MSK-Surgery Flashcards
DM with low back pain, elevated ECR and CRP. Dx? NSIM?
Spondylodiscitis (vertebral osteomyelitis), CT guided biopsy
“Clunk” heard and felt on abducting a flexed hip is called__________ suggestive of ________
Ortolani sign , Dysplasia of the hip (DDH)
Dysplasia of the hip (DDH) tx?
Apply a rigid harness of the hips (von Rosen harness) that maintains the hips in 90-100 degree flexion and 50% abduction
Shoulder adducted, internally rotated, appears flattened with prominent coracoid process. Dx? NSIM? TX?
- Posterior shoulder dislocation,
- Axillar radiograph of shoulder
- Closed reduction (after imaging)
Fever, elevated ESR, CRP, x-ray with bacterial infection of the hip. NSIM?
Synovial fluid drainage plus nafcillin and cerfazolin therapy
Child with antalgic gait, limited abduction and internal rotation at his hip, x-ray shows erosion of the femoral epiphysis with minimal damage to the femoral head. Dx? NSIM?
- Legg-Calve-Perthes disease,
- Limited weight bearing and physical therapy
- Casting and bracing (If femoral head deformities start to develop or ROM worsens)
Tx for scaphoid fracture
Thumb spica cast and repeat x-ray in 2 weeks
Rear-end collision, right groin pain, right leg shorter, flexed, adducted and internally rotated. Dx? Tx?
- Posterior Hip dislocation, (dashboard injury)
- Emergent closed reduction
Tibia is displaced posteriorly when force is applied to the proximal tibia after flexing the knee. This is called? Dx?
Postive posterior drawer sign. Posterior cruciate ligament injury (PCL)
Pain in the calf muscle on passively dorsiflexing the foot is called? Suggests?
+ stretch test
Compartment syndrome
Tx for compartment syndrome
fasciotomy
how long before doing fasciotomy to prevent necrosis
6hrs
Test used to differentiate rotator cuff tear from rotator cuff tendinopathy
Subacromial lidocaine (it also helps to relief pain)
Knee pain worst at the end of the day, crepitus, limited ROM, osteophytes, subchondral sclerosis and joint space narrowing . Dx? NSIM?
osteoarthritis
Weight loss program (if that fails- Total joint replacement)
Laterally displaced patella, right knee effusion & pain, hx of similar episodes, hx of Ehlers-Danlos syndrome. Dx? NSIM?
Acute patella dislocation
Arthroscopy
What to do before attempting reduction in shoulder dislocation
Test sensation of the lateral shoulder to assess for axillary nerve palsy
Medial joint tenderness, laxity, and positivity valgus stress test is
Medial Collateral ligament injury
Treatment for mid shaft fracture of the clavicle without neuromuscular damage
apply simple shoulder sling 4-6 weeks
When to do physiotherapy for mid shaft fracture or the clavicle
2-4 weeks after sling.
Obese children age 10-16 with hip pain and externally rotated thigh. Dx?NSIM?
- Slipped capital femoral epiphysis
- X-ray
what bacteria is risk with prosthetic joints, prosthetic cardiac valves, iv catheters, and pacemakers
Staph epidermidis
acute onset knee pain, hx of locking and popping, joint line tenderness, + McMurray test. Dx? Imaging?
- Meniscal tear
- MRI- hyper intense line in the meniscus
- Arthroscopy if pt have metal implants
Passive flexion causes external rotation and abduction-called
Drehmann sign
Drehmann sign and widening of the hip joint, inferiorly displaced femoral head on x-ray. Dx? NSIM?
Slipped capital femoral epiphysis (SCFE)
Surgical pinning of femoral head
Empiric antibiotic treatment for osteomyelitis
Ciprofloxacin (Pseudomonas)
vancomycin (Staphlococci)
Flexed distal interphalangeal joint, inability to actively extend the distal phalanx after an indirect trauma to the finder. Dx? Tx?
- Extensor digitorum tendon injury (Mallet finger)
- Stack splint - to stabilize the joint for 6-8 weeks
Recent URI on a child with hip pain
Transient synovitis- Effusion will improve over 2 weeks
Child with hip slightly abducted and external rotated indicates
pain
Avascular necrosis of the femoral head
Legg-Calve-Perthes disease (Coxa plane)
Hx DM, swollen and erythematous and tender knee with fever and leukocytosis, Dx? NSIM?
- Septic arthritis
- Arthrocentesis of the knee
Tx for trimalleolar ankle fracture
Open reduction and internal fixation (ORIF) is always required
Nerve that innervates the radial aspect of the forearm and the thumb
C6 nerve root
Test that is high specificity for C6 radiculopathy
Spurling’s maneuver
C6 nerve affects what motor function and reflex ?
wrist extensor and brachioradialis reflex
extending the neck to the side of pain and applying downward pressure to the head
Spurling test - + if limb pain/paresthesia
