Orthopedics Flashcards
Ed: Fifth metacarpal fracture
Boxers fracture
Punching someone
FOSH
Scaphoid, distal radius/ ulna or radial head fracture at elbow
Reverse Colles fracture
Fall backwards
Smiths fracture
Distal radius with volar / palmar angulation
Tennis elbow vs golfers elbow
Tennis; lateral epicondylitis
Golfers ; medial epicondylitis
Stress, inflammation, swelling
Adhesive capsulises of shoulder
Acute inflammation of glenohumeral joint
Leads to fibrosis and contraction of joint and tissues
3 stages:
Inflammatory - 2-9months progressive pain
Fibrotic - 4-12months pain less severe, stiffness and decrease ROM
Resolution phase- 6-24months gradual improvement of ROM
Most common dislocation in shoulder
Anterior
Associations: capsule tear, labrum torn, subscapularis tear , fracture greater T, damage to axillary or brachial plexus
Most common muscle tear in rotator cuff injury
Supraspinatus
Trouble abducting and forward flexion
65 yo lady with deformed second toe
Flexed at PIP joint and there is an extension deformity at DIP
Calluses and corns over dorsum of PIP joint
Deformity is flexible and reducible
Hammer toe Common in older women and middle toes May be rigid or flexible Caused by overpull of extensor digitalis longus and imbalance of intrinsic muscles Shoe advise
Claw toe is DIPs
Hip pain/ problem in children
Development dysplasia- often picked up as newborn , unequal leg length
Irritable hip- transient synovitis, 2-10yo , post viral infection, very common
Perthes disease- 4-8yo, avascular necrosis, limb, stiffness, early sign widening of joint space on X-ray, progressive pain over weeks, pain in knee or groin often
Slipped upper femoral epiphysis- 10-15yo, obese, posto-inferior, May present acutely following trauma , knee or distal thigh pain common, loss of internal rotation in flexion
Juvenile idiopathic arthritis (JIA) - <16, joint pain and swelling, knees elbows ankles, limp, associated with anterior uveitis
Septic arthritis - acute hip pain, with systemic illness, severe limitation of joint.
Shortened internally rotated leg
Posterior dislocation
Shortened externally rotated
Hip fracture
Valgus vs varus
Valgus : GUM legs stick together
- knees in
Varus: Rum - knees apart
Arthrocentesis
Polarising microscopy
+ biorofringence :
- birofrigence:
+ pyrophosphate (pseudogout)
- urate
Types of mono arthritis
Gout
- MSU crystals
Pseudogout
- + crystals
Septic arthritis
- wCC
Tx for gout
Raised serum Uric acid
Or can be low during attack so don’t rely on levels
MSU crystals = tophi - look in helix ear, acillis, elbows
NSAIDs
allopurinol
