Orthopaedics Flashcards
How may investigations present with metastatic breast cancer?
Raised ALP
Raised Serum Calcium
(pain waking from sleep)
How does Paget’s disease appear on x-ray?
thickened and sclerotic
A 45-year-old man presents with a 2-day history of groin pain. He describes a sensation of snapping in the hip with deep groin and hip pain.
The patient played in a rugby match the weekend prior.
What is the diagnosis?
Acetabular labral tear
How may avascular necrosis of the femoral head present on x-ray and what are it’s risk factors?
Flattening and a decrease in volume of the femoral head
long-term steroid use
chemotherapy
alcohol excess
trauma
What is the gold standard investigation for osteomyelitis?
MRI
How does Iliotibial band syndrome present? How is it treated?
Common cause of lateral knee pain in runners
Snapping sensation on lateral knee during repeated flexion/extension
tenderness 2-3cm above the lateral joint line
iliotibial band stretches and physio
A patient has a number of rib fractures.
What measures can be taken to help avoid this patient developing a chest infection?
- ANALGESIA
(add regional nerve block if max dose of analgesia in effective) - Chest physio
What branch of what artery is effected in a scaphoid #?
The dorsal carpal branch of the radial artery
How does fat embolism syndrome present?
Triad of symptoms:
Respiratory
Neurological
Petechial rash (tends to occur after the first 2 symptoms)
At what age would a RA and acromegaly patient present with carpel tunnel syndrome?
RA - 30s
Acromegaly - 50+
What is the name of a non tender lump overlying the distal interphalangeal joint of the index finger.
Heberdens nodes
How does Chondromalacia patellae present?
A 19-year-old sportswoman presents with knee pain which is worse on walking down the stairs and when sitting still.
How does a Acromioclavicular dislocation present?
Pain and swelling of the shoulder joint.
The clavicle is prominent and there appears to be a step deformity
What is a Galeazzi fracture?
a dislocation of the distal radioulnar joint with an associated fracture of the radius
What nerve root supplies the triceps reflex?
Radial never C7
What would L5 compression cause?
Weakness of hip abduction and foot drop, no specific reflex lost
What would L3 compression cause?
sensory loss over anterior thigh
weak hip flexion,
weak knee extension
weak hip adduction
reduced knee reflex
When do you get squaring of the thumbs?
OA of hands
How does aseptic loosening of a THR present?
Hip pain radiating to the knee that is worse on weight bearing
What could you do for a patient in SEVERE pain with a NOF#?
Iliofascial nerve block
What is the first line for sciatica?
NSAIDs and physio
surgery referral if don’t respond to this
What hip dislocation is most common?
POSTERIOR
How does a NoF # present?
Shortened and externally rotated
What is the management for plantar fasciitis?
Weight Loss
Stretching exercises
Rest
What drug has dupuytrens contracture as a side effect?
Phenytoin
A patient has a tender base of her thumb and tender radial sytloid process. What is the diagnosis?
De Quervain’s tenosynovitis
How does a fracture of the radial head present?
Tender proximal forearm
Restricted supination and pronation
How are weber A fractures of the ankle treated?
Analgesia
Controlled Ankle Motion (CAM) boot w/ weight bearing
What nerve is often effected in a posterior hip dislocation?
Sciatic Nerve
How is a fibula fracture distal to the syndesmosis treated?
How is a fibula fracture at the level of the syndesmosis treated?
Both below knee plaster cast to include mid foot
How does L4 nerve compression present?
Anterior knee + medial malleolus sensory loss
Weak knee extension
Weak hip adduction
Reduced knee reflex
How does S1 nerve compression present?
Sensory loss of lateral foot + posterolateral leg
Weak planterflexion
Reduced ankle reflex
+ve sciatic nerve stretch
Where is the most common site of metatarsal stress fractures?
2nd metatarsal
What is a monteggia fracture?
Dislocation of proximal radio-ulnar joint
Ulnar fracture
What does a +ve straight leg raise suggest?
Sciatic nerve pain
What is the triad in leriche syndrome?
- Thigh/buttock claudication
- Impotence (ED)
- Leg muscle atrophy
How does perthes disease present?
4-8 yr old boy
progressive limp/hip+groin pain
X-ray: widening of hip joint space w/ flattening of femoral head
Which movements aggravate golfers elbow?
Wrist flexion + pronation
What is simmond’s triad in diagnosis Achilles tendon rupture?
- Calf squeeze
- Observe angle of declination
- Palpation of tendon
What is the treatment for a DISPLACED hip fracture?
THR
(hemiathroplasty if frail)
What is the management for a intracapsular NoF #?
Cannulated hip screw
What is the cause of burning thigh pain?
Meralgia paraesthetica
(Lateral cutaneous nerve of thigh)
What is the treatment for congenital bilateral clubfoot?
Manipulation and progressive casting soon after birth
How does frozen shoulder present with movements?
Weak active and passive movements
Especially external rotation
What could weak external rotation of the shoulder indicate?
Frozen Shoulder
Posterior dislocation
GH OA
What nerve is injured in foot drop?
What areas of sensation would be altered?
Common perineal nerve
Dorsum of foot and lateral leg
