MSK medicine Flashcards
What is Olecranon bursitis?
Inflammation of the olecranon bursa
Typically occurs after repetitive damage (i.e. leaning on the elbow)
Examination reveals swelling directly ober the olecranon which is fluctiant with no signs of infection
Management is conservative with use of ice, NSAIDs, an elbow support and potentially steorid injections if failed management and interfering with ADLs
How is osteomyelitis diagnosed?
MRI scan
What is a useful clinical sign for osteomyelitis?
Local tenderness on gentle spinal percussion
There will also be limited spinal flexion due to the pain
How does osteomyelitis present?
Back pain worsened by activity and often worse at night
Limited spinal flexion
Tenderness on percussion of affected vertebre
Risk factors for osteomyelitis?
Artificial joint, such as a hip replacement.
Blood infection or conditions like sickle cell anemia.
Diabetes, especially a diabetes-related foot ulcer.
Metal implants in bone, such as a screw.
Pressure injuries (bedsores).
Recent broken bone or bone surgery.
Diabetes
Previous spinal surgery
What is the first line treatment for MRSA?
Glycopeptides - Vancomycin
What is Kaposi’s sacrcoma
An AIDS defining illness
Painless macular patches on arms and legs
How does slipped upper femoral epiphysis present?
Adolescent patients, where children go throw a period of rapid growth (10-16 yrs), usually obese and male
Groin and hip pain over weeks-months before diagnosis with associated antalgic gait
Obligatory external rotation on examination as you flex the hip
Patients may prefer to sit with crossed legs
Can also present as knee pain due to pain activation of the media obturator nerve which can lead to misdiagnosis
What causes plantar fascitis?
Chronic overuse leading to microtears in the origin of the plantar fascia, which is a layer of connective tissue that supports the arch of the foot. These microtears will eventually cause recurrent inflammation at the origin which will present as heel pain.
Describe the pain associated with plantar fascitis
The heel pain is often worse in the morning and some patients will start walking on their tip toes.
Pain settles throughout the day
Tenderness on medial side of the heel is where the medial tuberosity of calcneus is located
How should all patients with inflammatory back pain be investigated radiologically?
Pelvic X-ray
What is a cervical rib and what can it cause?
A cervical rib is an abnormality that is present from birth. It is not usually a problem, but if it
presses on nearby nerves and blood vessels, it can cause neck pain, numbness in the arm and other symptoms. Can cause thoracic outlet syndrome
A cervical rib in humans is an extra rib arising from the 7th cervical vertebra which is
congenital . It is relatively rare and most people do not have symptoms.
Cervical rib syndrome can cause the following effects:
Reduced range of movement of the neck
Pain on movement of the neck
Weakness in lower arm and hand
Pins and needles or numbness in lower arm and hand
What is thoracic outlet syndrome?
A group of disorders that occur when blood vessels or nerves in the space between the clavicle and the first rib (thoracic outlet) are compressed. This can cause pain in the shoulders and neck and numbness in the fingers.
Causes of thoracic outlet syndrome?
Common causes of thoracic outlet syndrome include physical trauma from a car accident, repetitive injuries from job- or sports-related activities, certain anatomical defects (such as having an extra rib), and pregnancy.
Shoulder stiffness in elderly
Pmr
