Ortho/Rheum 6

Question 1

What is the common presentation of Osgood-Schlater Syndrome?

Answer 1

Adolescent during growth spurt, pain on tibial tuberosity, where patellar tendon is inserted.

Question 2

Temporal or Giant cell Arteritis is associated with what MSK disease?

What are the 4 main symptoms of Temporal Arteritis?

Answer 2

Polymyalgia Rheumatica.

1. Tender temple
2. HA
3. Jaw pain
4. Visual loss

Question 3

How do you manage suspected Temporal Arteritis

Answer 3

HIGH dose Steroids ASAP, if suspected, bc don’t want vision loss.

Then do Temporal Artery bx to confirm.

Question 4

What disease presents after minor injury to joint, which then progresses to pain OUT of PROPORTION, swelling, skin changes, increases sweating, temp changes, and allodynia?

How do you treat??

Answer 4

Complex Regional Pain Syndrome.

TRX = Regional Sympathetic Nerve block

Question 5

What is the MOST SENSITIVE modality of diagnosing osteonecrosis/avascular of femoral head?

Answer 5

MRI (XR can miss early disease)

Question 6

Patients with Sjogrens are at increased risk of what malignancy?

Answer 6

B-cell Non-hodgkins Lymphoma.

Question 7

Fibromyalgia is a clinical diagnosis…what labs do you want to order to make sure no other illness that may mimic similar symptoms is going on?

Answer 7

CBC (r/o anemia)
THS (r/o hypothyroidism)
ESR/CRP (r/o inflammatory arthopathy)

Question 8

What virus can cause flu-like symptoms, that gives way to symmetric polyarthritis of small joints +/- faint reticular rash +/- aplastic anemia?

What is the TRX?

Answer 8

Parvo B19

TRX = NSAIDS/supportive. SELF- LIMITTING. No long term sequela

Question 9

What is the prognosis of Pulmonary Sarcoidosis?

Answer 9

75% resolve with 12-24 months of steroids. Most don’t reoccur.

Question 10

how do you typically get Radial Head Subluxation? How do children present?

How do you treat?

Answer 10

Child is pulled by the arm or is swinging by the arm.

Present with refusal to move arm that is held close to body in pronated position.

TRX = reduction by extension and full supination of arm, then flexion of elbow.

Question 11

Femoral nerve injury presents with:

What motor dysfunction?
What sensory dysfunction?

Answer 11

MOTOR = poor extension of knee, loss of knee jerk reflex.

SENSORY = Loss in Anterior/Medial thigh, Medial shin and arch of foot.

Question 12

Sensory loss in femoral nerve damage to arch of foot and medial shin is due to what branch of Femoral N?

Answer 12

Saphenous N.

Question 13

Sciatic N injury causes what MOTOR and SENSORY deficits?

Answer 13

Weakness of Hamstrings most of lower leg.

NO SENSORY deficits.

Question 14

Obturator N damage causes what MOTOR and SENSOR deficits?

Answer 14

MOTOR = poor Adduction of hips

SENSORY = decreased in medial thigh.

Question 15

Common Peroneal N injury (which splits off into deep and superficial brances) causes what MOTOR and SENSORY deficits?

Answer 15

MOTOR = 
foot drop (poor dorsiflexion (deep branch)
Poor eversion(superficial branch)) 

SENSORY = decreased in dorsum of foot and lateral shin.