Orthopaedics Flashcards
What is transient synovitis and what joint does it usually affect
benign inflammation on the synovial lining
Often triggered by recernt URTI/gastro infection
Usuually affects the hip join
Features of pt with transient synovitis
3-10yrs
Waxing/waning pain
Limp but able to weight bear
No or low-grade fever
recent URTI/ gastro illness
Possible effusion + reduced int rotation
NORMAL bloods
Signs of AVN (hip)
Groin pain
antalgic gait
positive Trendelenburg sign
internal rotation of the right leg is reduced and is painful
pulled elbow
1-4 years
arm hanging loosely by their side in a pronated position. They are usually not distressed unless the arm is moved.
tx: hyperpronation
(best) or Supination and Flexion method
ITB band syndrome
Pain over tibial attachment of ITB, usually w sports, but this can become constant
Usually with running/cycling and repetitive movement
What is osteochronditis dissecans
- Repeititive overloading causing fragemne
- Mainly occurs (80%) around medial condyle
- causes poorly localised pain, mild swelling, and occassionally locking of the knee
Tx: non WB for >6/52, rest. If fragment is loose OT may be needed
What is osgood schlatters
from repetative movements putting stress on the patella tendon where it attaches to the tibial tuberosity
Sxpain, swelling, and tenderness over the tibial attachment , especially with exercise, stairs, kneeling.
The apophysis may be enlarged in later stages, which looks like a lump that is tender at the tibial tuberosity
Who gets osgood schlatters and when?
Tx
M»>F
Ages 8-15 during growth spurts
Self resolves in 2yrs
Analgesia and exercise modification in interim
What is de quervains tenosynovitis
Pain on radial aspect of wrist
Inflammation of wrist tendon sheaths due to repetitive movements
causes pain/weaknes
Sometimes called ‘mummy thumb’ as often occurs aften picking up babies
What muscles are involved in de quervains
What special test can you do
Abductor pollicus longus
Extensor pollicus brevis
both work to ABduct the tumb
finkelsteins: wrist w fingers over thumb and pull to the ulna side
Tx : rest and hand therapy, occassionally OT
What is cubital tunnel syndrome and how does it present?
caused by compression of the ulnar nerve
tingling/numbness of the 4th and 5th finger
Pain worse on leaning on the affected elbow
Management is often conservative but surgery may be required
Often a history of osteoarthritis or prior trauma to the area.
What is spinal stenosis and how does it present, how do you differentiate it from claudication
central canal is narrowed by tumour, disk prolapse or other similar degenerative changes.
Patients may present with a combination of back pain, neuropathic pain and symptoms mimicking claudication.
**Sitting is better than standing and patients may find it easier to walk uphill rather than downhill*
what is trigger finger
Nodule proximal to the flexor tendon pulley (annular pulley)
initially stiffness and snapping (‘trigger’) when extending a flexed digit
nodule gets stuck when trying to extend the finger, and may suddenly pop through the pulley (painful)
How does frozen shoulder/adhesive capsulitis present
Pain and restricted passive/actived movement in all ROM
20% of diabetics may have an episode of frozen shoulder however we dont know why
What are the phases of frozen shoulder/adhesive capsulitis
painful freezing phase, an adhesive phase and a recovery phase
Typically lasts between 6 months and 2 years
Most common in middle aged (40-60) year old females
