Ortho

Question 1

How does a fractured NOF present?

Answer 1

Pain
Can’t weight bear
Shortened, adducted, externally rotated

Question 2

Risk fractures for NOF

Answer 2

Age
Osteoporosis/osteomalacia
Falls - sensory loss, gait disturbance, weakness

Question 3

XR features of NOF

Answer 3

disruption of trabeculae
disruption of shentons lines
abnormality of pelvic contours

Question 4

Types of intracapsular NOF

Answer 4

subcapital
transcervical
basicervical

Question 5

Types of extracapsular NOF

Answer 5

intertrochanteric

subtrochanteric

Question 6

Garden classification

Answer 6

grading for intracapsular NOF fractures

I - crack
II - completed break but not moved
III - complete break slightly shifted
IV - completely moved somewhere else

Question 7

How would you manage a undisplaced intracapsular NOF?

Answer 7

DHS or arthroplasty if less fit

Question 8

How would you manage a displaced intracapsular NOF?

Answer 8

hemiarthroplasty or THR

or fixation if young and fit

Question 9

How would you manage an extracapsular NOF?

Answer 9

Internal fixation or arthoplasty

Question 10

Complications of NOF?

Answer 10

Infection
Haemorrhage
AVN
Malunion
VTE

Question 11

Advise for THR patient

Answer 11

dont bend to more than 90
Dont cross legs
Sleeping wedge
swivel out of car
dont squat or knees to chest

Question 12

Name the rotator cuff muscles

Answer 12

Subscapuralis
Supraspinatus
Infraspinatus
Teres minor

Question 13

Subacromial impingement

Answer 13

History of repeated movement
Muscle wasting
Pain - restriction of active, but full passive
Painful arc 70-120

Question 14

Signs of ACJ problems

Answer 14

trauma/OA
pain on palpation
“step” of separation

Question 15

Rotator cuff tear

Answer 15

trauma in young people/ atraumatic elderly
USS/MRI
mild difficult to distinguish from tendinopathy

Question 16

Causes of adhesive capsulitis

Answer 16

spontaneous
rotator cuff injury
immobility
higher risk; DM, thyroid

Question 17

Signs and symptoms of adhesive capsulitis

Answer 17

Gradual onset severe pain
restriction of active and passive, especially external rotation
interferes with daily living

Question 18

Red Flags of back pain

Answer 18

under 20 or over 50
violent trauma
cancer/IVDU/HIV/immunosupressed
worse lying flat/night
constant/progressive
severe morning stiffness
saddle anaethesia

Question 19

Questions to ask for temporal arteritis

Answer 19

Jaw claudication

Diplpopia/visual changes

Question 20

Chondromalacia patellae

Answer 20

Soft cartilage
teenage girl
anterior knee pain up and down stairs
responds to physio

Question 21

Osgood Schlatter Syndrome

Answer 21

Sporty teens

Pain and swelling over tibial tubercle

Question 22

Osteochondritis dissecans

Answer 22

Pain after exercise

Intermittent swelling and locking

Question 23

Patellar tendonitis

Answer 23

teen athletic boys
chronic anterior knee pain worse after running
tender below patella