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