Ortho Flashcards
best test for Acl
lachman
Lie the patient supine on the bed. Place the patient’s knee in about 20-30 degrees flexion. According to Bates’ Guide to Physical Examination, the leg should also be externally rotated slightly. The examiner should place one hand behind the tibia and the other on the patient’s thigh. It is important that the examiner’s thumb be on the tibial tuberosity. On pulling the tibia anteriorly, an intact ACL should prevent forward translational movement of the tibia on the femur (“firm end-feel”).
best test for meniscus
McMurray
supine, knee flexed, ER and IR
Ottowa ankle rules
bone tenderness at posterior edge of distal 6 cm or tip of medial/lateral malleolus
inability to bear weight for 4 steps
Ottowa foot rules
bone tenderness at navicular bone/base of 5th metatarsal
inability to bear weight for 4 steps
osteoperosis
T score less than -2.5
tx with bisphosphonates
MC fx is vertebral body compression fx
RA
morning stiffness >30 min
symmetrical joint swelling, boutonierre/swan deformity
-+ RF, anti-cyclic citrullinated peptide antibodies
gout
negative birefringent needle monosodium crystals
diuretics can make worse
Polymyalgia Rheumatica
proximal muscle (shoulder, neck, hip girdle) stiffness and aching in the morning
- ESR >40
- associated with temporal arteritis
- tx w/prednisone (quick response seen)
chondrosarcoma
30-50 YO
deep achey pain at night, popcorn calcifications
flexor tenosynovitis
Kanavel criteria
- tenderness along flexor tendon
- symmetrical swelling of finger
- pain wihth PROM
- flexed posture of finger
osteosarcoma
10-20 YO or >65
xray shows codman’s triangle, sunburst pattern
MC at the long bone metaphysis
MC malignant bone tumor
mallet finger can result in
swan neck deformity
hip dislocation
posterior
when is spinal stenosis pain better?
when leaning forward pain is less
TIA
transient episode of neurological disfunction caused by focal brain, spine, or retinal ischemia without infarct
how to dx carcinoid
5-HIAA
MS
CSF shows oligoclonal bands
MRI-multiple T2 hyperintensities
Scleroderma
ANA
Anti centromere
Anti topoisomerase
Anti Smith ab
Anti DS-DNA
SLE
Citrullinated
rheumatoid
Giant cell arteritis is a/w
polymyalgia rheumatica
Lisfranc injury
tenderness to tarsometatarsal joint
Tests for carpal tunnel
Phalen’s is best
Tinel
Nervw conduction confirms
dequervains tenosynovitis
finklestein test
Internal rotation hip pain
scfe
Osgood schlatter tx
Tylenol and continue as tolerates
Mc bone fx that causes compartment syndrome
tibia
Pes anserine bursitis
Pain ober medial tibial condyle
sprain
ligmaent
strain
muscle, check for avulsion fx
most shoulder dislocations are
anterior, externally rotated
may injure axillary nerve
boxer fx
distal end of 5th metacarpal, gutter splint
Galeazzi
radial fx middle to distal 1/3 and dislocation of distal radioulnar joint
monteggia
ulna fx in proximal 1/3 and radial head dislocation
Gamekeepers
ucl injury
Duquervins
may have forearm pain as well, test with finkelstein
lateral epicondylitis
tennis elbow
kyphosis
thoracic spine curvature
may impact pulmonary function
scheurmans appears at puberty
scoliosis
right thoracic curve is MC
screen with Adams
>40 refer to sx otherwise just f/u
jefferson fx
C1, odontoid view
hangman fx
C2
Clay Shoverler
C6/C7
spondylolithesis
scotty dog, ant slippage of vert body on inf counterpart, pars inticularis defect, oblique view**
hip fx
leg is short held in ER
hip dislocation
90% posterior, adducted in IR
stress fx
3rd metatarsal
what will be elevated in osteo
Sed rate
who gets screened for osteoperosis
women 65+
PAN
palpable purpura, P-ANCA
anti-histone
drug induced lupus
scleroderma
+ANA
anticentromere
anti SCL70
osteosarcoma
10-14 YO, starburst/sunray, sx
typically effects knee
ewing
moth eaten
onion skin
effects long bones
nerve injury that produces foot drop
deep peroneal nerve
what nerve injury results in scapular winging
long thoracic
frozen shoulder
decreased PROM and AROM
biceps tendiopathy
anterior shoulder pain
MC hip fx location in older adults
femoral neck
