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MSRA > Ortho/MSK > Flashcards

Ortho/MSK Flashcards

1
Q

What age group is most commonly affected by Achilles tendon rupture?

A

30-50 year old recreational athletes

Achilles tendon rupture can occur at any age but is most prevalent in this age group.

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2
Q

What activities are commonly associated with Achilles tendon rupture?

A

Activities requiring a forceful push off or forced dorsiflexion of the foot

These actions create a sudden stretch on the tendon, increasing the risk of rupture.

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3
Q

List the risk factors for Achilles tendon rupture.

A
  • Increasing age
  • Chronic/recurrent tendonitis
  • Systemic corticosteroids (prolonged or high doses)
  • Previous steroid injections into the Achilles tendon
  • Cushing’s syndrome
  • Systemic conditions (e.g. gout, rheumatoid arthritis, SLE)
  • Quinolone antibiotics (mainly if >60 and/or also taking steroids)

These factors can increase the likelihood of tendon rupture.

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4
Q

What is a common presentation of an Achilles tendon rupture?

A

Acute sudden sharp pain in the tendon, sometimes a ‘snap’ is heard

The pain often transitions into a dull ache and may be accompanied by swelling.

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5
Q

What sign on examination of gait may be seen with Achilles tendon rupture

A

Inability to stand on tiptoe

This symptom is common due to weakness or absence of active plantar flexion.

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6
Q

What examination findings are typical for a complete Achilles tendon rupture?

A

Localized swelling and a palpable defect in the tendon

Bruising may mask the tendon defect.

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7
Q

What test is used to assess for a complete Achilles tendon rupture?

A

Simmonds / Thompson test

A positive test indicates a complete tendon rupture.

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8
Q

What does a positive Simmonds Test indicate?

A

Complete Achilles tendon rupture

The test is performed with the patient lying prone and involves squeezing the calf muscle to assess plantar flexion.

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9
Q

What imaging techniques can be used for the diagnosis of Achilles tendon rupture?

A

Ultrasound or MRI

These imaging modalities help confirm the diagnosis.

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10
Q

What is the initial management approach for an Achilles tendon rupture?

A

Non-weight bearing

This is crucial to prevent further injury to the tendon.

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11
Q

What are the two main management options for Achilles tendon rupture?

A
  • Conservative management with a splint
  • Surgical repair

The choice between these options depends on the severity and specifics of the rupture.

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12
Q

What is a Maisonneuve fracture?

A

A spiral fracture of the upper third of the fibula associated with a tear of the distal tibiofibular syndesmosis and the interosseous membrane

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13
Q

What type of force is usually involved in a Maisonneuve fracture?

A

Pronation-external rotation force

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14
Q

What are the common associated injuries with a Maisonneuve fracture?

A

Fracture of the medial malleolus or rupture of the deep deltoid ligament

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15
Q

What must be examined in all ankle injuries to detect a Maisonneuve fracture?

A

The proximal fibula

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16
Q

True or False: A Maisonneuve fracture is easy to detect.

A

False

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17
Q

What should be performed if there is local tenderness in a suspected Maisonneuve fracture?

A

X-rays

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18
Q

What is a stress fracture of the metatarsals also known as?

A

March fracture

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19
Q

In which populations are stress fractures of the metatarsals commonly seen?

A

People undertaking repetitive walking or running, such as army recruits and runners

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20
Q

What is the most common site for a stress fracture of the metatarsals?

A

2nd MT shaft

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21
Q

What are the other potential sites for metatarsal stress fractures?

A
  • 3rd MT
  • Navicular
  • Other MTs
22
Q

What symptom do patients typically present with in a metatarsal stress fracture?

A

A tender lump on the dorsum of the foot

23
Q

Where is the lump typically located during examination of a metatarsal stress fracture?

A

Just distal to the mid-shaft of a metatarsal bone

24
Q

What might early radiology show in cases of metatarsal stress fractures?

A

Normal findings

25
Q

What might later radiographs reveal in metatarsal stress fractures?

A
  • Hairline fracture
  • Development of callus in more severe cases
26
Q

What are the symptomatic treatments for a metatarsal stress fracture?

A
  • Analgesia
  • Elevation
  • Rest
  • Modified daily activity
27
Q

What type of footwear may be more comfortable for patients with a metatarsal stress fracture?

A

Firm shoes or boots

28
Q

What is the expected recovery time for a stress fracture of the metatarsals?

A

6-8 weeks

29
Q

What should be considered if a patient is unable to weight bear due to a metatarsal stress fracture?

A

A brief period in an ‘Aircast’ boot until symptoms improve

30
Q

What is developmental dysplasia of the hip (DDH)?

A

A condition where the hip joint does not properly form in infants and young children.

31
Q

True or False: DDH can occur in one or both hips.

A

True

32
Q

Which population is most at risk for developing DDH?

A

Females, particularly those who are firstborn and breech presentation.

33
Q

Fill in the blank: The __________ test is commonly used to assess hip stability in newborns.

A

Barlow

34
Q

What is the primary treatment for mild cases of DDH?

A

Pavlik harness

35
Q

Before 6 months what imaging is used to assess developmental dysplasia of the hip

A

USS
after 6 month Xray

36
Q

What is a potential long-term consequence of untreated DDH?

A

Early onset osteoarthritis

37
Q

True or False: DDH is generally asymptomatic in infants.

A

True

38
Q

At what age is it recommended to start screening for DDH?

A

At birth and during well-child visits until 1 year of age.

39
Q

What surgical procedure may be necessary for severe cases of DDH?

A

Open reduction and pelvic osteotomy

40
Q

What is injury causes a medial calf tear?

A

An injury resulting from an acute, forceful push-off with the foot

Often seen in athletes, particularly ‘weekend warriors’

41
Q

What symptoms might a patient experience during a medial calf tear?

A

An audible pop

This may be accompanied by a sensation of being struck in the calf

42
Q

What are common complaints from a patient with a medial calf tear?

A

Pain in the calf area, radiating to the knee or ankle

Patients may describe the pain as sharp or sudden

43
Q

What physical examination findings are noted in a medial calf tear?

A

Asymmetric calf swelling & discoloration

Swelling may spread to the ankle and foot

44
Q

What might be visible if swelling has resolved in a medial calf tear?

A

A visible defect in the medial gastrocnemius muscle

Indicates the location of the tear

45
Q

Where is tenderness most pronounced in a medial calf tear?

A

At the medial musculotendinous junction

Tenderness is also noted in the entire medial gastrocnemius muscle

46
Q

What should palpation of the Achilles tendon reveal in a medial calf tear?

A

An intact tendon

47
Q

What symptoms are associated with passive ankle dorsiflexion in a medial calf tear?

A

Moderate to severe pain

48
Q

What is the patient’s response to active resistance to ankle plantar flexion in a medial calf tear?

A

Moderate to severe pain

Pain occurs due to the firing of the torn muscle fibers

49
Q

What is recommended regarding weight bearing after a medial calf tear?

A

Early weight bearing, as tolerated

Helps in the recovery process

50
Q

Define Colles Fracture

A

Dorsally displaced distal radius fracture

MSRA (11 decks)

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