Orthopaedics

Question 1

Clinical Features of Achilles Tendonitis

Answer 1

posterior ankle pain
pain on palpation of the Achilles tendon
swelling and thickening of the Achilles tendon

Question 2

Tx Achilles tendonitis

Answer 2

Conservative, w/ rest and analgesia (NSAIDs)

Question 3

Which Abx is a risk factor for achilles tendonitis?

Answer 3

Ciprofloxacin

Question 4

What is avascular necrosis? + presentation

Answer 4

Occurs when there is limited blood supply to a bone, so the bone will necrose

Pain, stiffness and reduced function in affected limb
Commonest areas are at femoral head and the wrist

Question 5

Causes of avascular necrosis

Answer 5

Haematological disease (sickle cell and thalassaemia)
Systemic lupus erythematous
Drugs: steroids and NSAIDs

Question 6

Presentation of axillary nerve injury

Answer 6

Sensory loss: lateral deltoid (regimental patch)
Motor
- profound weakness of shoulder abduction (disruption in motor supply to deltoid and teres minor)
- weakness in shoulder flexion, extension and external rotation

Question 7

Causes of axillary nerve injury

Answer 7

Typically as a result of shoulder injury, particularly:
- anterior dislocation
- proximal humeral fractures

Question 8

Ix axillary nerve injury

Answer 8

Extension lag test:
- elevate patient’s arm to near full extension, ask patient to maintain position
- test +ve if arm drops

Question 9

Mx axillary nerve injury

Answer 9

Conservative w/ reconstructive surgery if no response