MSK- UE, Spine, Hip, LE Flashcards
Nickname for fracture at base of thumb
Bennett’s Fx
Nickname for fracture at base of thumb that is comminuted
Rolando’s Fx
Hyperextension of the thumb that leads to UCL injury is called
Gamekeepers thumb (aka skiers)
Nickname for fracture at head of 5th metacarpal
Boxer’s Fx
Tx boxers fracture
Ulna gutter
ortho consult, sometimes ORIF
MCC paronychia
staph
Main tx for paronychia
I&D
~abx
what is a closed space infection of the fingertip pulp
felon
Intensely painful vesicle along terminal phalanx. Patient unroofed the vesicle which helped with pain
Dx, Tx
Herpetic Whitlow
Acyclovir, self limited 4-6wks
40 y/o pt presents with bump on the dorsum of the hand. It is asymptomatic except mild pain with direct pressure. It is well circumscribed and feels fluid filled. You are able to transilluminate it on exam.
Dx
Tx
Ganglion Cyst
can just observe, some resolve
can aspirate with 18g needle (re-occurrence common)
pain in the anatomical snuff box
schaphoid fx until proven otherwise
splint and repeat films 10-14 days
distal ulna fracture with anterior radial head dislocation
Monteggia fx
proximal radial fracture with distal dislocation of radioulnar joint
Galaezzi fx
24 y/o girl fell on both elbows (walking home drunk. She presents to ED with L sided decreased elbow ROM and mild swelling. Xray doesn’t demonstrate fracture but there is a sail sign
Likely radial head fracture
nondisplaced tx- soft splint, ICE, NSAID, early ROM
distal radius fracture with dorsal angulation
“dinner fork” deformity
Colle’s fx
distal radius fracture with palmar displacement
Smith’s fx
55 y/o F presents with arm pain that is worse when picking up items that are palm down. She also has pain when turning door knobs. This affects her job as a machinist and assistant coach for her sons little league team
Medial epicondylitis (aka Golfers or Pitchers Elbow)
RICE, NSAIDS, Bracing
rarely ulnar nerve transposition
medial epicondylitis is inflamm of _________
lateral epicondylitis is inflamm of______
flexors
extensors
Tennis Elbow is
lateral epicondylitis
tender or lat elbow, pain pulling doors
Elbow dislocation MC _____
posterior
C1 (atlas) burst Fx nickname
Jeffersons Fx
Fracture of C2 pedicles with anterior displacement of body nicknamed
Hangmans Fx
spinous process fx
nickname and MC locations
Clay Shovelers Fx
usually C6 or C7
avulsion by supraspinatous ligament
60y/o male with chronic LBP. Has hip and leg pain that is relieved by rest. He can only walk short distances before having to take a break. If he leans over his shopping cart at the market he can go a little further.
Spinal Stenosis
-neurogenic claudication
MC cervical HNP
C6-C7 which compresses C7
MC lumbar HNP
L5-S1 which compresses S1
spurlings sign
pain reproduced when examiners exersts pressure down on vertex while tilting head towards symptomatic side
lhermitte’s signs
electrical shock like sensation radiating down spine
diminished Achilles reflex and weakenss with plantaf flexion
which nerve being affected
S1
traumatic back injury and pt has
loss of motor fx, pain sensation, and temp sensation distal to lesion
there is preservation of vibration, position and crude touch only
Anterior Cord Syndrome
traumatic back injury and pt has
decreased strength distal to lesion, UE>LE
some decreased pain and temp sensation
Central Cord Syndrome
osteoarthritis of spine
Spondylosis
fx from interior facet, across pars, to superior facet
xray- scotty dog
Spondylolysis
anterior slippage of vertebral column relative to an adjacent inferior vertebrae
MC at L4-5 L5-S1
Spondylolisthesis
When do you treat scoliosis
> 20 degrees
MC seen scoliosis curves
which do you suspect in neuro disease?
MC R thoracic or L lumbar
suspect neuro disease with L thoracic
exaggerated curvature of the thoracic spine
kyphosis
Back pain worse in am
improves with activity
radiates to buttock
Ankylosing spondylitis
buzzwords for ankylosing spondylitis
“bamboo sign” “shiny sign”
HLA-B27
hip and lbp
1st line tx for ankylosing psondylitis
NSAIDS, many trials
then TNF inhib
12 y/o boy tenderness over anterior knee worse with activity
soft tissue swelling
xray nonspecific changes
Osgood-schlatters
Ortolanit test
detects DISLOCATED
hip abducted, feel reducing back into acetabulum
Barlow test
detects UNSTABLE
adduction, feel “pistoning”
MC joint injury
inversion ankle sprain
lateral ligament- primarily ATF
Jones fx
fx base of 5th metatarsal
wrist drop would correlate to what nerve?
Radial
Thompson test
squeeze gastrocnemius
(+)= no foot movement
indicative of Achilles rupture
MC mechanism of meniscal tear
axial loading with rotation
MCL complete tear would have laxity of the knee with _____ stress
valgus
patella MC dislocated what direction
lateral
what test is most sensitive for ACL injury?
Lachmans
