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IPAP JUNIOR SEM. > ORTHO BLOCK1 > Flashcards

ORTHO BLOCK1 Flashcards

1
Q

Define Clinical Symptoms and adverse outcomes of Osteoarthritis

A

Clinical:

Stiffness, joint pain, deformity
Common locations: fingers, knees, hips, and spine
Mechanical symptoms
Secondary- history of trauma
*Fracture
*Osteonecrosis
*Developmental hip dysplasia

Adverse:

Progressive degeneration
Chronic pain
Decreased ROM
Decreased strength
Instability
Lower extremity contracture
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2
Q

Pt on Physical exam:

presents with decreased ROM, Crepitus, Muscle atrophy, and joint line tenderness

What is Most likely Dx?

A

OA

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3
Q

Shoulder arthritis presents as

A

Posterior shoulder pain

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4
Q

OA in the hands presents as

A

DIP (herberden) and

PIP (Bouchard)

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5
Q

OA in the thumb presents as

A

CMC ( Carpal/ Metacarpal) OA,

W/ grip and pinch activity pain

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6
Q

What is a CMC grind test

A

Pushing in the thumb and grinding it, pain is a positive finding of OA

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7
Q

OA in the Hip present with…

A

Anterior pain; Walk in external rotation with limited internal rotation

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8
Q

OA in the Knee presents with

A

Most commonly genu varum due to medial compartment wear

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9
Q

OA in the foot presents with..

A

1st MTP= hallux rigidus, subtalar joints

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10
Q

Hallmark imaging findings of OA

A 
joint space narrowing
Sclerosis 
-(whiting of bone sub joint space) 
subchondral cysts
Osteophytes (bone spurs)
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11
Q

Referral and Red Flag points for OA

A

Non-operative failure
Limited functional ROM
Young with severe disease

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12
Q

What is the best imaging study for finding fragments in a joint

A

CT

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13
Q

How does RA vs OA progress over the day

A

OA is better after rest ( mornings) and gets worse throughout the day

RA is worse in the morning and improves throughout the day

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14
Q

RA most commonly infects which joints

A

Small joints, wrist, MCP, PIP, MTP

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15
Q

What are the adverse outcomes associated with RA

A

C1- C2 instability due to erosion of odontoid ligaments

Tendon Ruptures

Deformity of the hands fingers and toes

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16
Q

What are the wrist and finger deviations in RA

A

Wrist will radially deviate

Fingers will ulnarlly deviate

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17
Q

Osteopenia and bony erosions, w/ symmetric joint space narrowing/ involvement
Malalignment of joints

Indicates…

A

RA

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18
Q

What is the best lab test for specificity of RA

A

Anti CCP

Anti Cyclic citrullinated peptide bodies

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19
Q

What is the DOC for RA

A

DMARDS

  • TNF alpha
  • ANAKINRA
  • RITUXIMAB
  • ABATACEPT

2* Injections

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20
Q

Seronegative spondyloarthropathies most often affect what joints

A

The sacral joints, S1 (BACK PAIN)

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21
Q

What is the cant see, cant pee, cant bend the knee

A

Conjunctivitis + enthesitis + urethritis

Reuters syndrome
MOC: Chlamydia

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22
Q

Limited ROM, male 15-30, back pain, hand swelling, and nail abnormalities, enthesitis

Indicates

A

Ankylosis spondylitis

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23
Q

What is the #1 S/s of compartment syndrome

A

PAIN OOPT

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24
Q

What is the most sensitive earliest exam finding in compartment syndrome

A

Passive stretch of the muscles in the compartment

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25
Q

Parenthesis in the 1st web space ( dorsal) with weak Dorsi flexion with pain on passive great toe flex is compartment syndrome where

A

Anterior leg

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26
Q

Pain with passive ankle inversion is compartment syndrome where

A

Lateral leg

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27
Q

Pain with passive extentsion of the great toe is compartment syndrome where

A

Deep posterior leg

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28
Q

Pain with passive Dorsi flexion of the ankle is compartment syndrome where

A

Superficial posterior leg

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29
Q

What is a NML resting compartment pressure

A

Less than 15 mmHg

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30
Q

What are the pressure readings for acute compartment syndrome

A

Absolute pressure greater than 30 mmHg or w/in 30 mmHg oh the DBP

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31
Q

What are the pressure readings for chronic compartment syndrome

A

Resting pressure greater than 15mmHg
Greater than 30 mmHg post exercise
or
Greater than 20 mmHg 5 minutes post exercise

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32
Q

What are type I and II Complex regional pain syndrome

A

Type 1- No identifiable nerve injury

Type 2- Nerve lesion exists

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33
Q

What does algodystrophy mean

A

Burning pain ( associated with Complex regional pain syndrome)

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34
Q

What are the clinical findings in Complex regional pain syndrome

A

START NOW

Swelling 
Temperature 
Agony/ Pain 
Redness 
Tremors

Nerve medication (DOC) (Gabapentin)
Opiods (Helpful)
Workouts (key to Tx)

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35
Q

What does Homans test detect

A

DVT

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36
Q

What disorder is marked by osteophyte formation spanning three or more intervertebral disks involving the anterior longitudinal ligament

A

DISH

Diffuse idiopathic skeletal hyperostosis

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37
Q

True or False:

DISH effects men more than women?

A

True

Men ( 2:1) and older than 60

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38
Q

What is the Tx approach to DISH

A

Non operative, Walking, NSAIDS

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39
Q

What is the most common soft tissue tumors of the hand and wrists oh pts between 15-40 years old

A

Ganglia

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40
Q

Where is a bakers cyst located

A

Popliteal cyst

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41
Q

Mucoid cysts are located where

A

In the fingers

( typically in arthritic pts)

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42
Q

What imaging study is best to look at ganglia

A

US ( popliteal cysts)

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43
Q

What imaging study can find occult volar wrist cysts

A

MRI

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44
Q

Should you aspirate cysts located on fingers

A

No!

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45
Q

What is the referral criteria for a ganglia

A

Atypical location
Aspiration failure
Septic joints

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46
Q

What is the most common spread of osteomyelitis in peds

A

Hematogenous spread

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47
Q

All open fx patients get referred to ortho to prevent

A

Osteomyelitis

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48
Q

Most common organisms that cause osteomyelitis

A

S. Aureus ( most common overall)

S. Epidermis ( prosthetic joints)

Salmonella ( common in sickle cell)

Group B Strep ( neonates)
Group A beta hemolytic (Skin or peds)

Pseudomonas ( Puncture wounds in tennis shoes)

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49
Q

Knee Inflamation is…

Bone infection/ inflamation

A

Knee: septic joint

Bone: osteomyelitis

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50
Q

Osteopenia with soft tissue swelling and periostea reaction/ elevation is an early indication of ..

A

Osteomyelitis

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51
Q

What is the gold standard/ definitive Dx for osteomyelitis

A

Biopsy/ bone aspiration

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52
Q

What 4 labs should be ordered for osteomyelitis

A

ECP( more useful)
ESR
WBC
Blood culture

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53
Q

Are oral ABX effective against osteomyelitis

A

NO!, use IV and debridement

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54
Q

What joints are most likely to be infected in young children vs adults with septic arthritis

A

Hip in young children

Knee most common in older children and adults

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55
Q

What are the organisms that cause septic arthritis

A

S. Aureus ( most common in all age groups )

Strep Group A and B ( Neonates and infants)

N. Gonorrhea ( sexually active young adults)

Pseudomonas ( Immunocomp pts)

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56
Q

What are the ADE of septic arthritis

A

Joint destruction and OA

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57
Q

What is the best initial and most accurate test for septic arthritis

A 
Joint aspiration 
( WBC > 50, 000- primarily neutrophils) 
( WBC> 1,100 In prosthethic joints)
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58
Q

What is the difference between type I and type II primary osteoporosis

A

Both types most common in women

Type I: hormonal changes that lead to bone loss

Type II: metabolic changes that leads to bone not forming

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59
Q

What DEXA scan numbers relate to osteoporosis

A

O to -1 is normal

  • 1 to -2.5 is osteopenia
  • 2.5 or below is osteoporosis
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60
Q

What is a strain

What is a sprain

A

Strain Involves muscles or ligaments
Graded 1-4

Sprain involves ligaments
Graded 1-3

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61
Q

Grade 1 strain

A

Less than 10 percent muscle involved

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62
Q

Grade 2 strain

A

10-50 percent muscle involvement

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63
Q

Grade 3 strain

A

50-100 percent muscle involved

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64
Q

Grade 4 strain

A

100 percent of the muscle and fascia is disrupted

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65
Q

Grade1 sprain

A

Partial tear without instability

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66
Q

Grade2 sprain

A

Partial tear with laxity

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67
Q

Grade 3 sprain

A

Complete tear of the ligament

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68
Q

Is it more likely for a child with an open growth plate to sprain a joint or fracture a bone

A

No, salter Harris 1 are more common as the growth plates are weaker than the ligaments

(Opposite in adults)

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69
Q

Referral criteria for a Sprain/ strain

A

Chronic laxity

Severe Grade 2 and above

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70
Q

What is the difference between radiculopathy and myelopathy

A

Radiculopathy:
Disease of the spinal nerve roots and spinal nerves

Myelopathy:
Disease of the spinal cord

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71
Q

Where does the cauda equina start

A

After the conus medularis at L1-L2

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72
Q

Cauda equina causes what kind of paralysis ?

A

Paralysis without spasticity

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73
Q

Bilateral radicular saddle distribution S/s w/ loss of bowel and bladder control (s2-4) think what pathology

A

Cauda equina

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74
Q

What are the common causes of cervical radiculopathy in young vs old pts

A

Young: disk herniation

Old: osteophytes at the foramen

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75
Q

What is the Tx approach for cervical radiculopathy

A

Non-operative-
Anti-inflammatory and traction
Physical therapy
NO NARCOTICS, no manipulation

Operative-
Decompression +/- fusion

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76
Q

What is the AKA for Degenerative Disk Dz

A

Cervical spondylosis

Bone spurs w. Narrowing of disks

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77
Q

Pts with palmar paresthesias, decreased dexterity, and gait disturbances ( Tandem Walk)

A

Cervical spondylosis

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78
Q

What is Hoffmanns sign

A

Flicking the Middle DIP causes the thumb or first finger to flex involuntarily

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79
Q

What are the most common changes in the spine with cervical spondylosis

A

Osteophytes at C5-6 and C6-7
BIG BONE SPURS

With joint space narrowing

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80
Q

Tx approach to Cervical Spondylosis

A

NSAIDS
Doxepin or Amitriptyline (sleep)
PT
NOT NARCS

Operative- Decompress

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81
Q

What is the most common pathogen for discitus

A

Staph Aurus

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82
Q

When giving Cortisosteroid injections it is important to avoid what anatomical structures

83
Q

What are the ADE of Steroid injections

A

Depressions in the skin, degeneration of bone/ joint and tendon degen

84
Q

What imaging modality is;

Confirmatory, used for surgical planning, assentuates soft tissues, spine and required pediatric sedation

85
Q

What imagine modality is used for surgical planning, is good for fracutures at joints, used in stable trauma pts and required s pediatric sedation

86
Q

Is OA reversible

87
Q

Lower extremity contracture is an ADE outcome of what arthritis DZ

88
Q

On physical exam you find decreased ROM, Joint line tenderness, crepitus without obvious inflammation.. .suspect?

89
Q

What are the non operative Tx options for OA?

What are the operative?

A

Non op: NSAID, rest, Wt loss, low impact activities
Injections

Op;
Arthorplasty
Or arthodesis

90
Q

ADE outcomes of steroid injections

A

Infection RSK
Transient synovitis
Cartilage destruction

91
Q

A pt with Morning joint stiffness greater than 1 hr for 6 weeks.. suspect/.?

92
Q

OA is associated with what joints

RA is assoc with what joints

A

OA: weight bearing ( KNEE, HIP, SPINE)

RA ( small joints, wrist, fingers, FOOT ANKLE)

93
Q

Synovial Hypertophy is know as.? And is associated with?

A

“Boggy joint”

RA

94
Q

What are the op Tx for RA

A

tenosynovectomy ( tendon and protective sheath)

If severe: Arthroplasty/ Arthodesis

95
Q

Sacroiliac back pain that is “ascending” in nature is a clinical S/s of what spinal D/o

A

Seronegative spondyloarthopathies

96
Q

A pt with a negative RF and ANA, positive HLA-B27, on X-ray there is resorption of phalanges, and bone reactions in the DIPs

Suspect

A

Psoriatic Spondylosis

97
Q

What is the Tx approach to Arthritis w/ IBS?

A

Tx the IBS

98
Q

Tx approach for psoriatic arthritis

99
Q

Tx approach to reactive arthritis/ rieters syndrome

A

Tx the active infection (Chlamydia)

100
Q

HLA B27 positivity indicates

A

Seroneg Spondylosis

  • ankylosing
  • psoriatic
  • reactive/ Rieters
101
Q

What are the 6 Ps of compartment syndrome

A 
Pain 
Pallor 
Parenthesias 
Pulslessness 
Paresis 
Poikilothremia (cool to touch)
102
Q

Chronic compartment syndrome is defined as

A

Compartment syndrome S/s on activity w/o S/s 30 min post activity

103
Q

What are the ADE outcomes of compartment syndrome

A

Necrosis
Nerve damage
Kidney failure
Limb loss

104
Q

Back pain, stiffness, decreased ROM, worse in the morning and at rest, decreases with activity and exercise/ activity, +sacroiliitis, and is Seronegative
+HLA B27

May have: uveitis
Pulm fibrosis
AV blocks, AR

A

Ankylosing Spondy

105
Q

What is an early finding of Ankylosising Spondylosis

A

Narrowing of the SI joint

Bamboo spine is later found

106
Q

Keratoderma Blennorrhagicum is what? And is a sign of what

D/o?

A

Hyper-keratotic lesions on the palms and soles

Is a sign of reactive arthritis aka Rieters syndrome

107
Q

Septic arthritis presents with WBC of what in athrocentsis

A

Greater than 50, 000

108
Q

Alpha fetoprotein is a tumor marker for what

A

Hepatocelllualr CA

Nonseminomatous germ cell testicular CA

109
Q

What is the most common cause of Compartment syndrome from trauma

A

Fx of a Long bone (75%)

And Crush injuries

110
Q

What is the definition of Complex regional pain syndrome

A

Cyclic inflammatory response

Reflex sympathetic dystrophy

111
Q

What is podagra

A

Swelling of the big toe (1st MTP joint) associated with GOUT

112
Q

Triangular Fibrtocartillage Complex calcifications on X-ray is a sign of

A

Psuedo gout

113
Q

Subchonrdal erosions, with periarticualr spurs, and a negative bifringment crystals are a sign of

114
Q

What is the Tx approach for crystalline deposition Dz like gout and psuedo gout

A

Indomethacin/ NSAIDs
COLCHICINE!

Underexcresion: probenecid
Overproduces: Allopurinol

115
Q

How does Allopurinol work

A

Decreases uric acid production

Used as a 1st line agent for over production GOUT

116
Q

What is the DOC that can be used in both GOUT and psuedo GOT

A

Colchicine

Anti-inflammatory medication

117
Q

What is Virchows triad

A

Venous stasis
Injury
Hyper-coag

118
Q

What are the imaging modalities used to observe a DVT

A 
Venous US ( 1st line) 
Contract venography ( CT) 
EKG- PE? 
CXR-PE? 
VQ scan- PE?
119
Q

What are the non op and preventative Tx for DVT

A

Non op: mechanical prophylaxis ( stocking, compression)

Prevention

1: Hepari/ enoxaparin
2: warfarin
3: aspirin

120
Q

When should a DVT be referred to Vascular

A

Proximal DVT in the popliteal area or higher

121
Q

Osteophyte formation spanning 3 or more intervertebral disks, involving the thoracic or thoracolumbular spine (specifically the Anterior longitudinal ligament)

122
Q

DISH is worse in what joints

A

Excessive bone formation worst around the spine and hips

Leading to Hip and knee replacements

123
Q

A pt with Decreaed spine ROM in both forward flexion and extension, reduced hip motion, +/- knee OA, spinal stiffness in both the morning and evening, with excessive bone formation worse around the spine and hips is what condition

124
Q

Ganglia are filled with..

A

Joint fluid

125
Q

A ganglion cyst located in the wrist should raise worry of what vascular issue

A

Mass effect of the radial artery

126
Q

What is the Tx approach for Cysts

A

Treat the underlying Cause

In the wrist: immobilize, aspirate, and possible surgery

Hand: aspirate, possible surgery

Finger: DO NOT ASPIRATE

Knee: US guided aspiration

127
Q

Why do all open fractures get referred to ortho

A

Prevent osteo myelitis

128
Q

What are the S/s of osteomyelitis in Adults and Kids

A

Adults : fever (100.4) , deep pain (not a joint), with Hx of injury/ puncture, possible gait changes and Decreased ROM

Peds: malaise, crying (signs of pain or discomfort), fever greater than 100.4, Hx of illness (hematogenous)

129
Q

What is the definitive D/o for osteomyelitis

130
Q

Tx approach for Osteomyelitis

A

Surgical debridement

IV ABX

131
Q

What is the most common cause of hemoatogeouns spread of Osteomyelitis in adults

A

Vertebral Osteo

132
Q

What is the WBC # in septic arthritis of a prosthetic joint

A

Greater than 1,100

133
Q

WBC # greater than 50,000 in a knee is indiacation of

A

Septic Arthritis/ joint

134
Q

What is the Tx approach to septic joint

A

1: aspirate and culture
2: empiric ABX tx
3: Surgical washout

135
Q

What is the referral criteria for septic joint

136
Q

Secondary Osteoporosis (from drugs, diet, or Endo D/op) is most common in men or women ?

137
Q

What is the precursor to osteoporosis

A

Osteopenia

138
Q

Post menopausal women/ old

Are at increased risk of what bone D/o

A

Osteoporosis

139
Q

What is the best diagnositic scan for osteoporosis

A

DEXA scan

osteoporosis hides,and so did dexter

140
Q

What is the Tx approach to osteoporosis

A 
Calcium and Vit D 
Walking for Wt loss 
Avoid Alcohol and smoking 
Decrease fall risk 
Overall prevention
141
Q

When evaluating a sprain or strain what is the Physical exam approach

A

Locate point of maximal tenderness

Palpate for a defect ( strain) 
Evaluate strength (5/5?)
Test stability (Special tests)
142
Q

Define Ottowa Ankle rules

A

There is any pain in the malleolar zone; and,
Any one of the following:

-Bone tenderness along the distal posterior edge of the tibia or tip of the medial malleolus
Or

Bone tenderness along the distal posterior edge of the fibula or tip of the lateral malleolus

  • An inability to bear weight both immediately and in the emergency department for four steps.
  • Pain over the navicular
  • pain at the base of the 5th metatarsal
143
Q

When should you MRI a sprain or strain

A

When the D/o is unclear or there is excessive laxity of the joint

144
Q

TX approach to strains and sprains

A

PRICE, NSAIDs, Rehab

Severe: Reconstruction or repair

145
Q

What is the difffernce between dermatomes and myotome

A

Dermatomes are associated spine and skin innervation

Myotome is associated spine and muscles inneravtion

146
Q

What is the SOC from Cauda equina

A

MRI is best…

US can asses post void residual (Overflow inconstinence)

147
Q

A pt presents with unilateral parasethsias in a dermatomal/myotomal pattern in the neck/ shoulder… suspect?

A

Cervical radiculopathy

148
Q

Radiculopathy progresses to..

A

Myelopathy

149
Q

A pt with cervical radiculopathy needs what images ordered

A

X-ray to r/o spondylosis
MRI to ID nerve/ root compression
CT w/ myelogram
EMG to locate area of neuro dysfunction

150
Q

A pt with decreased ROM in the neck and Pain with up right activity.. suspect

A

Cervical spondylosis

151
Q

Referral criteria for Cervical Spondylosis

A

Intractable neck pain or major neuro changes

152
Q

What is the most common mechanism of cervical strain

153
Q

S/s of cervical strain

A

Whiplash Hx
No radical non focal neck pain

Mechanical pain ( pain on movement)
Headache
Back Spasms

154
Q

A pt with non radicular non focal pain in the neck with a head ache and back spasm.. suspect what ?

A

Whiplash Hx

Cervical strain

155
Q

Is there nerve involvemt in cervical strain

156
Q

Tx approach to cervical strain

A

Non op
Reassurance (self limiting)
Soft collar ( placebo)

NSAID, muscle relaxers

Doxepin/ Amytryptline ( SLEEP)

157
Q

Most common area for cervical spondylosis

158
Q

Discitis in a pt older than 5 is typically caused by

A

Osteomyelitis

159
Q

A pt with fever malaise and BACK PAIN, suspect

A

Discitis (inflammation/ infection of the spinal disc)

160
Q

ADE outcomes of Discitis

A

Disc space narrowing or vertebral fusion

161
Q

TTP over a specific vertebrae indicates

A

Possible Discitis

162
Q

What is the imaging modality for Discitis

163
Q

Tx approach to Discitis

A

Non op:
Bed rest, brace, ABX 6wks (2 wks inpatient)

Operative (RARE)
Biopsy, debridement, decompression of any absecess

164
Q

Referral criteria for Discitis

A

ALL PTS! ADMIT!

165
Q

What is the normal “kyphosis” (curvature) of the spine

A

20-50 degrees (on lateral view)

166
Q

What are the two causes of hyperkyphosis

A

Postural ( correctable)

  • women
  • slouching

Scheurmanns Dz ( uncorrectable)

  • men
  • wedge shapes discs
167
Q

Tx approach to postural vs scheurmanns kyphosis

A

Postural: exercise
Scheurmanns: brace

168
Q

Acute LBP presents where

A

Pain over buttocks and posterior thighs

169
Q

What are phase I and phase II of acute LBP Tx

A

Phase I: S/s Tx

Phased II: return to duty

170
Q

Where is the most common area for lumbar herniated disc

A

L4-LF (L5 root)
Or
L5- S1 (S1 root)

171
Q

L1 radicular pain is pain where?

A

Over the buttocks at the L1 area

172
Q

L2 Radicualr pain is where

A

From the Buttocks at L2 down to the superior Lateral thigh

173
Q

L3 radicualr pain is where

A

Medial thighs

174
Q

L4 radicualr pain is where

A

medical calf’s

175
Q

L5 radicular pain is where

A

Lateral calf

176
Q

A pt with severer unilateral radicular pain in the lower extremity/ lower back with pain even on minor activities.. suspect

A

Lumbar herniated disc

177
Q

For lumbar herniated disc, what is a postive finding on seated leg raise

A

The pt will lean back to lift the leg

178
Q

For lumbar herniated disc, what is a postive finding when doing a contra lateral straight leg raise

A

The with have pain on the symptomatic side

179
Q

When do you order an MRI for Lumbar herniated Disc

A

When S/s are longer than 4 weeks, or have a neuro deficit

180
Q

A pt with a PMHx of spinal surgery presenting with LBP/ Lmbar disc herniation gets what imaging modality

A

Contrast MRI

181
Q

Tx approach to herniated disc ((lumbar)

A

NSAIDs,
Profile ( limited standing, walking, running)
PT
Epidural steroids injections

Operative: discetomy +/- fusion

182
Q

What is the definition of lumbar spinal stenosis

A 
Narrowing of the spinal canal, 
Arthritic changes (bone spurs) narrow or compress the canal.
183
Q

What are the common sites for lumbar spinal stenosis

A

L3-l4, L4-L5, then L2-l3

184
Q

A pt presents with neurogenic Claudication that improves when leaning forward.. suspect

A

Lumbar spinal stenosis

185
Q

Claudication that does not resolve immediately, improves on stationary bike, moves proximally to distally, and is worse when walking down hill

A

Neurogenic Claudication

spinal stenosis

186
Q

What is a positive Romberg test

A

Standing and placing arms at the side, and the patient falls over or sways side to side

187
Q

A pt with lumbar spinal stenosis will have what findings on X-ray

A

DDD or spondylothesis

188
Q

Tx approach to Lumbar spinal stenosis

A

NSAIDSs,
PT
Epidural steroids

Operative:
Surgical decompression or fusion

189
Q

Dz of the spine is most often from..

A

Metastatic Dz from other CA

190
Q

A pt that present with back pain that prevents them from sleeping.. think

A

Metastatic Spinal CA

191
Q

“ Winking owl” pattern on the spine is a sign of

A

Pedical degeneration

Metastatic cancer of the spine

192
Q

Imaging that can find metastatic Dz

A

Tc99m bone scan

193
Q

Tx approach to metatatic dz of the spine

A

Non op: treat the tumor

Operative: stabalize the spine

194
Q

What is the Cobb angle in scoliosis

A

Greater than 10 degrees

Girls greater than 30 degrees

195
Q

When should you order an MRI for scoliosis

A 
Young pt, abNML Phys exam 
AbNML X-rays 
\+kyphosis 
Wide canal on X-ray 
Erosions on X-ray  
Rib changes
196
Q

Tx approach to Scoliosis

A

NSAIDs + exercise
(Swimming)

operative:
Surgical correction

197
Q

What is spondylolisthesis; degenerative

A

Disk+facet joint changes = Slipage of disk

Lamina remains intact
Non Inter articular (pedical) defects

Commonly at L4-L5
Commonly anterior
Commonly Women

Can be radicular or myelopathy

198
Q

What is the Tx approach to Degenerative spondylothisis

A

NSAIDs
exercise
Wt loss
Brace

operative: fusion

199
Q

What is spondylolisthesis : isthmic

A

Slipage of the spine form the Inter articular defect

Most common at the L5
Common in young pts with repetitive axial loading

200
Q

Back pain that radiates beyond the knees, with hamstring spasms.. suspect

A

Spondy slippage from Isthmic cause

201
Q

What does the Scotty dog collar defect indicate

A

Spondy spillage from isthmic

202
Q

Immature (young) pts with Spondy slippage get what imaging

A

SPECT scan

203
Q

What view is important in Spondy slippage

A

Oblique view

IPAP JUNIOR SEM. (43 decks)

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