MSK/Rheum Flashcards
How does an ankylosing spondylitis patient typically present?
Present with low back pain and stiffness, patient is usually a young male in his 20s
What is the “buzzword” for Ankylosis spondylitis?
“bamboo sign” on x-ray
In order to diagnose someone with kyphosis, the Cobb angle must be greater than what?
45 degrees. Angle of 20 to 45 is normal.
If someone has kyphosis, you brace them if the angle is between ______ and ______. and you do surgery if the angle is greater than _______.
50 and 70.
70.
This presents with radiculopathy or neurogenic claudication with exercise. Pain is relieved with forward bending “shopping cart sign”.
Spinal stenosis
Where is the most common place to have a herniated nucleus pulpous?
L5-S1
How do we treat spinal stenosis?
NSAIDs, short course of steroids, epidural injection, and surgery
what is the appropriate management for scoliosis?
Observation
if cobb angle is greater than 30, brace.
If angle is greater than 50, surgery.
What is the name of the test when you ask the patient to bend over and look for scoliosis?
Adams test
What are some “red flag symptoms” if someone presents with low back pain?
weight loss, age over 50, history of cancer, night time pain, and fever.
What is a good test to do on PE if you suspect sciatica?
Straight leg raise
True or False, Bouchard nodes affect the PIPs and are a sign of osteoarthritis.
True.
Bouchard affect PIPs and Herberden nodes affect the DIPs
When should we start screening women for DEXA scans? and how often should we repeat them?
65
at least 2 years before repeating
Osteopenia is defined as a t-score of what? what about osteoporosis?
Osteopenia: t score between 1-2.5
Osteoporosis: t score greater than 2.5
How do we treat osteomyelitis?
6 weeks of IV antibiotics – vanco
Osteosarcoma presents with what type of pattern on x-ray?
Sunburst
What is chondrosarcoma?
Tumor in the cartilage – usually older adults
Ewing sarcoma presents with what type of pattern on x-ray?
onion peel
What are the four muscles of the rotator cuff?
SITS muscles
Supraspinatus, infraspinantus, teres minor, subscapularis
What are some tests you can do to look for impingement syndrome?
Hawkins test, drop arm test, Neers test
Lateral epicondylitis (tennis elbow) is due to what?
excessive pronation and wrist extension
Medial epicondylitis (golfer’s elbow) is due to what?
repetitive wrist felxion
What presents with pain at the radial wrist, radiates to forearm, especially with thumb extension and gripping. Also has a positive Finkelstein’s test.
DeQuervian’s
How do we treat carpal tunnel?
Wrist immobilization at night – if not improved can do surgery.
What are the two PE tests to look for carpal tunnel?
Phalen’s and Tinel’s
Gamekeeper’s thumb is due to a _____________ injury.
hyperabduction
MCL strain is caused by a ______ force.
LCL strain is caused by a _____ force.
Valgus
Varus
Anterior drawer and Lachman’s test, look for?
ACL injury
How do people typically tear their PCL?
dashboard injury or fall on flexed knee
Locking, popping, giving way are common symptoms of what knee injury?
Meniscal injuries
Meniscus tears may present with a positive ______ sign.
McMurray’s
What is the name of the disease that is caused by osteochondritis of the patellar tendon at the tibial tuberosity?
Osgood Schlatter’s
Slipped capital femoral epiphysis is due to the femoral head slipping _______ and ______ at the growth plate.
Posterior and inferior
How do you treat SCFE?
ORIF and crutches
What are the names of the test to look for developmental dysplasia?
Ortolani (abd and anterior pull) and Barlow (add + post push)
Male with an inflamed/tender toe, think of?
Gout
How do we treat gout in both the acute and chronic setting?
Acute: 1. NSAIDS 2. colchicine 3. corticosteroids
Chronic: Allopurinol + lifestyle modifications (avoid seafood, red meats, EtOH)
Can you start allopurinol during an acute attack of gout?
No
What presents with fatigue, arthritis, malar rash (cheeks and nose), discoid rash (scaling rash), and photosensitivity?
Systemic Lupus Erythematous
How do you diagnose SLE?
ANA (1:160) and DS DNA anti-smith antibodies
What is Reiter’s syndrome?
Reactive arthritis.
Infection, then weeks later joint pain.
