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Year 2 > Msk Investigations > Flashcards

Msk Investigations Flashcards

1
Q

First line investigation when suspecting SLE

A

Urinalysis to test for renal failure

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2
Q

Investigation for Giant Cell Arteritis
(Include 1st line)

A

1st line: ultrasound
Confirm with temporal artery biopsy (although not always positive)

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3
Q

Anti ro/ anti la indicates?

A

sjorgens (60-70%)

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4
Q

1st line investigation for cauda equina symptoms (bilateral scaitic radoculopathy + incontenince)

A

Urgent MRI + pr exam

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5
Q

Pagets
(Ix and what it should show)

A

X ray- initial: well define lucency, mishapen bone
- sclerotic phase: enlarged bone, inc cortex density, coarse trabecular pattern

Isotope bone scan- shows distribution

Biochem: inc alkaline phosphatase

skull x ray showsthickened calvarium and ill defined sclerotic lucent areas throughout

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6
Q

septic arthritis investigations

A

Hot swollen acutely painful joint- assume septic arthritis til proven otherwise.

1st line: aspirate joint for microscopy, culture & sensitivity and bloods- inc CRP, blood culture if pyrexial

x ray/MRI

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7
Q

Gout
(most appropriate investigation?)

A

most appropriate: joint aspiration and CRP on admission and

to confirm diagnosis: serum urate after 2 weeks

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8
Q

Rheumatoid arthritis investigations

what to use if in diagnostic doubt?/ what is the gold standard test for RA

A

Clinical diagnosis
bloods: raised inflammatory markers
rheumatoid factor, anti CCP (more specific)
X-ray hands and feet of all suspected RA patients

MRI is gold standard!!, only use if in diagnostic doubt

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9
Q

sjorgens investigations

A

schirmers test- occular dryness

bloods:
-positive anti-Ro & anti La
-possible inc in IgG & plasma viscosity/ESR
- lymph

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10
Q

osteomyelitis investigation

A

MRI

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11
Q

Ixs for ankyosing spndylitis

what test is used if in diagnostic doubt

A

-( Spondyloarthritis cannot be reliably diagnosed or ruled out by a single test)

1st: X ray; (sacroillitis: subchondral erosions, sclerosis, squaring of lumbar vertebrae, bamboo psine etc.)

if X ray doesnt show anything but suspicion remains high do MRI

other tests:
HLA B27 gene- test for if 3 of criteria have been met

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12
Q

What confirms diagnosis of a metatarsal fracture

A

MRI or bone scan to confirm diagnosis

Xray wont show fracture for 3 weeks (until resorption at the fracture ends occurs or callus begins to appear)

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13
Q

Extension of the big toe indicates what nerve is working?

A

Deep peroneal

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14
Q

Who should be referred for dexa

A

Patients >50y with low trauma fracture “stop at one”

Patients at inc risk via risk assessment tools eg. Frax or qfactor >10% risk of fracture over 10years

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15
Q

Diagnostic test for ankylosing spondylitis

A

MRI of sacroilliac joints

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16
Q

Lateral to medial layout of femoral triangke

A

Femoral nerve, fem. Artery. Fem vein. Lymphatics.

NAV

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17
Q

Serious trauma from a car accident or fall from high place, what type of bone fracture

A

Comminuted fracture

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18
Q

Fall on an iutstretched arm associated with what type of fracture

More common in kids because…

A

Greenstick
(Partial fracture)

Kids bones are softer

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19
Q

positive phalens test indicates…

A

carpal tunnel syndrome

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20
Q

aspirate of synovial fluid in gout shows?
what are you testing when you aspirate

A

-microscopy- needle shaped, negatively befringeent monosodium urate crystals (confirms diagnosis)
- gram stain/culture to rule out septic arthritis

21
Q

how to diagnose SLE

A

(ANA very specific for SLE)
SLE criteria 4 or more (at least 1 lab and 1 clinical) or biopsy proven lupus nephritis + antidsdna/anti sm

22
Q

diagnostic test for osteoporosis

A

DEXA score of <-2.5

23
Q

occult hip fracture Ix (not able to see on x ray)

A

MRI

24
Q

gold standard test for rib fracture

A

CT

25
Q

diagnostic test for polymyositosis/dermosyotsis

A

muscle biopsy: shows perivascular inflammation and muscle necrosis

26
Q

what are the criteria to diagnose kawasaki disease

A

4/5 of these symptoms
CRASH & Burn

Conjunctivitis
Rash
Adenopathy (lympadenopathy)
Strawberry tongue
Hands/feet (peeling of hands/feet)

burn: fever for 5/more days

27
Q

criterion to diagnose atypical kawasaki disease

A

2/3 of the CRASH and burn symptoms
and
CRP> 3mg/dl
ESR>40mm/hr
>3 supplemental labs (eg albumin) OR abnormal echocardoigram

28
Q

what do you have to screen for in kawasaki disease? and what tool do you use

A

echo to check for coronary artery aneurysms

29
Q

initial imagiing of choice for suspected achilles tendon rupture

A

ultrasound

30
Q

what is the result for schobers test in someone with ankylosing spondylitis and what does it indicate

A

<5cm

redcuded lumbar flexion

31
Q

vertebral tb (aka potts disease) ix

A

x ray and MRI

32
Q

gold standard test for any joint pathology

A

MRI

33
Q

what does the DAS 28 score take into account

A

Sore joint count,
swollen joint count,
ESR
global health score.

34
Q

Ix for SUFE and confirm diagnosis

A

X-ray AP and frog leg view on BOTH hips

confirm diagnosis and graded by klein line (how much is intersecting the femoral head)

35
Q

suspected psoas absecess investigation

A

CT abdomen

36
Q

polymyalgia rhuematica Ix findings

A

inc ESR and CRP

37
Q

if there is osteoporosis in a man what should you check

A

testosterone

38
Q

first line investigation for suspected osteoporotic vertebral fracture

A

X-ray spine

39
Q

scaphoid fracture ix

(2)

A

1st line: two oblique, AP (anterior posterior) and lateral x-ray view

definitive: MRI

40
Q

can you age a bruise for non accidental injury

A

no

can age diff fractures tho

41
Q

septic arthritis vs rheumatoid arthritis joint aspirate findings

A

septic: cloudy/opaque, yellow , >90% leukocytes, usually g+ (s.A)

RA: clear, viscuos, predominantly polymorphonuclear neutrophils

42
Q

what are the ottowa rules

A

when to x ray for ankle fracture:

if there is pain in malleoulur area and any one of the criteria below then an ankle x-ray series is indictaed

-bony tenderness at posterior edge/tip of lateral malleoulus
- bone tenderness at the posterior edge/tip of the medial malleoulus
- inability to bear weight for 4 steps both immediatley after the injury and when examining

43
Q

what does a positive simmonds test indicate

A

calcaneal tendon (achilles tendon) rupture

44
Q

what is more reliable lachman or anterior drawer test

A

lachman

45
Q

cauda equina Ixs

A

PR exam and urgent MRI

46
Q

1st line imaging Ix for ACL rupture

A

MRI

47
Q

acetabulum fracture imaging

A

CT

48
Q

shoulder dislocation Ix

A

X:ray two planes> AP erect and lateral

49
Q

first line Ix for rotator cuff tear

and gold standard

A

1st line: ultrasound

G.S: MRI

Year 2 (50 decks)

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