MSK TMA clinical relevances

Question 1

what is a supracondylar fracture? occurs how? what can be damaged

Answer 1

fracture of distal humerus
> fall on outstretched hand (FOOSH)

contents of cubital fossa damaged

Question 2

which muscle does the ok sign? clinical rel?

Answer 2

flexor pollicis longus > unable to do it if have Vokmanns ishcaemic contracture (damage to brachial artery)

1. flexor digitorum Profundus
2. flexor Pollicis longus
3. Pronator quadratus

Question 3

most commonly fractured carpal bone?

method of injury?
symptoms?
risk?

Answer 3

scaphoid
via FOOSH

pain and tenderness in anatomical snuffbox

risk of avascular necrosis of scaphoid due to its retrograde blood supply. OR osteoarthritis in wrist later in life if the fracture isn’t identified

Question 4

Two common fractures of metacarpals?

Answer 4

boxers fracture > 5th metacarpal > shortened affected finger

Bennetts fracture> 1st metacarpal > forced hyperabduction of thumb > usually requires surgical repair due to the extension into the carpometacarpal joint

Question 5

which muscle group will atrophy in carpal tunnel syndrome?

Answer 5

thenar eminence

> median nerve innervation lost

Question 6

which branch of the median nerve is spared in carpal tunnel syndrome?

Answer 6

palmar cutaneous nerve > given off prior to carpal tunnel

Question 7

rheumatoid nodules commonly found in?

Answer 7

smokers

Question 8

which finger joint does osteoarthritis commonly effect?

Answer 8

1st carpometacarpal joint

squaring at base of thumb

Question 9

what is a swan neck deformity?

Answer 9

caused by rheumatoid arthritis of finger joints,

presents with hyperextension of the proximal interphalangeal joint (middle one)
& flexion of the metacarpal phalangeal joint (bottom) and distal interphalangeal joint (top)- (bent)

Question 10

diff between swan neck deformity and boutonnieres

Answer 10

swan neck- PIP hyperextended

boutonniers- PIP flexed

Question 11

what is Dupuytren’s contracture. which metas most commonly affected?

Answer 11

‘localised thickening and contraction of the palmar aponeurosis’

4th and 5th most commonly affected

Question 12

Which finger joint does psoriatic arthropathy most commonly affect?

Answer 12

distal interphalangeal

Question 13

what is is psoriatic arthropathy ?

Answer 13

autoimmune mediated inflammatory arthritis

associated with psoriasis