MSK prac exam injuries Flashcards
Ankle Sprain
Achilles Rupture
Achilles Tendinopathy
Plantar Fasciopathy
Ligament Injuries - ankle
Ligament injuries - knee
Ligament injuries - hip
ROM
MMT/IMT
Ligament injuries - elbow
Ligament injuries - shoulder
Meniscus Injury
PFPS
Patellar Tendinopathy
Hoffa’s Pad Syndrome
Femoroacetabular impingement and Hip labral tear/injury
Mechanism of injury:
Structures involved: labrum,
Assessment:
1. FADDIR test (bring leg into end of range flexion, passive adduct and internally rotate hip, note pain response, if no pain then repeat and add compression. Looking for pain location and type of pain)
2. MMT/IMT (hip flexion/extension)
Differential Diagnosis:
Gluteal Tendinopathy/ greater trochanter pain syndrome (GTPS)
Mechanism of injury: excessive compression and high tensile loads within tendons
Structures involved: gluteus maximus, medius and minimus tendons attaching to the greater trochanter
Assessment:
1. Adduction test: Patient side lying on unaffected side knees bent to 80-90 degrees. Stabilise the pelvis and passively adduct the hip. Ask the patient to perform isometric hold against resistance. pain provocation)
2. Hip ROM (flexion/extension/abduction)
3. Greater trochanter palpation
Differential diagnosis:
SI dysfunction
Mechanism of Injury: primarily is due to a combination of axial loading and abrupt rotation
Structures involved:
Assessment:
1. FABER (stabilser hand on other side ASIS, figure 4 stretch)
2. Hip ROM (flexion, extension)
3. Cluster of Laslett (4 tests:
- distraction test (stand on symptomatic side, hands on both hips and distract apart, 3-6 moderate velocity thrusts and gradually increaseing pressure)
- thigh thrust test (stand on asymptomatic side, flex knee and other hand under sacrum, compress hands together, 3-6 higher velocity thrusts and gradually increasing pressure)
- compression test (pateint lays on asymptomatic side with knees and hips flexed, apply downward compression force over the anterior rum of the ilium)
- sacrul thrust test (prone position, hand over S2 and apply vertical pressure downwards)
2 positive tests - can rule in
Differential diagnosis?
Hip muscles contracture
RC tear
Subacromial impingement syndrome
- Subacromial impingement cluster: hawkins-kennedy, Neers, painful arc, empty can, resisted shoulder ER
Shoulder instability
Tennis elbow
SLAP tear
Cubital Tunnel Syndrome
Mechanism of injury: when a person frequently bends the elbows, leans on their elbow a lot, or has an injury to the area.
Structures involved: The cubital tunnel extends from the medial epicondyle of the humerus to the olecranon process of the ulna. Compression of the ulnar nerve
Assessment:
1. Elbow flexion test (the ‘what do you mean’ position, held for up to 3mins. Positive test - reproduction of pain, tingling or numbness along the ulnar nerve)
2. Tinel’s tap of the elbow
3. Wrist flexion and elbow flexion ROM (since the ulnar nerve innervates these movements)
Differential diagnosis:
1. Medial epicondylitis
De Quervain’s Tenosynovitis
Mechanism of injury: overuse of the wrist (such as picking up a child, picking up grocery bags)
Structures involved: abductor pollicus longus and extensor pollicus brevis tendons
Assessment:
1. Finkelstein’s test (done actively by the patient by making a fist over their thumb and doing ulnar deviation. Positive test if pain aggravation at the tip of styloid process)
2. Thumb ROM (fulcrum at scaphoid, stationary arm pointer finger, moving arm thumb)
Differential diagnosis to rule out:
1. CMCJ OA - grind test
Carpal Tunnel Syndrome
Mechanism of injury: repeated motions of the wrist such as typing, video games)
Structures involved: Median nerve (also in the tunnel are the tendons of the flexor digitorum profundus, flexor digitorum superficialis, flexor pollicus longus)
Assessment:
1. Phalen’s test (back of hands press together to compress the median nerve in the carpal tunnel, holding for 1min, positive test is indicated by tingling/numbness in thup, pointer or middle finger)
- ROM: Wrist flexion and extension (ROM may be limited)
1st CMCJ Osteoarthritis
Mechanism of injury: previous damage?
Structures involved: 1st carpometarcarpal joint
Assessment:
1. Grind test (stabilise wrist and hand, then apply an axial force down the thumb whilst rotating back and forth, positive test if there is any pain)
2. Thumb ROM
Differential diagnosis:
1. De Quervain’s - Finkelstein test
Deep gluteal syndrome/piriformis syndrome
