Musculoskeletal Diff Diagnosis Lab (10/14c) [Examination/Intervention] Flashcards

1
Q

Ottawa Knee Rules (aka when to image)

A

Age ≥55

Isolated tenderness of the patella (no other bony tenderness)

Tenderness at the fibular head

Unable to flex knee to 90°

Unable to bear weight both immediately and in ED (4 steps, limping is okay)

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2
Q

Diff Dx - Bone Problem

A

Specific tenderness over bony prominence

Difficulty weight bearing

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3
Q

Diff Dx - Contractile Problem

A

Muscle or tendon problem

Isometric test midrange will be positive

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4
Q

Diff Dx - Ligamentous Cartilage Problem (Noncontractile)

A

Special tests point in this direction

Cartilage locking, catching, giving way

Joint line tenderness

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5
Q

Diff Dx - Ligament Problem (Noncontractile)

A

Tenderness to palpation of ligament

Immediate onset of swelling

Joint laxity (positive valgus/varus tests)

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6
Q

Pain Location - Joint Line

A

Medial - medial meniscus or MCL

Lateral - lateral meniscus or LCL

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7
Q

Pain Location - Tibial Tuberosity (young pt)

A

Osgood-Schaletters

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8
Q

Pain Location - Anterior

A

Patellofemoral

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9
Q

Pain Location - Medial Tibial Plateau (2” below joint line)

A

Pes anserinus bursitis

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10
Q

Pain Location - Posterior

A

Baker’s cyst

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11
Q

Injury Mechanism - Ligament Problem

A

deceleration injury or twist of the knee

immediate swelling and pain

may hear a pop sound

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12
Q

Injury Mechanism - Meniscus Problem

A

twisting or deceleration injury

delayed swelling until minutes/hours after injury, or no swelling

no popping

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13
Q

Injury Mechanism - Chronic Onset

A

patients with osteoarthritis, patellofemoral syndrome, and Osgood-Schlatter’s syndrome have a more chronic onset of symptoms

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14
Q

Characteristic - Grinding

A

characteristic of osteoarthritis

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15
Q

Characteristic - Locking and Catching

A

characteristic of meniscus injuries and osteochondritis dissecans

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16
Q

Characteristic - Giving Way

A

characteristic of ligamentous injuries

17
Q

Positions - Patellofemoral

A

Pain with prolonged knee flexion

Relief from knee extension