NMS III FINAL Flashcards
Panner’s Disease is AKA
OCD of elbow
Def of OCD of the elbow
Avascular necrosis of the capitellum joint surface; inflammation d/t to fissures in the articular cartilage and bone followed by fragmentation
Common gender of OCD
MALE 10:1
Etiology of OCD of elbow
repetitive valgus stress to the medial elbow causes compression of the capitellum against the radial head
What other condition should a young male with medial epicondylosis be examined for?
OCD of the elbow laterally
Risk factors of OCD of elbow
Instability and Medial epicondylitis
Direction of movement that is most affected with OCD elbow?
Dec AROM especially extension
Common sign and sx of OCD elbow
gradual lateral elbow pain with or without crepitus and catching
What stage of OCD involves a capitellum that is fragmented?
stage III
T/F The correct vector of manipulation OCD elbow is varus stress.
FALSE: MANIPULATION IS CONTRAINDICATED!
Most important stabilizers of the elbow
MCL and LCL
Structures of the elbow (4)
MCL/UCL, RCL/LCL, Annular ligament, joint capsule
Boutonniere Deformity DEF
Forced flexion causing extensor tendon rupture at the PIP
Mallet Finger DEF
forced flexion causing extensor tendon avulsion at the DIP
Most common affected finger of Mallet finger
3rd digit
Important DDX of a mallet finger
RA (swan neck deformity looks like mallet)
Which of the following is non tender? Heberdens, haygarth, or bouchard
heberdens and bouchards, HAY GARTH is TENDER
Location of:
Heberdens:
Bouchards:
Haygarths:
Heb=DIP
Bou=PIP
HAY=MCP
Madelung deformity=
genetic disorder incolving a radial growth plate disturbance
seal fin deformity assoc with what condition
RA
madelung predisposes you to what condition?
keinbocks disease and TFC tears
another name for Dupuytrens contracture
hypertrophic nodular fibroplasia
Those with what condition have a RR ratio of 4 of getting dupuytrens contracture?
diabetes
What condition can also be seen coinciding with frozen shoulder?
Dupuytrens contracture
What condition involves contracture of forearm in flexion and is d/t supracondylar fracture, acute compartment syndrome, and tight cast?
volkmans ischemic contracture
WHat is the common age group for volkmans ischemic contracture
Children
6 P’s of Volkmanns ischemic contracture and acute compartment syndrome?
pain paresthesia paralysis pallor pulseless paresis
ape hand involves what nerve involvment
median nerve neuropathy
What is the cause of ape hand
neurotmesis: most severe nerve damage
Is ape hand irreversible
yes if there is full damage, early signs of damge are reversible
what nerves are involved in claw hand fingers?
ulnar, median, radiculopathy, or plexopathy
Jersey finger/sweater sign MOI
forced finger extension causing rupture of the FDP
WHat is the jersey finger/sweater sign?
inability to flex the finger when making a fist
Game keepers thumb PT will complain of BLANKK thumb pain where Dequervanies will complain of BLANKKK thumb pain
Lateral Thumb Pain=Dequervaines
Medial Thumb Pain=Gamekeepers
What ligament is sprained in gamekeepers thumb
MCL/UCL of MCP of thumb
MOI of Gamekeeprs
Hyperabduction/Hyperextension of thumb
If they point to lateral and medial sides of the thumb what condition could it be?
BOTH dequervaines and gamekeepers
How should you perform stress testing to check for gamekeepers?
0/30 degrees abduction stress test
weakness with pain=
Musculotendionous
wekaness without pain
neuro
T/F It is relatively easy to differentiate sprain/strain in case of medial thumb pain
FALSE
Gamekeepers thumb will test - or + in isometric muscle testing?
+
stener lesion
a torn UCL and volar plate causing singnificant instability
Should you adjust the thumb in game keeprs thumb
probably not, mobilizayion good though
DEF of ganglion cyst
a swelling or bulge overlying a joint (arthrosynovitis) or tendon (tenosynovitis)
Which type of cyst is more common? worst sxs?
tenosynovial is more common, arthrosynovial is worst
ganglion cyst most common gender
women 3:1
where is a ganglion cyst most common?
wrists
treatment for ganglionic cyst
watchful waiting, protect rest splint nsaids
which type of ganglionic cyst has a higher recurrence rate?
arthrosynovivits
surgery is most likely a treatment for what type of ganglionic cyst?
arthrosynovial ganlgionic cyst
how does arthrosynovial ganglionic cyst compare to tenosynovial
arthro is larger, softer, and more painuful and requires surgery more likely
carpal boss
small protuberance of bone frequently at the base of the 2nd and 3rd CMC joint.
DEF of LAteral epicondylosis
lateral elbow pain due to degenerative tendinopathy, periostitis, and probably adhesions at the lateral epicondyle of the humerus and lateral joint capsule
the muscle most commonly involved is the
Extensor carpi radialus brevis
what test can be done to dx lateral epicondylosis?
long finger test
what is the most common elbow condition?
lateral epicondylosis?
age of lateral epicondlyosis
40-60
etiology of lateral epicondylosis
repetitive overuse involving wrist extension/flexion, gripping, finger movements, pronation and supination
risk factors of lateral epicondylosis
correlated with aging (2x increase in men, 4x increase in females >40), frequency and amount of time spent playing tennis
is forehand or backhand more provocative of lateral epicondylosis? why?
forehand because of the eccentric load being placed on the elbow at the poin tof impact
sxs of lat epicondylosis
lateral elbow pain and stiffness, worse in the AM, weakness and pain during gripping
medial epicondylosis
medial elbow pain tendinopathy of the common flexor tendon at its attachment to the medial epicondyl
typical age of med. epiconylosis
older than 40
race that is more common in medial epicondylosis
whites (golf)
medial elbow pain in children makes you think of what other diagnosis?
salter harris fracture from traction apophysitis of medial epicondyl
TF children will be able to pin point a specific point of pain, where as adults are more generalized.
F. Children are generalized and adults can be specific
orthos for ME
reverse cozens and revese mills
orthos for LE
cozens and mills
sxs of ME
medial elbow pain, insidious onset, pain after rest, pain during exerccise
