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Yr5 MSK > Orthopaedics > Flashcards

Orthopaedics Flashcards

1
Q

What is a frozen shoulder?

A

Adhesive capsulitis
Chronic fibrosing condition characterised by insidious & progressive severe restriction of active & passive RoM of the shoulder

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2
Q

What are the Sx of a frozen shoulder?

A

Insidious shoulder pain

Stiffness lasting 6m-2yr then resolves

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3
Q

What are the phases of a frozen shoulder?

A

Painful phase: Pain worse at night & moving, ↓RoM
Frozen phase: Pain resolves, shoulder still stiff
Thawing phase: Slowly regains RoM

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4
Q

How is a frozen shoulder managed?

A

Physio

1) NSAIDs:
2) IA Steroid injection

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5
Q

What is a rotator cuff tear?

A

Acute injury or chronic degeneration leading to rotator cuff damage in subacromial space
Leads to tendon tear

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6
Q

The tendon of which muscle usually tears in rotator cuff injury?

A

Supraspinatus

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7
Q

What muscles make up the rotator cuff?

A 
SITS:
S: Supraspinatus
I: Infraspinatus
T: Teres minor
S: Subscapularis
Tendons pass through subacromial space to attach to humeral head
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8
Q

What are the Sx of a rotator cuff tear?

A 
ACUTE shoulder pain & weakness
Worse on moving
PAINFUL ARC
↓RoM: Abduction limited to 40-50degrees = COMPLETE TEAR
Clicking/catching during moving
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9
Q

How is a rotator cuff tear investigated?

A

USS:
Xray: Exclude other causes
MRI: If muscle wasting

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10
Q

How is a rotator cuff tear treated?

A 
Analgesia: NSAIDs + Paracetamol
ICE
Physio
Steroid injection
Complete = surgery
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11
Q

What is epicondylitis?

A

Inflammation at common extensor tendon arising from lateral epicondyle
OR
Forearm flexor muscle origin at medial epicondyle of humerus

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12
Q

What are the RF for epicondylitis?

A

Repetitive strain
Heavy lifting
Sports

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13
Q

Which is more common lateral or medial epicondylitis?

A

Lateral x5 more common than medial

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14
Q

How does lateral epicondylitis present?

A 
Pain & tenderness
Radiates to forearm 
EXACERBATED: Resisted wrist extension
Mill's test
Cozen’s test
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15
Q

How does medial epicondylitis present?

A

Pain & tenderness
Dull ache
Worse w/grasping movement
EXACERBATED: Pronation & forearm flexion

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16
Q

How is epicondylitis treated?

A

Avoid activities that overload tendon- physio

NSAIDs

17
Q

What tumours commonly metastasise to bone?

A 
Prostate
Thyroid
Lung
Breast
Kidney
18
Q

What type of cancers present as a primary in bone?

A

Myeloma: Back pain, pathological #, hyperCa
Osteosarcoma: Bone pain, mass, pathological #
Ewing’s: Malignant round cell tumour of diaphysis of long bones & limb girdle
Chondrosarcoma: Popcorn calcification on xray, malignant transformation of chondromas, pain/lump in axial skeleton

19
Q

What are the usual fragility fractures?

A 
Osteoporosis of vertebral body
Distal radius
NOF
Pubic ramus
Neck of humerus
20
Q

What is a fragility fracture?

A

Low impact fracture from standing height that would not otherwise be expected to cause a fracture

21
Q

What are the causes of a fragility fracture?

A

Osteoporosis
Advanced age
Osteogenesis imperfecta

22
Q

What are the red flags of back pain?

A 
Saddle anaesthesia
Recent bladder dysfunction
Recent faecal incontinence
Perianal/perineal sensory loss
Laxity of anal sphincter
Severe/progressive neuro deficit
Pain at night
Point tenderness
>50yo or <20yo
Hx of cancer
23
Q

What is the difference between a sprain & strain?

A 
Sprain = Injury to ligament
Strain = Injury to muscle/tendinous junction
24
Q

How do ankle sprains occur?

A

Majority Inversion injury
Causes damage to structures of lateral malleolus
Most commonly ATFL injury

25
Q

What are the Sx of an ankle sprain?

A 
Tender
Swollen
Bruising
Functional loss (pain weight bearing)
EXTENSIVE swelling &amp; bruising = lig tear or #
26
Q

How are ankle sprains investigated?

A

Exam

Ankle Xray: If Ottawa rules apply

27
Q

What are the Ottawa rules?

A
  • Pain in malleolar region AND 1 of:
  • Tenderness at POST edge of LATERAL malleolus
  • Tenderness at POST edge of MEDIAL malleolus
  • Inability to weight bear immediately AND in A&E
28
Q

How are sprains treated?

A 
RICE
R: Rest
I: Ice
C: Compression
E: Elevation
Cannot weight bear: Crutches, physio follow-up
29
Q

What are the complications of an ankle sprain?

A

Weakness & instability

Peroneal tendon subluxation

30
Q

What survey is carried out after in a multi-system trauma?

A 
Primary Survey:
(C) ABCDE
C: Catastrophic haemorrhage control
A: Airway &amp; C-Spine control
B: Breathing &amp; ventilation
C: Circulation
D: Disability &amp; neuro deficit
E: Extremity/exposure/environment

Yr5 MSK (9 decks)

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