MSK/rheumatology Flashcards
Shoulder pain after repetitive activity, point tenderness at anterior humerus or AC joint. + drop arm test or apprehension test
Rotator cuff injury (SITS muscles)
FOOSH, radial fracture w/ dorsal displacement, dinner-fork deformity
Colle’s Fx; Tx = volar splint
Typing, secretary wrist pain and numb/tingling from wrist to hand. New mothers, pregnant may worsen
Carpal tunnel syndrome
Pain at base of thumb, distal radial styloid. Pain reproduced with ulnar deviation of clenched fist.
deQuervain’s tenosynovitis
Hand injury after a punch
Boxer’s fracture. Ulnar gutter w/ intrinsic plus positioning. ORIF if angulation > 40 degrees
Posterior hip dislocation
Limb will be:
shortened
internally rotated
adducted
Female exam, asymmetric posterior chest wall or uneven scapula height with forward bending
Scoliosis (>25 degree Cobb angle = surgery)
Hip fracture
Limb will be:
-externally rotated
-shortened
Knee injury during football game
ACL (look for description of lachman or drawer test)
8-10 year old male with limp, knee pain
Legg-Calve-Perthes disease
12-15yo overweight male knee pain, limp, hip pain (knee XR normal)
SCFE
Adolescent male with knee pain, tenderness over tibial tuberosity
Osgood-Schlatter disease
Retropatellar knee pain esp. in females
Patellofemoral pain syndrome - increased Q angle, strengthen quadriceps
Pain on plantar foot @ 2-3rd metatarsal. Associated w/ tight shoes, relieved by removing shoes. Palpable painful mass
Morton’s neuroma; Tx with NSAIDs, wide shoes, then steroid injections
Pain after tx of fracture w/ cast
Compartment syndrome
HLA-B27
Ankylosing spondylitis, Reiter’s syndrome
Acute joint pain. Swollen, warm, erythema
Septic arthritis (synovial fluid = leukocytosis, low glucose)
Large joint pain. Knees w/ medial joint space narrowing, osteophytes. No erythema or warmth.
Osteoarthritis. Acetaminophen #1 choice
Enlarged PID, DIP
Osteoarthritis (herberden - DIP; bouchard - PIP)
Female morning joint pain and stiffness esp. hand/wrists. MCP joint swelling, ulnar deviation
Rheumatoid arthritis. Methotrexate (DMARDs) #1
Proximal symmetric muscle pain and stiffness esp. shoulder, neck, pelvic girdle
Polymyalgia rheumatica
Male w/ low back pain, stiffness. Pain worse wakening, improve during the day. Decreased ROM at spine. Plain films show sacroiliac abnormality. HLA-B27 positive.
Ankylosing spondylitis; Tx = NSAIDs (Indomethacin)
Conjunctivitis, iritis, arthritis, cervicitis, urethritis
Reiter’s syndrome
Female with arthralgias, malar rash, +ANA, +anti-double stranded DNA antibodies, +antiphospholipid antibodies
SLE
Female, fatigue, general aching, pain at neck, upper shoulders, sleeping problems, tender points
Fibromyalgia (exercise program good management)
Cold induced pain at extremities with color change as they warm up
Raynaud’s phenomenon
Osteomyelitis after stepping on nail wearing sandals or tennis shoes
Pseudomonas aeruginosa (foam padding in shoes)
Teenage female with long bone pain without trauma or injury. XR w/ lytic mass, multi-laminated periosteal reaction
Ewing Sarcoma - periosteal “onion skin” reaction
Lytic lesions in the back or skull
Multiple myeloma
Parts of the rotator cuff
SITS (supraspinatus, infraspinatus, teres minor, subscapularis)
Common dislocation directions
elbow
shoulder
Hip
Posterior - FOOSH
Anterior
Posterior - MVA
Nursemaid’s elbow
Annular ligament - subluxation of radial head
Unable to extend at DIP
Mallet finger
Progressive fibroproliferative dz of palmar fascia. Most commonly ring finger
Dupuytren’s contracture
Pediatric growth plate classification system
Salter Harris
“SAL”
I=S - separation of growth plate (GP)
II=A - above GP
III=L - below GP
IV= through both
V= crush
Splint for non-displaced scaphoid fx
Thumb spica spint
McMurray test
Meniscal tear
Thompson test
Achilles tendon integrity
Footdrop
Deep peroneal nerve
5 Ps of compartment syndrome
Pain, pallor, pulselessness, paralysis, paresthesia
