Ortho Flashcards
Compression fx
- Common in vertebrae, 1 bone against other
Comminuted fx
3 + fragments of fracture
Transverse fx
Perpendicular to long bone axis
Oblique fx
Slanted on shaft of long bone
Greenstick
Incomplete twisting, usually in children
Torus/ buckle fx
Compression of cortex- bulging of cortical bone
- Distal portion of radius
Soft tissue injuries
- Control hemorrhage
- Test PV and nerves distal
- Test joints
- Exposures, rhabdo
Ottawa knee rules
> 55
- Isolated patellar tenderness
- Fibular tenderness
- Unable to flex knee to 90
- Unable to bear weight
Ottawa ankle rules
- 5th metatarsal
- Navicular
- Posterior malleoli- lat and med
- inability to bear weight
Gout- Sx
1 joint, lE, 1st metatarsal MC
- Exquisite tenderness and erythema
- Urate crystals
- Negatively birefringent, needle shaped urate crystals
Gout- Tx
- NSAIDs- Indomethacin
- Colchicine (acute & chronic)
- Allopurinol
- Low purine diet
Pseudogout- Sx
- Calcium pyrophosphate deposition
- Acute, recurrent arthritis- knees and wrists
- Rhomboid shaped crystals, positivly birefringent
Pseudogout- Tx
- Intrarticular steroids
- NSAIDs, cholchicine
OA- Sx
- Weight bearing joints,
- Stiffness decreases with rest
- Best in AM, worst in PM
- Heberden nodule at DIP
- Bouchard nodule at PIP
- Imaging- narrow joint space, osteophyte formation
OA- Tx
NSAIDs, steroid injections
Drugs that induce hyperuricemia
- Loop & thiazide diuretics
- Aspirin
- Immunosuppressants- cyclosporine and tacrolimus
- Niacin
Hyperextension of C spine- MOA, Sx
Whiplash
- Neck pain
- Weakness, numbness, tingling
Hyperextension of C spine- Tx
RICE, PT, NSAID
Disc herniation- MOA/ Sx
L5-S1
- Degenerative or heavy lifting
- Back pain with sitting, numbers or weakness
- Worst at level of affected disc
- Cauda eqina
Disc herniation- Tx
- Bed rest, NSAIDs, injections, repair
Acute lumbosacral strain- MOA/ Sx
Poor lifting
- Pain and spasm in lower back muscles
- Dec. ROM
- No neuro changes
Acute lumbosacral strain- Tx
- PT
- Brief bed rest
Bicipital tenosynovitis- MOA, Sx
- Inflammation of long head bicep tendon
- Pain with lifting, anterior shoulder
- Yergason test
Bicipital tenosynovitis- Tx
PT, steroids
Rotator cuff tendonitis- MOA, Sx
- Pain with overhead activities, internal rotation
- Pain in front of shoulder
- Neer and Hawkins
Rotator cuff rupture- MOA, Sx
MC shoulder pain
- Trauma & overuse
- Weakness, atrophy and pain
- empty can, drop arm test
- Full PROM
Rotator cuff rupture- DX/ Tx
- MRI
- Rehab, NSAIDs, steroids, surgery
Subacromial bursitis- MOA/ Sx
- Acutely painful, swelling and focal tenderness
- Full ROM
Subacromial bursitis- Dx, Tx
- Aspiration
- Heat, rest, NSAIDs, steroids
Lateral epicondylitis- MOA, Sx
- Tennis elbow
- Tenderness of lateral epicondyle
- Pain with extension
Medial epicondylitis- MOA, Sx
- Golfers elbow
- Pain with flexion, pronation, pulling activities
- Medial epicondyle tenderness
Epicondylitis- Tx
- PT
- RICE
- Braces
Olecranon bursitis- MOA, Sx
Trauma, gout, inflammation
- Abrupt goose egg swelling
- Boggy, tender, red
- Limited flexion
Olecranon bursitis- Tx
Heat, rest NSAIDs
- Aspiration if suspicions
Carpal tunnel- MOA, Sx
- Median nerve entrapment neuropathy
- Pain & paresthesias, worse at night
- Thumb, pointer, middle fingers
- Thenar hypertrophy
Carpal tunnel- Dx, tx
- tinel and phalen
- Volar splint
- NSAIDS
- Surgery
Ganglion cyst- MOA, Sx
- Synovial outpouching
- At wrist, flexor sheath
- Movable, compressible mass
- Tx: Steroid injection with aspiration
DeQuervian tenosynovitis- MOA, sx
- Inflammation of abductor pollicus longus, extensor pollicus brevis
- Repetitive thumb use- gripping
- Pain along radial aspect radiates to forearm
DeQuervian tenosynovitis- Dx, Tx
- Finkelstein
- Thumb spica splint, NSAIDs, steroids
Ulnar nerve entrapment- MOA, SX
- Pinky & ring finger paresthesias
- Medial elbow pain, worse with flexion
Ulnar nerve entrapment- Dx, Tx
- tinel sign at elbow
- Pain worse with flexion
- Wrist immobilization, NSAIDs
Duputren contracture- MOA, SX
- Genetic, men 40-60
- Fixed flexion at MCP- 4th & 5th
- Nodule over crease, painful
Duputren contracture- Dx, Tx
- Clinical dx
- Steroid injections
- PT, surgical correction
Finger/ wrist sprain
- Pain at ligament insertion site
- Joint laxity
- Tx: immobilzation,
Trochanteric bursitis- MOA, Sx
Local, acutely swollen at trochanter
- Heat, rest, NSAIDs, steroids
Medial meniscus- MOA, Sx
- Repeated use, micro trauma
- Pain, clicking and locking
- Antalgic gait, difficulty squatting
Medial meniscus- Dx, Tx
- MRI
- McMurray test- click with external rotation and varus stress
- Analgesics and PT
Chondromalacia patellae- MO, Sx
- Runners knee- repetitive use
- Softening/ fissureing of patellar articular cartilage
- Anterior knee pain BEHIND patella
- Worse with flexion
Chondromalacia patellae- Dx, Tx
- Apprehension, patellar grind
- PT- quad strengthing, NSAIDS, brace
Baker’s cyst- MOA, Sx
Synovial fluid effusion at popliteal fossa- d/t meniscal tear
- Acing, clicking, locking of knee
Baker’s cyst- Dx, Tx
US
- Ice, NSAIDs, steroids
ACL- MOA, Sx
- MC knee injury
- Pivoting
- Loud pop, swelling
- Non-weight bearing
- Stiff knee
ACL- Dx, Tx
- Lachman test
- MRI
- Surgery or therapy
PCL- MOA, Sx
- Force to flexed knee
- Large effusion, anterior brusing
PCL- Dx, Tx
- Posterior drawer
- MRI
- Immobilization, Surgery
MCL/ LCL- MOA, Sx
- MCL- Valgus stress with rotation
- LCL- Varus stress with rotation
- Pain, swelling, siffness
MCL/ LCL- Dx, Tx
- Sprain or incomplete tear- Control pain, PT, RICE, NSAIDS
- Complete tear- Surgical
Hallux valgus- MOA, Sx
- Bunion deformity
- Pain, at 1st metatarsal with lateral deviation
- Tx: Wide toe box, surgical correction
Hammertoe- MOA, Sx
PIP deformity- inflexion
- DIP and MTP hyperextended
- Pain
- Wear larger shoes
Ankle sprain- MOA, Sx, Tx
- Anterior talofibular ligament MC
- Eversion = deltoid ligament
- Pop, swelling, pain
- RICE, NSAIDs, strengthening
Stress fracture- MOA, Sx
- 3rd metatarsal
- Insideous onset of local, achy pain, swelling and tenderness
Stress fx- Dx, Tx
- XR- 50% will not be seen
- RICE, NSAIDs, splint
Plantar fasciitis- MOA, Sx
- Inflammation of aponeurosis d/t overuse- flat foot, heel spur
- Tenderness, heel pain
- Worst in with first few steps
Plantar fasciitis- Dx, Tx
RICE, support, NSAIDs
Morton neuroma- MOA, Sx
Degeneration of plantar nerve- high heels
- Painful mass near tarsal head at plantar surface
- Pain with palpation, squeezing forefoot
Morton neuroma- Dx, Tx
- Pain in webspaces
- Wide shoes, steroid injection
