Musculoskeletal and Sports Medicine Flashcards
[MSK/Sport/Concussion]
Risk factors for development of postconcussive syndrome? (3)
- Multiple prior concussions
- Pre-existing disorders: anxiety, depression, learning disorder, migraine
- Factors related to the concussion itself (severe initial symptom burden or delayed symptom onset, loss of consciousness for >1 minute, vestibular symptoms)
[MSK/Cong/Foot]
Diagnosis?
Metatarsus Adductus
[MSK/Cong/LL]
Most common cause of intoeing?
Surgery indication?
Internal Tibial Torsion
- Surgery:
Functional or cosmetic deformity past 8 years old
(spontaneous resolution by school age)
[MSK/Cong/LL]
Diagnsosi?
Surgical indicaiton?
Children find “W” sitting position comfortable
PE: increased internal rotation with decreased external rotation, inwards rotation of the toes and patella when walking
Internal Femoral Torsion
- Surgical indication:
Rotation persists past 11 years old with cosmetic concerns
Functional deficit
Unilateral
[MSK/Cong/Shoulder]
Diagnosis?
Associated malformation?
Affected scapula, elevated, adducted, medially rotated
PE: limited shoulder ROM on the affected
Sprengel deformity
- Associated with:
Kippel-Feil syndrome
VACTERL association
[MSK/Cong/Back]
Scoliosis degree of curvature is measured by ___ angle
___ Risser grade + ___ SMR = increased risk of progression
(Risser grading is the measurement of occification of the iliac crest)
Scoliosis degree of curvature is measured by Cobb angle
Low Risser grade + Low SMR = increased risk of progression
(Risser grading is the measurement of occification of the iliac crest)
[MSK/Cong/Back]
Management for scoliosis
Curvature < ___: activity without restrictions
Curvature between ___ and ___: bracing
Curvature > ___: surgery
Curvature < 20: activity without restrictions
Curvature between 25 and 45: bracing
Curvature > 45-50: surgery
[MSK/Cong/Back]
Diagnosis?
Boys 10-15 years old
Repetitive flextion (weight lifting)
Anterior curvature of thoracic vertebrae
Scheuermann kyphosis
[MSK/Cong/Chest]
Diagnosis?
Associated condition?
Pectus excavatum
- Associated with:
Marfan, EDS
[MSK/Cong/Chest]
Diagnosis?
Pectus Carinatum
[MSK/Cong/Hip/DDH]
For developmental dysplasia of the hip
Hip ultrasound applicable till ___ (age)
Pavilk harness till ___
Spica splint between ___
Hip ultrasound applicable till 4-6 months old
Pavilk harness till ≤6 months
Spica splint between 6 months and 2 years
[MSK/Cong/LL]
Diagnosis?
Progressive pathologic genu varum
Infantile form < 4 years, bilateral
Adolescent form ≥ 4 years, unilateral
Blount disease
[MSK/Hip]
Diagnosis?
Management?
Male between 3 and 10 years old
Hip pain, limp, refusal to walk
After viral illness
PE: limited ROM of the hip
Normal x-ray, mild effusion in US
Transient synovitis
- Management:
Ibuprofen
[MSK/Hip]
Diagnosis?
X-ray finding?
Management?
Girls around 12 years old, boys around 13.5 years old, obese
Hip pain
PE: antalgic gait, impaired internal rotation and flexion of the hip
Slipped Capital Femoral Epiphysis (SCFE)
- X-ray:
extension of the epiphysis past the Klein line - Management:
Non-weight bearing, emergent surgical repair
[MSK/Hip]
Diagnosis?
Mechanism?
Treatment?
Age 4-8 years old
Sx: Patient with limping and hip pain, pain worsen with activity
PE: shortened leg on the affected side, Trendelenburg sign (pelvic tilt)
Legg-Calvé-Perthes disease (LCPD)
- Mechanism:
Avascular necrosis of femoral head - Treatment:
Non-weight bearing with crutches
[MSK/Bone]
Diagnosis?
Management?
Severe nighttime pain responds to NSAIDs, not responding to Acetaminophen
X-ray: radiolucent, sharp, oval lesion
Osteoid Osteoma
- Management:
If NSAIDs responding, x-ray every 4-6 months
If severe pain, surgical resection or radiofrequency ablation
[MSK/Bone]
Diagnosis?
Management?
Asymptomatic, incidental finding
Xray: eccentric radiolucent lesion with thinned cortex, which can have a multilocular appearance
Non-ossifying fibromas
- Management:
Serial x-ray observation
[MSK/Bone]
Diagnosis?
Painless mass on exam
Osteochondroma
[MSK/Bone]
Diagnosis?
Management?
After blunt tissue trauma
Painless, enlarging mass
X-ray: mature peripheral ossification with a distinct margin surrounding a radaiolucdnet center of immature osteoid and primitive mesenchymal tissue
Tramumatic Myositis Ossificans
- Management:
Rest, stretching, NSAIDs
[MSK/Overuse]
Diagnosis?
Mechanism?
Heal pain with runner, jumper
PE: calcaneal tenderness
Sever disease
- Mechanism:
Inflammation of the calcaneal growth plate
[MSK/Overuse]
Diagnosis?
Mechanism?
Lower knee pain for runner, jumpers
PE: bump on the tibial tubercle
Osgood-Schlatter disease
- Mechanism:
Traction of the tibial tubercle at the point of the patella tendon insertion
[MSK/Overuse]
Diagnosis?
Anterior lower knee pain in female athletes
Knee pain with squatting, climbing chairs
PE: pain with compression of the patella (positive patellofemoral compression test)
Patellofemoral syndrome
[MSK/Overuse]
Diagnosis?
Lateral knee pain for long-distance runners, cyclists
Stinging pain during activity
PE: lateral knee pain on knee extension (Nobel test)
Iliotibial band syndrome
[MSK/Overuse]
Diagnosis?
Medial elbow pain for pitchers
PE: medical epicondyle tenderness, pain with valgus maneuvers
Medial Elbow Apophysitis
(Little League Elbow)
[MSK/Overuse]
Diagnosis?
Lateral elbow pain for tennis player
PE: lateral epicondyle tenderness
Lateral epicondylitis
(Tennis Elbow)
[MSK/Overuse]
Pain in a single joint (knee, elbow, ankle)
PE: swelling, crepitus, decreased ROM of the affected joint
X-ray: subchondral fragment
Osteochondritis Dissecans
[MSK/Overuse]
Mechanism?
Spondylolysis: __
Spondylolisthesis: __
Spondylosis: __
Spondylolysis: stress fracture of the pars interarticularis
(lower back pain for gymnastics, hyperextension of the back)
Spondylolisthesis: spontaneous translation subluxation
Spondylosis: osteoarthritis of the spine
[MSK/Knee]
Diagnosis?
Management?
Sudden knee pain after twisting or trauma
PE: swelling, pain with lateral displacement of patella, laterally displaced patella
Patellar dislocation
- Management:
Closed reduction
[MSK/Knee]
Diagnosis when Lachman tet positive?
Management?
Anterior Cruciate Ligament (ACL) injury
- Management:
Surgical reconstruction
[MSK/Knee]
Diagnosis when Valgus stress tet positive?
Management?
Medial Collateral Ligament (MCL) Injury
- Management:
Nonsurgical, RICE
[MSK/Knee]
Diagnosis?
Management?
Fall or direct blow to the anterior knee as wrestling or basketball
Prepatellar Bursitis
[MSK/Knee]
Diagnosis?
Management?
Twisting injury while foot is planted
Sx: localized pain, moderate effusion
PE: pain with duck walk test, pain or clicking with McMurray test
Meniscal tears
- Management:
RICE for small tear, Surgery if large
