Orthopaedic examination

Question 1

When are diseased joints usually most painful

Answer 1

On extension, except the carpus which is most painful on flexion

Question 2

Ortolani test

Answer 2

Test for hip instability

Anaesthetised or sedated in dorsal recumbency

Femur perpendicular to the spine

Place ventral pressure to subluxate hip

Slowly abduct limb until a palpable or audible click

Adduct hip until hip reluxates

Angles useful for deciding whether to do a Triple Pelvic Osteotomy

Question 3

Bardens test

Answer 3

Hip lift

Test of laxity

Anaesthetised/sedated in lateral

Apply lateral displacement to the femur

Question 4

Thumb displacement test

Answer 4

Test of traumatic hip luxation

thumb in between greater trochanter and ischial tuberosity

Externally rotate hip - if thumb displaced, hip is not luxated

Question 5

Technique for arthrocentesis

Answer 5

5ml syringe or larger to achieve high enough negative pressure

23G (carpus) or 21G (stifle)

Aseptic technique

Apply negative pressure without moving the needle

Once fluid obtained release pressure to stop blood being aspirated

Normal joint 0.05-0.3ml of viscous clear fluid

Make smear of fluid

Submit sample in EDTA