MSK (New) Flashcards
What condition is caused by overuse and inflammation at the flexor carpi radialis?
Medial Epicondylitis (Golfer / Pitcher Elbow)
A patient presents with a tibial plateau fracture that is found to be displaced. What should be checked?
Peroneal Nerve (foot drop)
In an anterior shoulder dislocation, what should be ruled out? How is this determined?
- Axillary nerve injury
- Pinprick sensation over deltoid
What fracture is characterized as fracture of distal 3rd of radius and dislocation of distal radioulnar joint?
Galeazzi Fracture
A patient presents with a humeral shaft fracture. What injury should be ruled out?
Radial nerve injury (wrist drop)
A patient complains of 3 months progressively symmetric muscle weakness that is usually painless in her shoulders and pelvic girdle. She has difficulties rising from a chair and combing her hair. What is the likely diagnosis?
Polymyositis
What test is positive in De Quervain’s Tenosynovitis?
Finkelstein’s
An x-ray showing volar displacement and angulation of distal radius (“garden spade” deformity) would signify what type of fracture?
Smith
With Monteggia fracture, what injury needs to be ruled out?
Radial nerve injury (wrist drop)
A patient complains of bilateral joint pain and stiffness***. She reports morning stiffness of >30 mins of pelvis, neck and shoulder girdle plus some muscle weakness. She has difficulties brushing her hair and standing from a chair. What is the likely diagnosis?
Polymyalgia Rheumatica
What are 3 possible complications of Supracondylar Humerus Fracture?
- Median nerve injury
- Brachial artery injury
- Volkmann Ischemic contracture
- Radial nerve injury
An x-ray showing dorsal displacement and angulation of distal radius (“dinner fork” deformity) would signify what type of fracture?
Colles
A patient presents with a proximal / head humeral fracture. What injury should be ruled out?
Brachial plexus and axillary nerve injury
What is the treatment for a Boxer’s Fracture?
Ulnar gutter splint at 60 degree flexion
What condition is caused by overuse (usually a new activity) and inflammation at the extensor carpi radialis brevis (ECRB)?
Lateral Epicondylitis (Tennis Elbow)
What condition present with subchondral sclerosis (joint space narrowing) and cysts, and osteophyte formation?
Osteoarthritis (Degenerative Arthritis). Can be of glenohumeral, knee, hip joints ect.
What is the condition that is caused by ulnar nerve compression at elbow which causes paresthesias over pinky and ring fingers?
Cubital / Ulnar Tunnel Syndrome
What condition is associated with a finger flexed at PIP joint and
hyperextended at DIP joint?
Boutonniere Deformity
What signs are positive in Carpal Tunnel Syndrome?
Phalens and Tinels
What fracture is characterized as fracture of proximal 3rd of ulna with dislocation of proximal radial head?
Monteggia Fracture
What is the treatment for Dupuytren Contracture (Claw Hand)?
1st: intralesional steroid and/or collagenase shots
2nd: fasciotomy
What condition is associated with a tear at the DIP joint and inability to straighten distal finger?
Mallet (Baseball) Finger
Carpal Tunnel Syndrome is caused by compression to:
Median nerve
An abscess at the tip of the fingernail is called:
Felon
What condition is characterized by inflammation of calcaneal growth plate (apophysis) seen in 8-12 year olds?
Sever Disease
A young female runner comes to clinic for knee pain “behind” the patella that is worse with stair climbing, jumping and long periods of sitting. On PE, she has a positive apprehension sign and patella crepitation. An axial x-ray reveals a patella sitting in the femoral trochlear groove. What is the diagnosis?
Patellofemoral Syndrome (Chondromalacia)
A patient presents with bone pain that is work at night. He reports relief with ASA or NSAIDs. An x-ray shows a small, round lucency (nidus) with a sclerotic margin. What is the likely diagnosis?
Osteoid Osteoma
A female athletes presents to clinic complaining of irregular periods and weight loss. PE reveals osteopenia. What is the likely diagnosis?
Female Athlete Triad
A marathon runner presents with myalgia, weakness and dark colored urine. His creatinine phosphokinase is > 20K and his ALT, K, Phos and LDH are all elevated. Calcium is reduced. What is the likely diagnosis?
Rhabdomyolysis
A patient with a history of IVDA presents with back pain, fever and neuro deficits. Labs show an increased ESR. What is the likely diagnosis?
Spinal Epidural Abscess
A woman who repeatedly wears high-heeled, pointed shoes complains of pain in the forefoot after prolonged standing or walking. PE reveals no obvious deformities and a very tender spot in the 3rd interspace, between the 3rd and 4th toes. What is the likely diagnosis?
Morton’s Neuroma
A patient presents with extreme knee pain and swelling. He reports recent unprotected sex. WBC is >50K. What is the likely diagnosis and etiology?
- Septic arthritis
- Gonorrhea
What is the difference between Reactive Arthritis and Septic Arthritis?
RA: involves multiple joints in association with conjunctivitis and urethritis
SA: involves monoarticular arthritis
What condition is seen in obese males during early teens and presents with progressive limp and knee pain but knee is normal on PE?
Slipped Capital Femoral Epiphysis (SCFE)
A 65 yo lifts a bag of groceries to place in the trunk. While doing so, a sharp, sudden pain is felt in the middle of the arm, and the humerus suddenly breaks. At the ED, the patient is cradling the arm. What is the likely reason for the fracture?
A lytic lesion from metastatic cancer. In men likely lung CA and in women likely breast CA.
Herniated intervertebral discs occur when the:
Nucleus pulposus protrudes posterolaterally through a weakened anulus fibrosus
What condition is a primary malignant bone tumor usually found in long bones (MC femur) and x-ray findings show periosteal elevation that forms an angle with cortex of bone?
- Osteosarcoma
- That finding is characteristic of Codman’s triangle
What dislocation is common with common in seizures and electric shock?
Posterior glenohumeral shoulder dislocation
IM shots should be given in the upper, outer quadrant of the buttocks to prevent damage to what nerve?
Sciatic
What condition is due to idiopathic avascular necrosis of femoral head in kids and presents with painless, unilateral intermittent limp?
Legg-Calve-Perthes Disease
Due to complete paralysis of the respiratory muscles (diaphragmatic paralysis), patients with spinal cord injury above ______ have acute ventilatory failure and do not survive unless manual ventilation is rapidly instituted.
C3
Lateral blow to the knee of a planted leg would likely injure what 3 structures?
O’Donoghue’s triad: ACL, MCL, medial meniscus
In a patient with a herniated lumbar disc, at what point would surgical decompression be a good option?
If neuro deficits progress, such as poor anal sphincter tone or perineal anesthesia.
What makes up “CREST” syndrome in Systemic Sclerosis?
- Calcinosis of the skin (tender ulcers at fingertips)
- Raynaud’s
- Esophageal dysmotility
- Sclerodactyly
- Telangiectasia
A patient presents for frequent tripping and falling. PE shows the inability to dorsiflex the foot and a loss of sensation between the first and second toes. What nerve is likely injured?
Deep Peroneal Nerve (foot drop)
Ankylosing Spondylitis is associated with what other disorders?
“PAIR” HLA-B27
- Psoriatic arthritis
- Ankylosing spondylitis
- IBD (Crohns and UC)
- Reactive arthritis
What autoantibodies are found in Scleroderma / Systemic Sclerosis?
- Local: Anti-centromere ab
- Systemic: Anti-topoisomerase I (anti-Scl-70) ab
A lower extremity appears shortened and externally rotated. A fracture of which part of the femur is suggested by these findings?
Neck
What is the treatment for Developmental Dysplasia of Hip by age: <6 month old, 6-15 months old and 15-24 months old?
<6 mo: Pavlik harness (abducted brace)
6-15 mo: hip spica cast
15-24 mo: open reduction followed by hip spica cast
How do you diagnose Reactive Arthritis vs. Septic Arthritis?
- Reactive: HLA-B27
- Septic: arthrocentesis
What xray finding is pathological for radial head fracture?
Posterior fat pad
How is Dermatomyositis diagnosed?
↑muscle enzymes (aldolase*, creatine kinase)
