Orthopedics Flashcards
Osteoarthritis
Pain exacerbated by movement, relieved by rest. AM stiffness less than 30 minutes, tenderness to palpation, crepitus, osteophytes, joint space narrowing
Rheumatoid arthritis
Autoimmune disease, symmetric peripheral polyarthritis, morning stiffness greater than 30 min
What joints are usually affected with RA?
MCP and PIP joints
How long should sx be present with RA?
6 weeks
Risk factors for gout
High purine diet, diuretic use, ASA use, low fluid intake, alcohol overuse
Lateral deltoid shoulder pain dif dx
Impingement syndrome, SA bursitis, rotator cuff tendonitis or tear
Lateral shoulder pain
chronic or non-traumatic shoulder impingement syndrome, subacromial bursitis
Test for ritator cuff pain
Painful arc sign, drop arm test, weakness in external rotation
Painful arc test
Pain with active abduction beyond 90 degrees
Drop arm test
Start with patient abducted 90 degrees, slowly lower arm, pt will be unable to lower slowly or smoothly
Anterior shoulder pain
AC, GH OA, AC separation`
Posterior shoulder pain
cervical strain, cervical rediculopathy
What structure is compressed with carpal tunnel?
Median nerve
Positive Finkelstein means?
DeQuervain’s tenosynovitis
Snuffbox tenderness
Consider scaphoid fx, dull pain
Dupuytens contracture
Inherited but may be related to alcoholic cirrhosis
Muscle injury called?
strain
Ligament injury called?
sprain
Anterior groin pain indicates?
OA of the hip
When should you consult ortho with a sprain?
Grade III, eversion sprain, if not improved 3 weeks in
Local point tenderness of heel indicates
Plantar fasciitis
A/P stability - acute knee pain
Anterior drawer test, posterior drawer test, Lachman test
Torn meniscus
McMurray’s test
Systemic reaction - erosion or scale on the penis and crusting scaling papules on the soles and palms
Reiter’s syndrome (arthritis, uvitis, urithritis)
Systemic reaction - Red, burning, and itchy eyes
Reiter’s syndrome, Behcet’s Syndrome
Systemic reaction - Preceding sore throat
Acute rheumatic fever of gonacoccal arthritis
anterior dislocation of shoulder shows?
Rounded lateral aspect of shoulder appears flattened.
Crossover test
Adduct patient’s arm across the chest. - Suggests inflammation or arthritis on acromioclavicular joint
Apley scratch test
Touch the opposite scapula. Suggests rotator cuff disorder
Neer’s impingment test/Hawkins impingement test
suggests rotator cuff tear
Tenderness distal to the epicondyle means most commonly?
lateral epicondylitis (tennis elbow)
Tenderness distal to the epicondyle means less commonly?
medial epicondylitis (golfers/pitchers elbow)
Heberden’s nodes
DIP joint deformity. Common with osteoarthritis
Bouchard’s nodes
PIP joint deformity. Common with osteoarthritis
Joints affected with rheumatoid arthritis
PIP, MCP, and wrist joints with ulnar deviation
Thenar atropy indicates
carpal tunnel syndrome
Hypothenar atropy indicates
ulnar nerve compression
snuffbox tenderness indicates?
scaphoid fracture, injury of carpal bones. Poor circulation to area putting at risk for avascular necrosis.
Systemic conditions that worsen carpal tunnel
pregnancy, RA, diabetes, hypothyroidism
What is the most common sites for herniated discs?
L5-S1 or L4-L5
Prepatellar bursitis stems from?
Kneeling too much
Anserine bursitis stems from?
Running, valgus knee deformity, fibermyalgia, and osteoarthritis
Absence of plantar flexion can indicate?
rupture of the Achilles tendon. Also may see sudden sever pain (gunshot wound), ecchymosis from calf to heel, and flat footed gate
McMurray and locking make what most likely?
medial meniscus tear
Ottowa ankle rule
inabillity to bear weight after 4 steps, tenderness over posterior aspect of the malleolus. Suspicious of ankle fx.
