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AS / OS Paces RT > MSK core > Flashcards

MSK core Flashcards

1
Q

ant shoulder disloc

A

abducted and externally rotated (inverse = P)

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2
Q

biceps rupture

A

Popeye

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3
Q

high arc pain abduction

A

AC joint pathology

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4
Q

middle arc pain

A

rotator cuff pathology

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5
Q

pain on passive joint movement

A

more joint than muscle issue

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6
Q

testing serratus anterior

A

scapular winging

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7
Q

testing supraspinatous

A

resisted empty can

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8
Q

testing infraspinatous/teres minor

A

resisted external rotation

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9
Q

testing subscapulais

A

lumbar handpushback

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10
Q

impingement syndrome

A

supraspinatous tendonitis (painful empty can/Hawkin’s test) -> physio, steroid inj, arthroscope

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11
Q

rotator cuff tears

A

SS wasting, weak abduction -> cons or surgical repair

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12
Q

adhesive capsulitis

A

– frozen shoulder – severe pain then persistent stiffness, lost active+passive ROM in all directions -> pain relief /steroid then long physio

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13
Q

persistent instability disloc

A

Persistently unstable shoulder disloc – MRI arthrogram and surgical repair

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14
Q

OA shoulder

A
  • painful movement restriction all directions, steroids + analgesia
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15
Q

olecranon bursitis

A

– localised boggy swelling over elbow, ROM intact

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16
Q

lateral epicondylitis

A

– tennis elbow – repetitive strain – pain on resisted wrist extension, rest the arm

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17
Q

medial epicondylitis

A

golfers – pain on resisted wrist flexion

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18
Q

cubital tunnel syndrome

A

– from elbow leaning – ulnar nerve entrapped

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19
Q

varus / valgus force

A

apply valgus force, press on Lateral side. Medial for varus F.

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20
Q

Heb/Bouch node

A

Heberden’s nodes DIP, Bouchard nodes PIP

OA

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21
Q

Rheum vs others keys dif

A

no distal hand joints

DIPs NO!

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22
Q

RA

A

low of guttering, swan neck deformity, boutonniere, Z thumb, ulnar deviation, palmar MCP subluxation

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23
Q

psoriatic hand changes

A

more distal arthritis, less symm?

notice NAILS

onycholysis
pitting

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24
Q

trigger finger

A

MCP bump with triggering on palpation

catches on extensoin

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25
Q

tender radial styloid

A

De Quervain’s tenosynovitis (do Finkelstein’s)

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26
Q

dactylitis

A

sausage finger = seronegative spondyloarthropathy

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27
Q

squaring at base of thumb

A

OA

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28
Q

RA full summary

A

chronic autoimmune disorder leading to a SYMMETRICAL DEFORMING POLYARTHROPATHY. synovitis, bony deformities as you know, palmar erythema, muscle wasting, loss of ROM, sublux.

DIP joints spared

NSAIDs, steroids, DMARDs, surgery

29
Q

OA hand summary

A

mechanical joint degradation with degen of art cart.

joint crepitus, lower ROM, bony defromities

analgesia, steroid injections, physio/splints, surgery

30
Q

carpal tunnel syndrome summary

A

median nerve entrapment neuropathy due to compression

intermittent pins and needles, pain/burning and numbness of thumb, worse at night

loss ofpower, wasting of thenar eminence, sensory loss median zone

splints, steroid inject, CT decomp surgry

31
Q

trigger finger summary

A

thickening of flexor tendon sheath causing entrapment at the pulley near the MCP

discomfort or bump at base of digit causing catching or cliking during extension

splints, NSAIDs, steroids, rsrugical release

32
Q

spine percussion tenderness

A

serious pathology e.g. cancers, osteomyelitis, compressoin fracture

33
Q

lost lumbar lordosis

A

= in pain or spondylolistehesis

34
Q

special spine tests

A

– Schober’s, chest circumference expansion, femoral nerve stretch test, straight leg raise, sacroiliac stress test

35
Q

OA spine

A

OA of spine stiff for <30 mins in morning, no neuro signs

36
Q

ank spond

A

spond stiff >30 mins, reduced ROM all directions

37
Q

sciatica

A

nerve root impinged, pain radiates down leg on SLR

38
Q

cauda equina summary

A

compression of c e nerves - lower back pain, urinary retention, perianal numbness, reduced anal tone

MRI emergency and surgical decompression

39
Q

Trendelenberg +ve

A

Trendelenberg +ve if the hip off the ground dips rather than raises

40
Q

NOF o/e

A

shortened,externally rotated leg NOF#

41
Q

unequal leg lenght

A

unequal leg length spinal or pelvic deformity

freacture

42
Q

torch bursitis

A

trochanteric bursitis tenderness on trochanter palpation, can’t lie on that side

43
Q

OA hip

A

OA hip lose internal rotation early, pain and reduced ROM, T+T tests +ve

44
Q

Thomas test +ve

A

Thomas test +ve contralateral thigh forced off the bed with passive flexion of other hip without lumbar lordosis reduction

45
Q

valgus knees

A

valgus knees feet splayed out

46
Q

varus knees

A

bow legged

Rickets = vaRus

47
Q

ACL teaer

A

ACL tear twisting injury with pop + imm swelling, can’t examine too painful, increased laxity on anterior drawer test – do physio or surgery

48
Q

PCL tear

A

PCL tear high energy trauma, often assoc injuries, posterior sag – physio/surg

49
Q

meniscal tear

A

Meniscal tear torn in twisting, hours later selling, sharp localised pain worse on hyperflexion / twisting, locking or giving way of knee, good ROM, +ve McMurr, MRI or athroscopy investigation then arthroscopic surgery

50
Q

collateral lig tear

A

Collateral lig tears varus laxity or valgus laxity (medial lig), effusion, tender, rest physio and brace

51
Q

knee OA

A

knee OA pain and stiffness, reduced ROM, crepitus

52
Q

prepatellar bursitis

A

prepatellar bursitis local patellar swelling, kneeling a lot, normal ROM, steroid/rest/NSAID

househusband’s knee ;’(

53
Q

recall knee special tests

A

Knee special tests posterior sag, anterior drawer, collateral stress tests, McMurr

54
Q

pes planus

A

Pes planus – flat foot – loss of medial arch, flexible flat foot normal toddlers. Rigid in adults = tarsal coalition or tib posterior tendon rupture SEs

55
Q

hallux valugs

A

hallux valgus – lateral angulation of big toe, older women, medial MTP pain and bunions – osteotomy, fusion, footwear

56
Q

gout

A

gout – monoarthropathy – ms urate crystals, hyperuric. V painful hot red joint. MTP common. NSAID, colchicine. Prevent – allopurinol, less rich diet, stop thiazide/loop diuretics

57
Q

Achilles rupture

A

achilles rupture – kicked in back of leg while running e.g can’t plantar flex, Simmond’s +ve

58
Q

charcot foot

A

charcot foot pain free joint destruction from minor trauma – diabetic feet – gross deformity – educate, treat cause, podiatry + cast/boot

59
Q

morton neuroma

A

Morton neuroma – benign, between metatarsals, ‘walking on a marble’

60
Q

lateral ligament sprain ankle

A

ateral lig sprain inversion injury – ant talofib lig injury, physio and splin

61
Q

syndesmosis injury

A

syndesmosis (high ankle sprain) external rotation and usually fractured too, surgical fixation

62
Q

toe deformities

A

flexed PIP joints (hammer), flexed DIP (mallet), flexed PIP+DIP (claw toes)

63
Q

osteoarthritis RFs and summary

A

osteoarthritis RFs age, obesity, FH, female, sports (primary), joint damage / inflamm disorder, metabolic disease (2nd ) inv – exclude other causes with CXR, FBC/ESR/CRP. Cons – exercise, physio, lose wt, footwear, pain ladder analgesia, steroid inject, replace the joint

64
Q

osteoarthritis x ray findings

A

loss of joint space
osteophytes
subchondral sclerosis
subhondral cysts

65
Q

gout RFs, treatment summary

and assoc probs

A

gout RF = CKD, male, diet, diuretics, obese. 2 weeks of monoarthritis. Can get tophi + kidney stones. Uric acid levels, aspirate -ve brief needles (pseudo = +ve rhomboids), XR. Allopurinol caution – first 3 months do NSAID/colchicine, then start allopurinol as can trigger an episode otherwise. Febuxostat if can’t have allopurinol

66
Q

rheum arth summary and extra articular manifestations

treatment pathway

A

rheumatoid arthritis symmetrical deforming polyarthropathy. Extra articular features – ACD, dry eyes, LNs, osteoporosis, pleurisy+fibrosis+effusions, nodules, pericardial effusion, Felty’s, Raynaud’s, vasculitis. DAS28 severity score. 1. Pred for remission 2. DMARDs maintain 3. NSAIDs symptom relief. Physio/OT. Infliximab instead can.

67
Q

classic rheum arth x ray

A

loss of joint space
soft tissue swellin
periarticular osteopenia
marginal erossions

68
Q

ank spond o/e

A

question mark posture
sacroiliac joint tender
Schober’s failed

night pain relieved by exercise radiates to hips
morning stiffness
fever, wt loss, fatigue

69
Q

ank spond extra articular

A

bamboo signs
MRI better for dx thanX RAY

exercise/physio
then NSAIDs
then TNF a blocker e.g. etancercept

AS / OS Paces RT (11 decks)

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