Orthopaedics Flashcards
Whats the commonest benign bone tumour?
Osteochondroma
What benign bone tumour presents with intense pain worse at night relieved by NSAIDs?
Osteoid osteoma
What bengin bone tumour is asymptomatic but may weaken bone and cause fractures?
Enchondroma
Which tumour has a ‘soap bubble’ appearance?
Giant cell tumour
What is a Brodies Abscess?
Subacute osteomyelitis
What is the commonest malignant primary bone tumour?
Osteosarcoma
What malignant bone tumour gives ‘popcorn calcification’ on x-ray?
Chondrosarcoma
What bone malignant bone tumour is assosciated with fever, increased inflammatory markers and swelling?
Ewings Sarcoma
What is the commonest cause of malignant bone tumours?
Metastases
What cancers cause sclerotic bone tumour?
Prostate, breast, TCC, SCLC, lymphoma
What cancers cause lytic bone tumours?
Thyroid, RCC, NSCLC
What is impingement?
Tendons of the rotator cuff compressed in the subacromial space during movement producing pain
What are the muscles of the rotator cuff?
Supraspinatus, infraspinatus, subscapularis, teres minor
How are rotator cuff tears managed?
Physiotherapy, analgesia, surgery (controversial)
What is shoulder instability?
Common ‘party tricks’ associated with connective tissue disorders
What is adhesive capsulitis?
Frozen shoulder
How does adhesive capsulitis present?
Progressive pain and stiffness of shoulder with loss of external rotation
How is adhesive capsulitis managed?
Thaws out itself over time, can give steroids
What nerve is compressed in carpal tunnel?
Median nerve
What nerve is compressed in cubital tunnel?
Ulnar nerve
What is Golfers elbow?
Medial epicondylitis
What is tennis elbow?
Lateral epicondylitis
What is dupytrens contracture?
Proliferative connective tissue disorder caused by type 3 collagen fibres
What patients get dupytrens contracture?
Alcoholics, diabetics, peyronies disease
How is dupytrens contracture treated?
Fasciotomy/fasiectomy
What is trigger finger?
Tendonitis of the flexor tendon to the digit
What pulley is generally affected in trigger finger?
A1 pulley
How is trigger finger treated?
IA steroids, division of A1 pulley
What is a ganglion cyst?
Mucinous filled cyst found adjacent to a tendon or synovium joint that transilluminates
How is a ganglion cyst treated?
Needle aspiration or surgical excision
What is trochanteric bursitis?
Self limiting inflammation of the bursa caused by overuse
How is trochanteric bursitis treated?
Rest, NSAIDs, physio
Which meniscus is usually torn in meniscal tears?
Medial
How do meniscal tears present?
Pain on joint line, catching locking sensation
What mechanism of injury causes an ACL rupture?
Twisting movement on planted feet, often hear a pop
How is an ACL rupture investigated?
MRI
How is ACL rupture managed?
Reconstruction, rehab, 1 year out of sport
What mechanism of injury causes a PCL rupture?
Head on blows to the shin of a straightened leg (dashboard injury)
What ligament rupture does valgus pain indicate?
Medial CL tear
What ligament tear does varus pain indicate?
Lateral CL tear
What is a knee dislocation?
Rupture of all knee ligaments - orthopaedic emergency
What causes patellar dislocation?
Direct blow or thrust
What way does a patella usually dislocate?
Laterally
What way to the majority of shoulder dislocate?
Anteriorly (95%)
What signs are seen in shoulder dislocation?
Excessive external rotation
Loss of symmetry
What nerves and vessels are at risk in a shoulder dislocation?
Axillary nerve
Axillary artery
What nerves and vessels are at risk in a humeral shaft fracture?
Radial nerve
Brachial artery
What is a nightstick fracture and what is it caused by?
Isolated ulnar fracture usually caused by a direct blow
What is a Monteggia fracture?
Ulnar fracture (distal) Radial dislocation (proximal)
What is a Galeazzi fracture?
Radial fracture (proximal) Ulnar dislocation (distal)
What is a Colles fracture?
Fracture of distal radius with dorsal displacement
‘Dinnerfork deformity’
Colles fracture
How is a Colles fracture managed?
Plates, screws, manipulation, splintage
What is a common complication of Colles fractures?
Carpal tunnel
What is a Smiths fracture?
Distal radial fracture with volar displacement
How is a Smiths fracture treated?
ORIF as unstable
What is a Bartons fracture?
Intra-articular wrist fracture
What x-rays are needed for a scaphoid fracture?
AP, lateral, oblique
‘Pain in anatomical snuffbox’
Scaphoid fracture
What is there a risk of with scaphoid fractures and why?
AVN as scaphoid has retrograde blood supply
‘Externally rotated and shortened leg’
Hip fracture
How do you manage an intracapsular hip fracture?
Hemi-arthroplasty or THR
What vessel is at risk of damage with an intracapsular hip fracture?
Medial circumflex artery
How do you manage an extracapsular hip fracture?
Dynamic hip screw
How is a tibial shaft fracture managed?
IM nails with locking screws
How is compartment syndrome managed?
Emergency fasciotomy
How should non-displaced stable fractures be managed?
Plaster cast
How should displaced stable fractures be managed?
Closed reduction and plaster cast
What should be the initial management of hip and thigh injuries in A&E?
Thomas splint
How do you manage femoral shaft fractures in children?
Traction
What signs test for carpal tunnel?
Tinnels & Phalens
What sign tests for cubital tunnel?
Froments
What tool is used to assess fracture risk?
FRAX
What nerve is commonly injured in posterior hip dislocations?
Sciatic
What is an important differential to remember in backpain in IVDUs?
Psoas abscess
What nerve causes footdrop?
Peroneal/fibular
What is the commonest nerve damaged during knee arthroplasty?
Common peroneal
‘Positive simmonds sign’
Achilles tendon rupture
How is osteomyelitis imaged?
MRI