Orthopedic disorders Flashcards
Osteoarthritis is a bone disordered that is exacerbated by what?
by activity, it is relieved with rest
Anticitrullinated peptide/protein AB is a marker for what?
Rheumatoid arthritis
Rheumatoid factor is also a marker that can be used
for a diagnosis of fibromyalgia, what is the length needed for chronic widespread musculoskeletal pain?
more than 3 months
what are medications given to treat fibromyalgia?
amitriptyline, duloxetine, pregabalin.
what muscle in a rotator cuff is most likely to be injured?
supraspinatus
what test rules out rotator cuff?
the empty can test
shoulder should be abducted to 90 degrees, shoulder is internally rotated and angled forward 30 degrees, with thumb pointing to the floor, then resist
positive test mean there was pain or weakness
what test is done for shoulder impingement?
Hawkins-Kennedy test
If a patient presents: older, female age, joint pain with limited range of motion to shoulder, most likely what two differential diagnoses?
Adhesive capsulitis or impingement syndrome
lateral epicondylitis is also known as ?
tennis elbow
what is the most important carpal bone?
scaphoid (Navicular) bone
why is the navicular (scaphoid) bone so important?
it connects the hand to the wrist and it is the most common injured wrist bone
what splint needs to be done for a patient with a scaphoid fracture?
thumb spica splint
what does Waddell’s sign mean?
overexaggeration or overreaction sign , inappropriate physical signs
what is the nerve root for sciatica ?
L5 to S1
what is the test for sciatica?
straight leg raise
how do you perform the straight leg raise?
examiner raise the patient’s leg passively with the ankle dorsiflexed, positive sciatica is reproduced between 10 and 60 degree in the affected leg
when should you do a lumbar x-ray?
if there is trauma, suspected systemic disease, or pain is ongoing for more than 4 weeks
what is a grade I ankle sprain?
stretch
minimally torn ligament, stable joint.
what is a grade II ankle sprain?
(partial rupture)
incomplete tear, painful weight bearing
what is a grade III ankle sprain?
complete rupture
completely torn ligament, severe pain, swelling, tenderness
what is the most commonly seen ankle sprain in office?
grade II ankle sprain, partial rupture
what is the hallmark pain in plantar fasciitis?
heel pain, it is a local point of tenderness
what does collateral mean?
think cross
what does the metatarsal squeeze test do?
tests for Morton’s neuroma
A high purine diet is associated with what?
gout
HerbNodes on the distal (farthest) interphalageal joint is called what?
Herberden’s nodes
Nodes on the distal (farthest) interphalangeal joint is called what?
Herberden’s nodes
a positive Finkelstein’s test is indicative of what?
DeQuervain’s tenosynovitis
Burning pain between the 3rd and 4th toes is called what?
Morton’s neuroma
a positive tinel’s and phalen’s test is indicative of what condition?
carpal tunnel syndrome
how to do the Finkelstein test?
flex the thumb inside the palm and stretch out wrist downward
how to do the tinel’s sign?
tap over the carpal tunnel of the wrist
how to do the phalen’s test?
reverse prayer hands downward
what is a baker’s cyst?
fluid filled cyst behind the knee, it causes a bulge and a feeling of tightness
what condition causes injury to a bone that does not heal?
contusion
what condition: injury to a MUSCLE?
strain
what condition: injury to a ligament?
sprain
what are the nodes called on the proximal interphalangeal joints?
Bouchard’s nodes
when should allopurinol be used ?
for patient with gout for PROPHYLAXIS
what is the risk with a navicular fracture?
High risk of avascular necrosis and nonunion
very important to refer to hand surgeon and use a thumb spica cast even if first x-ray is normal, but pain is felt in the snuffbox
Genu varum is also called?
bowlegs
a positive McMurray’s test suggests injury to what?
Medial meniscus of the knee (MCL)
a positive Lachman’s test suggests what injury?
ACL damage to the knee
which nodes occur in RA and OA?
Bouchard’s nodes can occur in both
gold standard for diagnosing gout ?
joint aspiration of the synovial fluid of the joint
what are symptoms of ankylosing spondylitis?
early symptom is neck pain , has impaired spinal mobility. joint pain keeps pt awake at night. low grade fever and fatigue. has long term stiffness that is Improved with activity
what is the treatment for gout flares?
prednisone 40 mg once a day or BID for 5-7 days, taper the dose.
what medications can be used to treat a gout flare?
Prednisone
Naprosyn or naproxen
Indomethacin
Colchicine
why is colchicine used as a last resort to treat gout?
because it can cause diarrhea, nausea, abdominal pain and vomiting
