Orthopedics Flashcards
What are the Kocher criteria?
Hint = just a FEWw Kocher criteria
1) non-weight bearing status on the affected side
2) ESR >40
3) fever
4) WBC >12
What are the probabilities of a septic joint with the following Kocher criteria? 1/4 2/4 3/4 4/4
1/4: 3%
2/4: 40%
3/4: 93%
4/4: 99%
What is Sever’s disease?
Calcaneus apophysitis
How do you treat kingella kingae osteomyelitis?
Clindamycin
In the symptomatic patient, classic history will include a child or adolescent athlete playing a sport that requires repetitive lumbar extension and rotation. The onset of pain may be either acute or insidious over several weeks. Patients will report their low back pain increases with strenuous activity or hyperextension and improves with relative rest. Pain typically remains located in the low back with occasional radiation to the buttock and/or proximal lower extremities, while neurologic symptoms such as numbness/tingling in the lower extremities are uncommon.
spondylolysis
What is spondylolysis?
Pars interarticularis defect
What is spondylolisthesis?
L5-S1 anterior displacement
What should you consider with a limp, sub-acute non-focal back pain, refusal to walk, difficulty sitting upright and perhaps hip pain?
Discitis!
What is the name of traction apophisitis at the inferior pole of the patella at the infrapatellar tendon?
Larsen-Johansson disease
How do you diagnose developmental hip dysplasia?
U/S if <4 months, x-rays thereafter
abnormal abduction, abnormal skin folds, limb length discrepancy
What is the first line antibiotic of choice for septic arthritis?
What are the top three bugs?
Cefazolin! In the US: clindamycin (MRSA)
S. aureus
Kingella kingae
S. pyogenes (GAS)
What do you call an abscess in the deep space of the finger?
Felon
What do you call an osteonecrosis of the subchondral bone secondary to overuse?
How do you manage it?
osteochondritis dissecans
start with restricted activity
then immobilization and non-WB
then laparascopic repair unstable joint or free floating bone
How do you treat Lyme arthritis?
Doxycycline po x 1 month
If you spot a bony tumour and cortical destruction, how should you manage?
Do not weight bear!
Refer to orthopedics
What is the line to interpret a cervical pseudosubluxation?
the line of Swishuk!
used to distinguish between C2-C3 pseudosubluxation VS Hangman’s fracture
If the delta is >2mm then it is abnormal!
What is a Monteggia injury?
ulnar fracture with radial head dislocation
What is a Galeazzi fracture?
radial fracture with ulnar head dislocation
What is the Ottawa ankle rule?
An ankle X-Ray series is only required if there is any pain in the malleolar zone and…
Bone tenderness at the posterior edge or tip of the lateral malleolus (A)
OR
Bone tenderness at the posterior edge or tip of the medial malleolus (B)
OR
An inability to bear weight both immediately and in the emergency department for four steps
What is the Ottawa foot rule?
A foot X-Ray series is only required if there is any pain the midfoot zone and…
Bone tenderness at the base of the fifth metatarsal (C)
OR
Bone tenderness at the navicular (D)
OR
And inability to bear weight both immediately and in the emergency department for four steps
What are two possible injury complications of a shoulder dislocation?
Hill Sachs deformity: compression fracture of the posterolateral humerus
Bankhart lesion: detached antero-inferior part of the labrum from the glenoid
What are potential complications of an acute patellar dislocation?
osteochondral fracture of the femoral condyles or tibial plateau (best seen on MRI)
What distinguishes a greenstick from a torus fracture?
greenstick: only one side of the cortex is broken
torus: buckle fracture, cortex intact
What distinguishes a Tillaux fracture from a Triplane fracture?
The lack of a fracture component in the coronal plane (evaluated with lateral x-ray or CT) distinguishes a Tillaux fracture from a triplanar fracture.
