MSK Disease Definitions and Info Flashcards
1
Q
Reduction?
A
Action to reposition a deformed limb into anatomical alignment.
2
Q
ORIF?
A
Open Reduction Internal Fixation (reduction done after opening skin).
3
Q
Sprain?
A
Tearing of ligament.
4
Q
Strain?
A
Tearing of musculotendinous unit.
5
Q
Valgus?
A
Deformation of limb away from the body midline.
6
Q
Varus?
A
Deformation of the limb toward the body midline.
7
Q
Flexum?
A
Lack or deficit of extension in the range of motion (ROM) of a joint.
8
Q
Dull/ache?
A
Local pathology.
9
Q
Burning/tingling?
A
Nerve-related.
10
Q
Pain at rest that is relieved by movement and night pain?
A
Inflammatory.
11
Q
Pain upon effort?
A
Mechanical pathology.
12
Q
Diaphysis?
A
Long shaft of bone.
13
Q
Metaphysis?
A
Between the epiphysis and diaphysis.
14
Q
Epiphysis?
A
End of bone.
15
Q
Epiphyseal plate?
A
Growth plate.
16
Q
Articular cartilage?
A
Covers epiphysis.
17
Q
Periosteum?
A
Bone covering (pain sensitive).
18
Q
Medullary cavity?
A
Hollow chamber in bone.
Red marrow makes blood cells.
Yellow marrow is adipose.
19
Q
Endosteum?
A
Thin layer lining the medullary cavity.
20
Q
Open vs Closed?
A
Fracture is open when exposed to air (laceration or gross exposure).
21
Q
Pathologic fracture?
A
Implies fracture through weakened bone.
22
Q
Stress fracture?
A
Implies misuse or overuse.
23
Q
Spinal stenosis?
Cause?
MC in who?
A
Narrowing of spinal canal with impingement of nerve roots. Caused by arthritis and spondylolysis.
Over 60 y/o.
24
Q
Ankylosing spondylitis?
Risk factors?
A
Joint stiffness due to fusion; Chronic inflammatory arthropathy of axial skeletal.
Males 15-30 y/o AND HLA-B27 +.
25
Herniated disc MC where?
L5-S1 and L4-L5.
26
Compression fracture occur from what?
From jumping/falling from a great height but can occur in elderly or bc of ca.
27
What must you do in every pt who comes in with a compression fracture?
Rule out CA.
28
Spondylolysis?
MC?
MOA?
Pars interarticularis defect due to failure of fusion or stress fracture.
L5-S1.
Repetitive hyperextension trauma (football, gymnasts, weight lifters).
29
What is MC form of back pain in children and adolescents?
Spondylolysis.
30
Spondylothisthesis?
MC?
MOA?
Causes?
Forward slipping of the vertebra on another.
L4-L5.
Complication of spondylolysis.
Degen, trauma, malignancy, congenital anomalies.
31
Cauda equina?
| MCC?
Spinal nerve compression in lumbosacral region.
| Lumbar disc herniation.
32
Rheumatoid arthritis?
Onset age?
MC in men or women?
Etiology?
Chronic inflammatory autoimmune disease involving synovium of joints causing damage to cartilage and bone.
20-40 y/o.
Women.
Infection but genetic predisposition is necessary.
33
Reactive arthritis?
MC in who?
Reiter Syndrome?
Associated organism?
Asymmetric inflammatory oligoarthritis of LE preceded by infectious process.
HLA-B27 +.
No classic findings.
Salmonella, Shigella, Campylobacter, Chlamydia, Yersinia.
34
Polyarteritis nodosa?
What is involved?
Effects which?
Assx with?
Medium sized muscular arteries involved.
Renal, CNS, GI vessels (spares the pulmonary vessels).
Chronic Hep B & C, HIV and drug reactions.
35
Polymyalgia rheumatica?
Average onset?
MC in men or women?
Cause?
70 y/o.
Women.
Autoimmune.
36
Polymyositis?
Cause?
What else does it involve?
MC in men or women?
Muscle inflammation.
Though to be genetic plus environmental trigger leads to immune activation which results in chronic inflammation.
Skin.
Women.
37
Dermatomyositis is assx w/?
CA- remits once tumor is removed.
38
Fibromyalgia is MC in men or women?
Women.
39
Sjorgen Syndrome?
| MC in women or men?
A multi organ autoimmune disease in which lymphocyte infiltrate and destroy exocrine glands.
40
Systemic sclerosis (scleroderma)?
What causes problems?
MC in men or women?
Onset?
Chronic connective tissue disorder that can lead to fibrosis. Cyotkines stimulate fibroblasts causing abnml collagen deposit.
High amount of collagen.
Women.
35-50 y/o.
41
Systemic Lupus Erythematous (SLE)?
Patho?
MC in who?
Autoimmune disorder leading to inflammation and tissue damage involving multiple organ systems.
Autoantibody production, deposition of immune complexes, complement activation and accompanying tissue destruction/vasculitis.
Most common in young females (20-40s), African American women.
42
Antiphospholipid syndrome?
| What does it cause?
Idiopathic disorder characterized by venous or sartorial thromboses due to antibodies against negatively charged phospholipids.
Increased risk of arterial & venous thrombosis.
43
Juvenile (Idiopathic) RA?
Autoimmune mono or polyarthritis in children < 16 y/o for over 6 weeks.
44
Pelvic fractures?
Result of?
Complications?
High impact injuries.
| DVT, sciatic nerve damage, and bleeding.
45
```
Hip dislocation?
MMC?
MC Type?
What to check for anterior dislocation?
Complications?
```
Head of femur "pops" out of acetabulum.
High impact injury like MVA.
Posterior.
Check for femoral artery and nerve compression.
Avascular necrosis, sciatic nerve injury, DVT, bleeding.
46
Hip fracture?
MC in?
Three types?
High risk of what?
Elderly especially women who are more prone to developing osteoporosis.
Femoral head fracture, intertrochanteric (b/w the greater and lesser trochanter), and subtrochanteric (below the trochanters).
DVT.
47
What happens if the femoral neck is fractured?
It may disrupt blood supply to the femoral head which may lead to avascular necrosis.
48
Slipped capital femoral epiphysis?
| Risk factors?
Displacement of femoral head (epiphysis) from femoral neck through the growth plate.
Children 8-16, obese, African American, males during growth spurt, if before puberty suspect hormonal or system disorder (hypothyroidism, hypopituitarism).
49
Legg-Calve-Perthes Disease?
MC in?
Risk factor?
Idiopathic avascular osteonecrosis of femoral head in children due to ischemia of capital femoral epiphysis.
4-10 y/o males.
Coag disorders.
50
Femoral shaft fracture?
Occur after?
Also look for what fracture?
Lots of what assx w/ break?
Femur is strongest bone and surrounded by quadriceps and hamstrings.
High energy trauma.
Femoral neck fracture.
Bleeding.
51
MC long bone fracture?
Tibial-Often open fracture w/ soft tissue injury.
52
What physical assessment maneuver should you do for tibial/fibular fractures?
Check ROM in toes, dorsalis media and posterior tubular pulses (& compare) and for nerve injury.
53
Where does the blood supply to leg come from?
Tibial artery.
54
Genu valgum?
(knock-knee) deformity in which the tibia is bent or twisted laterally. May occur as a result of collapse of the lateral compartment of the knee and rupture of the MCL.
55
Genu varum?
(bow-legged) deformity in which the tibia is bent medially. It may occur as a result of the collapse of the medial compartment of the knee and rupture of the LCL.
56
Valgus and varus stress ?
Collateral ligament injury.
57
Drawer Test?
Anterior?
Posterior?
ACL injury.
| PCL injury.
58
Lachman Test?
ACL tear.
59
McMurray Test?
Medial/lateral meniscal tear.
60
Apley Test?
Meniscal Tear.
61
Popliteal (Baker's) Cyst?
Degenerative or inflammatory joint disease (or injury) that causes knee to produce too much synovial fluid which gets displaced and forms a cyst at the back of the knee.
62
Medial collateral ligament (MCL) MOA?
| Resists?
MC collateral ligament injury.
Lateral knee trauma.
Valgus.
63
Lateral Collateral Ligament MOA?
| Resists?
Medial knee trauma.
| Varus.
64
ACL Injury?
| MOA?
MC knee ligament injury.
| 70% sports related- a non contact pivoting injury.
65
PCL Injury associated w/?
MVA/"dashboard" injuries or direct blow injury or fall on flexed knee.
66
Meniscal tears occur why?
| Which is more common?
Degenerative changes or acute injury/trauma (squatting, compression, twisting).
Medial tear is 3x more common than lateral.
67
```
Patellofemoral syndrome (Chondromalacia)?
Common in who?
```
Idiopathic softening or fissuring of patellar cartilage from overuse.
Runners or cyclists.
68
Patellar dislocation MOA?
MC?
MC in men or women?
Valgus stress after twisting injury , direct blow.
Lateral is MC.
Women.
69
Patellar fracture MOA?
MC in who?
Helpful indicator?
```
Direct blow (ex. fall on flexed knee, forceful quad contraction).
MC in young patients.
Presence of joint effusion in context of trauma.
```
70
Femoral Condyle Fracture MOA?
Caused by axial loading (falling from height, direct blow to femur).
71
Tibial plateau fracture MC in?
MOA?
MC part?
Complications?
Children in MVAs.
Direct trauma (or axial loading, rotation).
Lateral Plateau.
Soft tissue injuries (Meniscal tears MC) and compartment syndrome.
72
```
Tibial Femoral dislocation MOA?
Why is it limb threatening?
MC?
Highest incidence of popliteal injury?
How much spontaneously reduce?
```
```
High velocity trauma.
Bc of damage to popliteal artery.
Anterior.
Posterior.
50% before ER arrival.
```
73
Osgood-Schlatter Disease?
| MC in men or women and age?
Apophysitis (inflammation or stress injury to areas around growth plates in children or teens) of the tibial tuberosity. Inflammation of patellar tendon at the insertion of tibial tubercle due to overuse or small avulsions from repetitive knee extension & quads contraction.
Males 10-15 y/o during growth spurts.
74
Ankle sprain MC?
What does eversion cause?
MC lateral ligament injury?
Lateral bc most time is ankle inversion.
Medial sprain.
AFTL.
75
What are the three main lateral ligaments?
Anterior Talofibular Ligament (ATFL)
Calcaneofibular (CFL)
Posterior Talofibular Ligament (PTFL)
76
Achilles Tendon Rupture MCC?
75% occur as a sports related injury, episodic athletes.
77
Ankle Fractures-Dislocations MOA?
Rotational injury, high impact collision, or repetitive stress (stress fracture).
78
Four MC ankle fractures?
Lateral malleolus *** MC Type.
Bimalleolar fracture.
Trimalleolar fracture (includes the POSTERIOR malleolus).
Pilon fracture (aka Plafond) which is the CENTRAL portion of the tibia (this typically occurs with high impact trauma, like jumping out a window).
79
What do we use with lateral malleolus fracture to define where the fibular/lateral malleolus fracture occurs in relation to the syndesomosis joint?
Weber Ankle Fracture Classification
80
Weber A?
Below syndesmosis.
81
Weber B?
Level of syndesmosis.
82
Weber C?
Above level of syndesmosis.
83
Maisonneuve Fracture?
| MC for what?
Involves a complete disruption of the ligaments around the ANKLE associated with a fracture of the fibula at the level of the KNEE.
Most commonly missed fracture.
84
Examination of which structure is important in any suspected ankle fracture or injury?
Fibular and lateral malleolus.
85
Stress/March Fracture MOA?
| MC involves what bones?
Due to overuse or high impact activities (athletes, military).
Metatarsals (mostly 3rd), tibia, fibula, navicular bones.
86
Plantar fasciitis?
MC in pts with?
MC in men or women of what age and weight?
Inflammation and microscopic tears of plantar fascia at its insertion on the calcaneus.
Pts w/ flat feet, high arches, heel spurs.
Females 40-60 y/o older and obese pts.
87
Tarsal Tunnel Syndrome MOA?
| Result of?
Posterior tibial nerve compression as it travels thru tarsal tunnel.
Overuse, restrictive footwear, or edematous states.
88
```
Hallux Valgus (Bunion)?
Assx w/?
```
Deformity of 1st metatarsophalangeal joint w/ lateral deviation of proximal phalanx.
History of of wearing tight pointed shoes, flat feet, RA.
89
Hammer Toe?
| Assx w/?
Deformity of the PIP joint: Flexion of PIP joint with hyperextension of MTP and DIP joint.
Having a 2nd, 3rd or 4th toe longer than the first; tight fitting shoes, OA, RA.
90
Charcot Joint/ Neuropathic arthropathy?
Due to?
MC affects?
Joint damage and destruction as a result of peripheral neuropathy from DM, peripheral vascular disease or other diseases.
Decreased sensation, autonomic dysfunction and repetitive microtrauma leads to bone reabsorption and weakening.
Midfoot and ankle.
91
Morton's Neuroma?
MC where?
Caused by?
MC in men or women, age and wear what?
Compressive neuropathy of the interdigital nerve.
2nd or 3rd interdigital nerve between metatarsal heads.
Repetitive microtrauma leading to degeneration and proliferation of the nerve.
MC in women 25-50, especially if they wear high heels, tight fitting shoes or have flat feet.
92
Jones Fracture?
May occur w/?
15%-20% end up w/?
Transverse fracture through the diaphysis of the 5th metatarsal at the metaphyseal-diaphyseal junction.
Ankle sprains.
Nonunion or malunion.
93
Lisfranc Injury?
| Patho?
Injury where one or more of the metatarsal bones are displaced from the tarsus.
Disruption of the articulation of the medial cuneiform and base of the 2nd metatarsal leading to ligamentous injury and/or fracture.
94
Glenhumoral dislocation MC?
What to think is posterior?
Assx/ fractures w/ anterior?
Anterior?
Seizure, electric shock, trauma.
Hills-Sach defect and Bankart lesion.
95
Hill-Sachs Lesion/Fracture?
| Result of?
Cortical depression in the posterolateral head of the humerus.
Forceful impaction of the humeral head against the anteroinferior glenoid rim when the shoulder is dislocated anteriorly.
96
Bankart Lesion?
Stripping of glenoid labrum & periosteum from anterior-inferior surface of the glenoid.
ANTERIOR.
97
Anterior glenohumeral dislocation MOA?
Abducted, external rotation; fall on outstretched hand.
98
Posterior glenohumeral dislocation MOA?
Adducted, internal rotation; seizures, electric shock.
99
Acromioclavicular joint dislocation/seperation?
Caused by?
What types are MC?
What types require surgery?
Clavicle separates from scapula.
Falling directly on shoulder.
Types 1, 2, and 3.
Type 4 and above.
100
Type 1 Acromioclavicular joint dislocation/seperation?
Acromioclavicular ligament is stretched or partially torn.
101
Type 2 Acromioclavicular joint dislocation/seperation?
Acromioclavicular ligament is totally torn and joint is slightly displaced.
102
Type 3 Acromioclavicular joint dislocation/seperation?
Acromioclavicular ligament AND coracoclavicular ligament torn; joint is completely displaced.
103
Impingement Syndrome?
Tendons of the rotator cuff and the subacromial bursa are pinched in the narrow space beneath the acromion causing causes the tendons and bursa to become inflamed and swollen. This is what causes the “pinching”, which is worse when the arm is adducted.
104
Grade 1 Impingement Syndrome?
Inflammation of bursa and tendons.
105
Grade 2 Impingement Syndrome?
Progressive thickening & scarring of bursa.
106
Grade 3 Impingement Syndrome?
Rotator cuff degeneration and tears.
107
Rotator Cuff Injury MOA?
Include both?
MCC?
Muscles?
Chronic erosion or trauma.
Tendonitis and tear.
Repetitive overhead movements.
SITS: Supraspinatus (MC), Infraspinatus, Teres Minor, Subscapularis.
108
Humeral Head Fracture MOA?
| Pathologic fracture in?
FOOSH.
| Metastatic breast cancer.
109
Humeral Shaft Fracture MOA?
FOOSH and direct trauma.
110
What must you rule out in humeral head fracture?
MUST rule out brachial plexus injury (deltoid sensation).
111
What must you rule out in humeral shaft fracture?
MUST rule out radial nerve injury (wrist drop).
112
Olecranon bursitis etiologies?
Direct trauma, repetitive microtrauma, gout, inflammation.
113
Olecranon Fracture MOA?
| Complications?
```
Direct blow (fall on flexed elbow).
Ulnar neuropathy, anterior interosseous nerve injury, loss of extension strength.
```
114
Elbow dislocation MOA?
MC?
Assx w/?
Complications?
FOOSH.
Posterior.
Radial head or coronoid process fracture.
Must rule out brachial artery injury.
Must rule out median, ulnar, radial nerve injuries.
Lost of terminal extension is MC sequelae.
Joint stiffness or contracture if splint is left on > 3 weeks.
Compartment syndrome.
115
Radial Head Fracture MOA?
FOOSH.
116
```
Ulnar shaft (Nightstick) Fracture?
MOA?
```
Fracture of the middle portion of the ulnar shaft without any associated fractures.
Direct blow.
117
Monteggia Fracture?
| MOA?
Fracture of the proximal 1/3 of the ulnar shaft & radial head dislocation.
Direct Blow.
118
Galeazzi Fracture?
MOA?
Complications?
Mid-distal radial shaft fracture with dislocation of the distal radioulnar joint.
Direct blow or fall on outstretched arm.
Anterior interosseous nerve injury: loss of pinch between thumb and index finger.
119
Lateral epicondylitis (tennis elbow)?
Inflammation of the tendon insertion of the extensor carpi radialis brevis muscle due to repetitive pronation of the forearm and excessive wrist extension.
120
Medial epicondylitis (Golfer's elbow)?
Inflammation of the pronator teres-flexor carpi radialis muscles due to repetitive overuse & stress at the tendon insertion of the flexor forearm muscle.
121
Cubital Tunnel Syndrome?
Ulnar nerve compression at the cubital tunnel along the medial elbow.
122
Scaphoid (navicular) fracture?
MC fracture carpal bone.
123
Scapholunate Dissociation?
Widened space between the scaphoid and lunate bones.
124
Colles Fracture?
Assx w/?
MOA?
Complications?
Distal radius fracture w/ dorsal angulation.
Ulnar fracture in 60%.
FOOSH w/ wrist extension.
Extensor pollicis longus tendon rupture most common.
Malunion or nonunion, joint stiffness, median nerve compression, residual radius shortening and complex regional pain syndrome.
125
Smith Fracture?
| MOA?
Distal radius fracture with ventral/plantar angulation of the distal fragment.
FOOSH w/ wrist flexed.
126
Lunate Dislocation MOA?
Complications?
Usually dorsiflexion, ulnar deviation and intercarpal supination.
Development of carpal instability that lead to early degenerative arthritis, delayed union, malunion, nonunion, avascular necrosis, and occasionally, median nerve compression from the volar dislocation of the lunate into the carpal tunnel.
127
Lunate Fracture?
MOA?
Complications?
The most serious carpal fracture since the lunate occupies 2/3 of the radial articular surface.
FOOSH.
Avascular necrosis of the lunate bone (lunate’s blood supply enters through distal end of the bone; risk of proximal avascular necrosis). Leads to lunate collapse, OA, chronic pain, decreased grip strength.
128
Mallet (baseball) Finger MOA?
Avulsion of the extensor tendon after sudden blow to tip of the finger causing forced flexion of an extended finger. `
129
Boutonniere Deformity MOA?
| Result of?
Sharp force against the tip of a partially extended digit results in hyperflexion at the PIP joint with hyperextension at the DIP. Disruption of extensor tendon at the base of the middle phalanx.
Result of trauma, ruptures central slip. Can be result of laceration injury to central slip and dorsal capsule. Also sequela of RA.
130
Swan Neck Deformity?
| Also occurs in?
Sharp force against the tip of a partially extended digit results in hyperextension at the PIP joint with flexion at the DIP. Disruption of extensor tendon at the base of the middle phalanx
RA: synovitis of PIP renders the volar plate ineffective.
131
De Quervain Syndrome?
| MOA?
Stenosing inflammation of the tendons (entrapment tendonitis) of the first dorsal compartment: APL & EBP abductor pollicis longus & extensor pollicis brevis.
Excessive thumb use with repetitive action (thumb abduction & extension).
132
Carpal Tunnel Syndrome?
| Risks?
Median nerve entrapment and compression at the carpal tunnel.
Women, DM, pregnancy, occupations with repetitive extension and flexion of the wrists.
133
Dupuytren Contracture?
| Risks?
Progressive fibrosis of the palmar fascia leading to contractures as a result of nodules or longitudinal bands (cords) in the palm.
Men > 40; ETOH, DM; Smoking.
134
Boxer's Fracture?
| MOA?
Fracture through the fifth metacarpal neck.
| Direct trauma to a closed fist against a hard surface.
135
Radial Head Subluxation?
MC in?
Caused by?
Radial head is wedged into the stretched annular ligament.
Kids 2-5 y/o.
Caused by lifting, swinging or pulling a child while the forearm is pronated & extended.
136
Clavicle Fracture MC fracture in?
MC in men or women?
Occurs w/?
If no hx of trauma, think?
Complications?
Children, adolescents & newborns during birth.
Men.
Mid-high energy impact to the area or FOOSH.
Malignancy, rickets or child abuse (esp if <2 yrs old).
PTX, hemothorax, coracoclavicular ligament disruption (distal), brachial plexus injuries.
137
Clavicular Fracture Classification?
Group 1: (midshaft) middle 1/3 -> most common.
Group 2: lateral (distal) third.
Group 3: proximal (medial) third.
