Orthopeadics teach amk day Flashcards
sunburst appearance on X-ray
osteosarcoma
tissue biopsy to confirm
what is osteosarcoma
most commonly found where
malignant bone tumour found at metaphysics of distal femur or proximal tibia
symptoms fo osteosarcoma
dull bone pain worse at night , localised mass , soft and tissue mass and swelling
pages disease of the bone is a metabolic bone disorder
symptoms - hearing and extra
constant achy bone pain
warmness
hearing loss
and heart failure
what do results from blood show pagets
raised ALP
normal calcium and phonate
differentials for hbperparathryism
management fo pagets
bisphosphonates e.g. IV parmidroante
osteomyelitis is the infection of the bone usually from
staph aureus
symptoms of OM
recent trauma or fractures due to infection getting in
bone pain at site
lump
fever and redness
investigation fro OM - infection of bone
managemtn
MRI
give antibiotics
children - cefaxolin and adults fluco
bony metastasis is when what
when cancers spread to the bone
most common causes are renal , trhyodi , lung , prostate, breast
syntposm of bony metastasis
bone pain worse at night
anaemia
raised calcium
normally just palliative care and chemo
chondrosarcoma is tumour and presents with painful and enlarging mass and if affects where
axial skeleton - ribs, shoulder and pelvis
what does an X-ray of a chondroarcoma show
lytic lesions with calcification , cortical remodelling
need to remove it
sliped upper femoral epiphysis SUFE this is where growth plate experiences some sort of fracture causing the femoral head to slip out of position
really common in boys 10-16 normally obese
symtpoms
limited abduction , internal rotation and flceion and present with externally rotated leg
pelvic xray - frog postion
managemnet is internal rotation - pops it back in
perthes affects boys 4-7 and is characterised by gradual hip pain and all hip movements are limited
managed b
NSAIDs and bed rest
transient synovitis of the hip 4-10 yr olds is acute onset hip pain and relived rest
upper resitpatiory tract infection relived with rest for the pain
investigations shwo
no findings or blood results on scan
for septic arthritis what diagnosis should do
aspirate and then blood cultures
kochers criteria
mangemtn with fluclox- staph and for strep use ceftriaxone
reactive arthritis comes after STI or campylobacter most common joint
anterior uveitis - red eye
knee
methotraxate
osgood-schlatters disease
overuse syndroom in paeds population and males. normally active patients. presents as
warmth and tender and swelling over the tibial tuberosity - just below the knee
conservative measures for management - rests ice, physiological and NSAIDs
if you have ligament damage what does it present as
swelling and pain and inability to weight bare
test for ACL
anterior draw test
post draw test
varus stress test
lateral
valgus is for medial
mamagemtn for ligament damage
PRICER - protect , rest, ice compression , elevation and rehab
meniscal tear presents with
pop sound and pain on side of knee
inability to weight bear and pain worse on flexion
main test for meniscal tear
McMurray test
MRI gold standard
chondromalaci patellae
anterior knee pain in teenage girls
grinding of the knee when flexed
worse on walking down stairs
MRI and physic
pre patellar bursitis very common n roofers and carpet layers - plumbers and gardeners - people who on their knees
symtpoms
massive swelling
warm
tender
clinical exma
poster hip dislocation - dashboard car
symptoms
pain radiating to the knee
shortened and internally rotated one
closed reduction within 6 hours for manage
femoral head injury present with groin pain and local swelling and bruising with sciatic nerve injury
how to mange
xray
repositioning ORIF 0 expose and manipulate structures to put back in place
neck of femur fracture common in elderly with osteoporosis
symptoms
hip pain worse on palpating greater trochanter
shortened and external rated
what criteria for neck of femur
garden criteria
anterior hip dislocations
lengthened externally rotated
femoral nerve injury
pain radiating to the knee
closed reduction within 6 hours
neck of femur fracture - intracapsular or extracapsualr
if you have dialled sub capital ( intra) you need a
Total hip replacement
or hemiarthroplasty - weak patents so old ( half replacement essentially)
non dispalced sub capital fracture - intracapsular what do you do
cannulated hip screw
extra - intertrochanteric
dynamic hip screw
subtrochnateric
intermudullary nail
adhesive capultiis more common in diabetics
glenohumeral joitn capsule adheres to humeral head
symtpsom
loss of active and passive movement
- freezing stage - pain worst , mvoemtn worse
frozen stage- pain better , movement worse
thawing stage - pain resolves and movement improves
rotator cuff tears present as
loss of active movement with pain on rest and movement
passive movement intact - they can’t move it themselves but we can
weakness on abduction
assessment for rotator cuff tear
xray to exclude fractures
US - to look for tear
MRI - looks at tears more clearly
management - depends on symptoms under 2 weeks conservative but if over 2 weeks will be surgery
anterior glenohumeral dislocation in Rugby and poster in seizures and electrocution
symtpoms
painful shoudle r reduced mobility asymmetry loss of shoulder contours antihero bulge
reduction immobilisation and rehab for manegmetn
assessment for dislocations
x ray
MRI if labral injury suspected
X- ray for poster is like a light bulb sign and again MRI is labral injury suspected
goes around the joint thats why if you’ve had one before likely to get one again
