MSK / Sports Flashcards
which hand condition affecting the MCP joint area is more common in patients with diabetes, RA, or amyloidosis?
trigger finger
ultrasound of a patient with finger pain shows flexor tendon thickening and fascial thickening over the tendon sheath. what is the diagnosis?
trigger finger
how long should conservative therapy with splint, nsaids, and therapy be attempted prior to considering injection for mild to moderate trigger finger?
4-6 weeks
a patient experiences pain at the base of the thumb, exacerbated by pinching and gripping activities. what is the most likely diagnosis?
CMC joint arthritis
how long after the start of conservative management with bracing and therapy for 1st CMC joint arthritis should injection be considered?
4-6 weeks
what type of splint is helpful for 1st CMC joint arthritis?
thumb spica
in what palpable anatomic landmark should an injection for 1st CMC joint arthritis be given?
anatomic snuffbox
what condition is marked by nodules and fibrous cords of the palmar aponeurosis?
Dupytren’s contracture / palmar fibromatosis
what mg of triamcinolone should be used for palmar fibromatosis?
60 - 120mg
for patients with palmar fibromatosis that is refractory to conservative management and corticosteroid injection, what other injection option could they try?
collagenase
t/f corticosteroid injection of ganglion cyst produces additional benefit when compared to aspiration alone
false
when performing the injection for carpal tunnel syndrome, from what direction should the needle be guided?
ulnar
once you have placed the needle for carpal tunnel injection, what is the sequence of how you should inject around the nerve?
inject the anterior portion to separate from the flexor retinaculum first, then redirect to the posterior aspect of the nerve
what is the cause of proximal intersection syndrome?
dorsal compartment 1 is intersecting over dorsal compartment 2
what wrist motion is the most problematic for patients with proximal intersection syndrome of the wrist?
wrist extension
what is the most common MOI for TFCC injury?
FOOSH in pronation
what is the most common physical exam finding of TFCC injury?
tenderness over the ECU
what is the screwdriver test for TFCC injury?
apply ulnocarpal axial load and then perform full forearm supination to pronation
describe how to perform an injecton of the TFCC
horizontal transducer over the dorsal wrist. approach from ulnar side, needle guided toward radial side. inject deep to the ECU
when compared to PT, arthroscopic surgery for degenerative meniscal tears does not result in better pain control, function, quality of life. However arthroscopic surgery may result in worsening of what two things when compared to PT?
cartilage surface area and range of motion may worsen with surgery
relative rest including limiting screen time and limiting activity is recommended for how many days after acute concussion?
2 days
how long after concussion should you wait before returning to light physical activity if symptoms are not exacerbated by activity?
24-48 hours
by how many points on a 10 point pain scale is an acceptable amount to tolerate when returning to activity after concussion?
no more than 2 points
referral to a sports related concussion specialist should be considered for patients who experience symptoms lasting longer than how many weeks?
4 weeks
a patient recovering from concussion has symptom exacerbation with activity that lasts beyond 1 hour. How long should a pause in activity occur?
1 day at least
a patient has dorsal wrist pain and squeaking in the wrist with wrist extension. what is the most likely diagnosis?
proximal intersection syndrome
what is the most significant exam finding in bone stress injury?
palpatory bony tenderness
what is the immediate step in management for a tension sided femoral neck BSI?
urgent surgical consultation
t/f populations with low vitamin D intake are at higher risk for bone stress injury
true
what is the definitive radiology study for BSI?
MRI
t/f femoral neck and tarsal navicular are considered high risk BSI sites
true
localized pain and loss of function in the setting of changes in training volume and frequency are hallmarks of what condition?
BSI
long term use of what pain medication class is associated with increased risk of stress fracture
nsaid
bone stress injury grading has how many levels?
4
what are the three most clinically concerning locations for BSI?
anterior tibial shaft, tarsal navicular and femoral neck
what are the two modalities used for acute pain control with bone stress injury?
acetaminophen and ice
what drug class is associated with increased risk of non union with stress fracture?
nsaid
t/f lighter shoes with smaller heel to toe drop and wider toe box reduce the rate of BSI
true
what modality, when added to exercise therapy can speed recovery from MTSS?
ECSWT
t/f vitamin D supplementation has a protective effect against stress fracture
true
t/f nsaids consistently reduce pain from hip OA
true
t/f intraarticular hyaluronic acid injections have benefit for hip OA
false
according to the AAOS, what is the general expected timeline/duration of treatment effect for intraarticular steroids when used for hip OA?
4 months treatment effect
what medication is recommended perioperatively for total hip arthroplasty to reduce the risk of anemia?
TXA
what is the major risk of using intrarticular steroid for hip OA, according to the AAOS guidelines?
rapidly progressing arthritis
t/f intraarticular steroids improve pain and function in adhesive capsulitis in the short and medium term
true
t/f intraarticular steroid can improve both pain and function of hip OA at 4 months
true
t/f US guided carpal tunnel injections have better symptom and functional improvement with reduced rate of complications compared to landmark guided injection
true
