MSK and Rheumatology Flashcards
What is the appropriate timing for hip fracture surgery?
Generally within 24 hours of the injury and not longer than 72 hours
What should be given prior to surgery for femoral neck fractures?
Single dose of IV prophylactic antibiotics - usually cefazolin
What are the four muscles of the rotator cuff?
Supraspinatus
Infraspinatus
Teres minor
Subscapularis
A patient presents with conjunctivitis, urethritis, and arthritis. What diagnosis do you suspect?
Reactive arthritis
What is the intitial treatment for a Jones fracture?
Spinting and non-weightbearing
What is the most common age range for osteosarcoma?
15-25 years old, males
Anti-Jo-1 antibodies should make you think of what diagnosis?
Polymyositis
What is the name for the 4th and 5th metacarpal fractures that often result from throwing a punch?
Boxer Fracture
You suspect a patient has polyarteritis nodosa. What is the test for a definitive diagnosis and what is the treatment?
Biopsy, high dose steroids
What is the most useful physical exam test for diagnosing an ACL tear?
Lachman’s followed by anterior drawer
What ligament is most commonly injured in an ankle sprain?
Anterior talofibular ligament (ATFL)
A positive straight leg test indicates what diagnosis?
Herniated disc
What vessel is at risk of being injured with a patellar dislocation?
Popliteal artery
What fracture is the most common cause of compartment syndrome?
Tibial shaft fracture
What is the first line treatment for rheumatoid arthritis?
Methotrexate
There is a sunburst appearance on x-ray. What is the most likely diagnosis?
Osteosarcoma
A positive Apley test indicates what diagnosis?
Meniscal tear
Where are Herberden’s nodes found?
Distal interphalangeal joint (DIP)
What is the most common radiculopathy?
L5
“onion skin” appearance on x-ray should make you think of what diagnosis?
Ewing sarcoma
Which deep tendon reflexes are affected in cauda equina syndrome?
Patellar (knee) and Achilles (ankle) reflexes
What is the most commonly fractured carpal bone?
Scaphoid
What are the risk factors for reactive arthritis?
- HLA-B27
- Male sex
- History of recent GI or chlamydia infection
In addition to acutely managing compartment syndrome, what other organ system should be evaluated?
Renal - need to evaluate for rhabdomyolysis with labs including creatinine kinase, renal function, urine analysis, and urine myoglobin
What organism causes cat scratch fever?
How does it classically present?
Bartonella henselae, a gram negative bacillus
Tender regional lymphadenopathy, low grade fever
In a 12-year old presenting with a longitudinal fracture of the distal radius through the physis what is the recommended treatment?
What type of Salter-Harris is being described?
Orthopedic evaluation for open reduction and internal fixation
Salter-Harris Type IV
What is the most specific test in detecting the presence of SLE?
Anti-double stranded DNA and Anti-Smith
When should bracing for scoliosis be considered?
What defines scoliosis?
A Cobb angle between 20-40 degrees
Cobb Angle > 10 degrees
Pulmonary function tests are recommended in patients with scoliosis. What will be found on PFT’s if scoliosis is affecting breathing?
Restrictive pattern
What is the recommended follow-up for a patient with a Cobb Angle of 18 degrees?
When is surgery indicated?
Serial AP radiographic follow-up every 3-4 months
Cobb Angle > 40 degrees
What is the most common mechanism of injury for a radial head fracture?
What will be seen on x-ray?
Fall on an outstretched hand
Posterior Fat pad sign (Sail Sign)
What are the side effects of estrogen therapy in osteoporosis?
Increased risk of breast or endometrial cancer
