM

TTP ant knee especially w/ patella compression

Special test:
Clarke
Step down

28
Q

Osgood schlatter disease

A

Age 8-13 female, 10-15 male

Traction apophysitis of tibial tubercle

Anterior knee pain w/ visible lump over site

Pain w/ running, jumping, squatting, kneeling, acute knee impact, ascend/descend stairs

Resisted knee ext or quad stress inc sxs

29
Q

Tarsal tunnel syndrome

A

Pain, n/t over medial malleolus
Posterior tibial nerve distribution

Aggravated with excessive dynamic pronation in walking/running

Pain w/ passive extreme DF and eversion; active PF and inversion

Special test:
Tinels

30
Q

Medial tibial stress syndrome (posterior shin splints)

A

Posterior-medial lower leg pain

Agg with exercising over involved lower extremity

Pain w/ active combined PF and inversion

TTP posteromedial calf

31
Q

Achilles tendinitis

A

Posterior ankle pain

Agg with jumping, running

Painful active PF (heel raises), pain with passive OP to DF, restricted ROM DF

TTP over posterior ankle

32
Q

Plantar fasciitis

A

Pain over sole of foot (under heel)

Agg with WB, especially first thing in the morning

Pain w/ passive OP to great toe ext

TTP plantar aspect heel

Special test:
Windlass

NPTE (40 decks)

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