Orthopedics/Rheumatology Flashcards
1
Q
a sprain involves _
a strain involves _ (2)
A
sprain: ligaments
strain: muscles/tendons
2
Q
stiff neck
paraspinal muscle tenderness and spasm
positive spurling test
A
cervical sprain
3
Q
cervical sprain can last _ months
A
18
4
Q
what does the spurling test evaluate
A
cervical radiculopathy
5
Q
tx for cervical strain
A
soft cervical collar x 2-3 days
ice/heat
analgesics
gentle active ROM asap
6
Q
mc cause of back pain
A
thoracic/lumbar strain
7
Q
2 mc cause of thoracic/lumbar strain
A
BLT
strenuous activity
8
Q
sx of thoracic/lumbar strain
A
stiff
difficulty bending
axial back pain
no radicular sx
NO neuro changes (pain below knees)
9
Q
tx for thoracic/lumbar strain
A
r.o red flags
NSAIDs
heat/ice
PT
home exercises
bed rest < 2 days
+/- muscle relaxants
10
Q
when should you re-eval back strain after conservative tx
A
4 weeks
11
Q
what is this
A
olecranon bursitis (scholar’s elbow)
12
Q
2 causes of bursitis
A
overuse
trauma
13
Q
tx for bursitis
A
rest
brace/support
NSAIDs
steroid injxn
14
Q
what is this
A
prepatellar bursitis
15
Q
septic prepatellar bursitis is common in what pt pop
A
wrestlers
aspirate and culture
16
Q
what is this
A
subacromial bursitis
17
Q
describe the pain associated w. subacromial bursitis
A
painful w. motion AND at rest
18
Q
indications for aspiration of subacromial bursitis
A
fever
DM
immunocompromised
19
Q
sx of tendonitis
A
pain w. movement
swelling
impaired fxn
20
Q
tx for tendonitis
A
ice
rest
stretching
21
Q
t/f: NSAIDs don’t penetrate tendon circulation
A
t!
they still help tho
22
Q
indications for surgery for tendonitis
A
excision of scar tissue
necrotic debris
23
Q
activity-related anterior knee pain
jumper’s knee
A
patellar tendinitis
24
Q
what is basset’s sign
A
ttp of distal patella in full extension
no ttp of distal patella in full flexion
25
what is this showing
inferior traction spur (enthesophyte) -> chronic patellar tendonitis
26
US finding of tendonitis
thickening -> hypoechoic
27
what is this showing
tendon thickening -> patellar tendonitis
28
what tx is contraindicated for patellar tendonitis
cortisone injxns -> due to risk of tendon rupture
29
pain at biceps groove
anterior shoulder pain
biceps tendonitis
30
PE finding of biceps tendonitis
pain w. resisted supination of elbow
31
what is this showing
increased T2 signal around biceps tendon -> biceps tendonitis
32
what is this
popeye deformity -> biceps tendon rupture
33
tx for biceps tendonitis
NSAIDs
PT
steroid injxns
surgical release for refractory
34
2 special test used for biceps tendonitis
speed
yergason's
35
pain elicited in bicipital groove when pt forward elevates shoulder against resistance with elbow extended and forearm supinated
speed test
36
speed's test may be positive in what 2 injuries
biceps
SLAP lesions
37
elbow flexed 90 degrees, pain w. wrist supination against resistance
yergason's test ->
38
cauda equina usually affects what nerve roots
L4/L5
39
sx of cauda equina
leg pain/numbness
saddle anesthesia
bowel/bladder dysfxn and/or paralysis
40
indications for MRI emergent MRI w. back pain (2)
saddle anesthesia
bowel/bladder dysfxn and/or paralysis
41
inflammation of the cartilage that connects a rib to the breastbone
costochondritis
42
describe costochondritis pain (3)
pain/tenderness on breastbone
pain in more than one rib
gets worse w. deep breaths or coughing
43
rf for costochondritis (7)
>40 yo
high impact sports
manual labor
allergies
rheumatoid arthritis
ankylosing spondylitis
RA
44
2 profession clues for costochondritis
painter
gardener
45
2 HPI clues for costochondritis
recent URI w. coughing
strenuous exercise
46
5 characteristics of costochondritis pain
sharp
aching
pressure like
unilateral
reproduced w. palpation
47
costochondritis pain is exacerbated by (2)
body movement
deep breathing
48
dx of costochondritis should be reconsidered if there is no
ttp
49
tx for costochondritis
NSADs/APAP
heat
steroids
PT
50
patients > _ yo w. sx of costochondritis must be worked up for CAD
35
51
_ can often mimic costochondritis
PE
52
inflammatory process causing visible enlargement of the costochondral area - aka "slipping rib syndrome"
tietze syndrome
53
any extremity injury w. ecchymosis is a _ until proven otherwise
fracture
54
acute, immune-mediated condition characterized by the appearance of distinctive erythema-like target-like lesions on the skin
erythema multiforme
55
upper extremity fx's to know
humerus
supracondylar
radial head
radial head subluxation
nightstick fx
monteggia
galeazzi
colles
smith
scaphoid
boxer's
bennett/rolando
56
mc site of radial nerve injury
humerus fx
57
what signs are associated w. humerus fx
fat pad
sail sign
58
splints for humerus fx:
distal:
shaft:
distal: sugar tong splint
shaft: coaptation splint
59
mc pediatric elbow fx
supracondylar
60
mc moi for supracondylar fx
foosh
61
XR finding of supracondylar fx
anterior fat pad
62
nerve/artery injuries associated w. supracondylar fax
median nerve
brachial artery
63
tx for supracondylar fx
long arm posterior splint followed by long arm casting
64
pain/tenderness along lateral aspect of elbow, limited forearm ROM
radial head fx
65
ROM most affected w. radial head fx
pronation/supination
66
mc moi for radial head fx
foosh
67
tx for radial head fx
sling
long arm splint @ 90 degrees
ORIF
68
what is a nursemaid fx
radial head subluxation
69
what ligament is associated w. radial head subluxation
annular
70
how will the pt present w. nursemaid elbow
lateral elbow pain
arm held in slight flexion, forearm pronated
71
tx for nursemaid elbow
supination-flexion technique
72
what fx is this
night stick -> fx of the ulnar shaft
73
mc moi for nightstick fx
blow to the arm
74
tx for nightstick fx
functional brace vs ORIF
75
what fx is this
monteggia -> proximal ulnar shaft w. radial head dislocation
76
mc moi for monteggia fx:
tx:
FOOSH
ORIF
77
what fx is this
galeazzi -> distal radial shaft w. dislocation of ulna
78
mc moi for galeazzi fx
pronated foosh
79
what fx is this
colle's -> dorsally angulated extra-articular distal radius fx
80
what deformit is associated w. colle's fx
dinner fork
81
what XR view is needed for dx of colle's fx
lateral
82
tx for colle's fx
sugar tong splint
83
what fx is this
smith -> extra-articular metaphysis of radius w. volar angulation/displacement
84
what deformity is associated w. smith fx
garden spade
85
moi's associated w. smith fx
fall w. palm closed, hands flexed
blow to back of wrist
86
nerve mc injured w. smith fx
median -> CTS over time
87
what fx is associated w. snuffbox tenderness
scaphoid
88
major complication of scaphoid fx
avascular necrosis
89
t/f: scaphoid fx may not be evident for up to 2 weeks following injury
t!
90
tx for scaphoid fx
10-12 weeks thumb spica splint
91
what fx is this
boxer's -> fx of neck of 5th/4th metacarpal
92
tx for boxer's fx
ulnar gutter splint w. joints at 60 degree flexion
93
what fx's are these
left: bennett -> simple/oblique
right: rolando -> comminuted
94
tx for bennett/rolando fx's
ORIF
95
complication of shoulder fx
adhesive capsulitis
rotator cuff tear
96
_ fx is commonly missed after MVA
scapula
97
tx for shoulder fx
immobilze 2-3 weeks ->
passive ROM ->
light strengthening after 6 weeks
98
shoulder dislocation is mc in what pt pops
sports
elderly
99
mc type of shoulder dislocation
anterior
100
w. anterior shoulder dislocation, arm is _ and _ roatated
abducted
externally rotated
101
w. posterior shoulder dislocation, arm is _ and _ rotated
abducted
externally
102
3 XR views for shoulder dislocation
AP
axillary
sacpular
103
tx for shoulder dislocation
pre/post films
reduce
sling/swath
PT
104
4 conditions associated w. shoulder dislocation
bankart lesion
hill-sachs lesion
axillary nerve injury
rotator cuff tear/labral tear
105
what is this showing
bankart lesion -> fx of anterior inferior glenoid
106
what is this showing
hill sachs lesion -> dent in humeral head
107
what do you think when you see transient neurapraxia and numbness/tingling of lateral shoulder following shoulder dislocation
axillary nerve injury -> C5/C6 fibers
108
what is this showing
rotator cuff tear
109
moi for clavicular fx (3)
direct fall/blow to lateral shoulder
birth trauma
110
mc type of clavicular fx
middle third
111
PE finding of clavicular fx
tending of overlying skin
112
muscle mc injured w. clavicular fx
supraspinatus
113
2 XR views for clavicular fx
AP
clavicle
114
tx for clavicular fx
simple arm sling vs figure 8 x 4-6 weeks
PT after 4 weeks
ortho consult if proximal 1/3
115
main blood supply to femoral head
medial circumflex femoral artery
116
what is the log roll maneuver
internal and external rotation of leg elicits pain -> hip fx
117
major complication of hip fx
avascular necrosis of femoral head
118
tx for hip fx
ORIF
hip arthroplasty
DVT prophylaxis til ambulatory
119
patient presentation for anterior hip dislocation vs posterior
anterior: abducted, flexed, externally rotated
posterior: adducted, flexed. internally rotated
120
mc moi for hip dislocation
trauma
121
mc type of hip dislocation
posterior
122
nerve mc injured w. hip dislocation
sciatic
123
XR findings of anterior vs posterior hip dislocation
anterior: femoral head superior to acetabulum
posterior: femoral head inferior to acetabulum
124
2 criteria used to determine need for knee radiographs
ottawa
pittsburgh
125
ottawa criteria
-age > 55
-tenderness to head of fibula
-isolated tenderness to patella
-inability to flex knee 90 degrees
-inability to bear weight for 4 steps immediately and in exam room (regardless of limp)
126
pittsburgh criteria
recent fall/blunt trauma
age < 12 OR > 50
unable to take 4 unaided steps
127
mc moi for knee dislocation
high impact trauma
128
injury associated w. kids after MVA
tibial plateau
129
nerve to test w. knee injury
peroneal -> foot drop
130
what is this showing
patella alta -> pulled quad muscles cause superior patella displacement
131
3 XR findings of osteoarthritis
joint narrowing
osteophytes
subchondral sclerosis
132
first and second line tx for OA
1. APAP
2. NSAIDs
133
ottawa ankle criteria
pain along lateral/medial malleolus
midfoot/5th metatarsal/navicular pain
unable to walk more than 4 unaided steps during exam
134
ankle fx to know
jones
stress
talus
fibular
135
what fx is this
jones -> 5th metatarsal diaphysis fx
136
tx for jones fx
walking boot/cast
RICE
surgery if displaced
6 weeks non weight bearing
137
ankle stress fx is mc in which location
3rd metatarsal
138
t/f: XR is 50% negative with stress fx
t!
bone scan/MRI more reliable
139
common moi for talus fx
snowboarding -> high impact
140
what is this showing
talus fx
141
weber ankle fx classification
a. fibular fx below mortise, tibiofibular syndemosis intact, unstable
b. fibular fx at level of mortise, tibiofibular syndemosis intact or mild tear, deltoid ligament intact or torn, stable vs unstable
c. fibular fx above mortise, tibiofibular syndemosis torn w. widening of talofibular joint, deltoid ligament damage or medial malleolar fx, unstable
142
gout involves altered _ metabolism
purine
143
mc type of gout attack
podagra -> great toe
144
PE finding of chronic gout
tophi
145
workup for gout
arthrocentesis
serum uric acid > 8 (not diagnostic)
XR
146
arthrocentesis finding of gout
negatively birefringent rod shaped crystals
147
XR findings of gout
small, punched out lesions
148
1st line tx for acute gout
indomethacin tid
149
2 meds to avoid w. gout
diuretics
ASA
150
management of chronic gout
colchicine
allopurinol
151
ages associated w. gout vs pseudogout
gout: > 30
pseudogout: > 60
152
3 characteristics of pseudogout vs gout
pseudogout:
> 60
large joints
no tophi
153
arthrocentesis findings of pseudogout
positively birefringent rhomboid shaped Ca pyrophosphate crystals
154
XR finings of pseudogout
fine, linear calcifications in cartilage
155
tx for pseudogout
acute: indomethacin
chronic: colchicine
156
mc location of cervical disc herniation
C5/C6
C6/C7
157
what differentiates rotator cuff tear from disc herniation
no pain at rest w. rotator cuff tear
158
weakness in shoulder elevation
C4
159
weakness of shoulder abduction and external rotation
bicep flexion weakness
C5
160
pain at shoulder tip w. radiation to anterior upper arm, radial forearm, thumb
weakness w. elbow flexion or shoulder external rotation
C5/C6
161
pain at shoulder blade, pectoral area, medial axilla, posterolateral upper arm, dorsal elbow, forearm, index, and medial digits or all of fingers
diminished triceps reflex
C6/C7
162
weakness of opponens pollicis and hand intrinsic muscles
weakness of finger abductors and grip strength
C7-T1
163
pain in a dermatomal pattern that increases w. coughing/straining/bending/sitting
L5-S1 (sciatica)
164
PE tests for sciatica
SLR
crossover SLR
165
red flag sx w. LBP
fecal/urinary incontinence
saddle anesthesia
urinary retention
immunosuppression
IVDU
fever
chronic steroids
focal neuro deficits
fx/infxn
trauma
> 50 yo w. mild trauma
hx ca
unexplained wt loss
no improvement x 6 weeks of conservative tx
166
inguinal pain
L1
167
spinal stenosis
pain at anterior aspect of thigh
L2-L4
168
mc radiculopathy
L5
169
pain down lateral aspect of leg into the foot
reduced dorsiflexion/toe extension/foot inversion/eversion
L5
170
pain down posterior leg into foot
reduced plantar flexion/ankle reflex
S1
171
sacral/buttock pain radiating down posterior leg into perineum
urinary/fecal incontinence and sexual dysfxn
S2-S4
172
2 mc cause of lbp
prolapsed intervertebral disc
low back strain
173
where is sciatica felt
buttock ->
posterior thigh ->
posterolateral aspect f leg ->
lateral malleolus ->
lateral dorsum of foot
174
unilateral lbp and butt pain taht gets worse w. standing
SI joint involvement
175
pain in elderly increased by walking and relieved by leaning forward
spinal stenosis
176
red flags for lbp
fever/wt loss
morning stiffness
IVDU
steroid hx
trauma
ca
saddle anesthesia
loss of anal sphincter tone
motor weakness
177
usefulness of CT in evaluation of lbp
bony stenosis
lateral nerve root entrapment
178
MRI usefulness in lbp evaluation
spinal cord pathology
neural tumors
stenosis
herniated disc
infxn
179
max amt of time to recommend rest for lbp
2 days
*w. support under knees/neck*
180
when to consider imaging if lbp isn't improved w. conservative tx
6 weeks
181
chronic infxn/inflammation of bone and bone marrow
osteomyelitis
182
3 sources of osteomyelitis
hematogenous seeding
contiguous spread of infxn
direct inoculation into bone (trauma/surgery)
183
3 PE findings of osteomyelitis
fever
restricted movement
refusal to bear weight
184
mc pathogen associated w. osteomyelitis
s. aureus
185
pathogen associated w. osteomyelitis caused by dog/cat bites
pasteurella
186
pathogen associated w. osteomyelitis in SSA pt
salmonella
187
pathogen assocaited w. osteomyelitis w. vertebral involvement (Potts Dz)
myobacterium TB
188
pathogen associated w. osteomyelitis in prosthetic joints
staph epidermidis
189
gs dx for osteomyelitis
bone aspiration w. culture
190
xray triad for osteomyelitis
demineralization
periosteal rxn
bone destruction
191
gs imaging for osteomyelitis
MRI
*XR lags behind symptoms 7-10 days*
192
what 3 labs are elevated in most osteomyelitis cases
CRP x 4-6 weeks
WBC
ESR
193
tx for osteomyelitis
-empiric abx -> tailored based on culture
-remove all hardware
194
duration of abx for osteomyelitis: acute vs chronic vs MRSA
acute: 4-6 weeks
chronic and MRSA: > 8 weeks
195
suspsect osteomyelitis if a diabetic foot ulcer is (2)
> 2 cm x 2 cm
OR
bone is palpable
196
first step in pain management
differentiate acute vs chronic
197
2 types of acute pain
nociceptive
neuropathic
198
t/f: NSAIDs/APAP are just as effective as opioids for nociceptive pain
t!
199
NSAID ceiling effect
naproxen: 500 mg (1,000 mg/day)
ibuprofen: 400 mg (1200/day)
diclofenac: 50 mg (150 mg/day)
200
nonpharm tx for pain
PT
heat/cold
OMT
acupuncture
masssage
201
non opioid pharm management of pain
topical analgesics
cymbalta
COX 2's: celebrex, mobic
muscle relaxants
gabapentin
TCAs
202
name 3 muscle relaxants
baclofen
cyclobenzaprine (flexeril)
tizanidine (zanaflex)
203
pharm for neuropathic pain (2)
gabapentin
TCAs
204
use NSAIDs w. caution in what pt pops (3)
ckd
hepatobiliary/GI dz
CVD
205
rf for NSAID GI toxicity
hx previously complicated ulcer
> 65 yo
high doses
concurrent use of ASA/steroids/anticoagulants
low = no rf
mod = 1-2 rf
high = > 2 rf or hx complicated ulcer
206
management of NSAIDs in pt's at high risk for GI toxicity
add a PPI
207
pt pop to avoid NSAIDs in
why?
-decompensated cirrhosis
-risk of PG mediated renal perfusion and bleeding
208
how to safely prescribe opioids
lowest dose for lowest amt of time
oral
short acting
209
direct bacterial invasion of joint space
medical emergency
septic arthritis
210
sx of septic arthritis
-single, swollen, warm painful joint that is ttp
-fever, sweats, myalgia, malaise, pain
211
2 mc locations for septic arthritis
knee
hip
212
3 causes of septic arthritis
hematogenous spread
direct inoculation
contigous spread
213
mc pathogen associated w. septic arthritis
s. aureus
214
pathogen associated w. septic arthritis in sexually active young adults
n. gonorrhea
215
2 pathogens associated w. septic arthritis in IVDU
streptococci
pseudomonas
216
definitive dx for septic arthritis
arthrocentesis w. gram stain
217
arthrocentesis findings indicative of septic arthritis: non prosthetic joints vs prosthetic joints
non prosthetic joints: WBC > 50,000, primarily PMNs
prosthetic joints: WBC > 1,000
218
tx for septic arthritis
abx x 2-4 weeks
arthrotomy w. joint drainage
219
abx for septic arthritis based on pathogen
-s. aureus: vanco/nafcillin
pcn allergy: vanco vs clinda
-gonorrhea: ceftriaxone
-IVDU: cipro/levaquin
220
pain w. resisted wrist flexion and pronation
pain at medial elbow
overuse syndrome
medial epicondylitis (golfers elbow/pitcer's elbow)
221
pain w. wrist extension and forearm supination
overuse syndrome
lateral epicondylitis (tennis elbow)
222
-ulnar n compression at wrist
-paresthesia's over small finger/ulnar half of 4th finger/ulnar dorsum of hand
-worse w. cell phone use
-caused by sleeping w. arm in flexion
cubital/ulnar tunnel syndrome
223
tx for cubital/ulnar tunnel syndrome
NSAIDs
nighttime bracing
ulnar n decompression
224
-pain/paresthesia in first 3 digits/radial half of 4th digit
-sx worse at night
carpal tunnel syndrome
225
what n is involved with carpal tunnel syndrome
median
226
PE tests for CTS
phalen
tinel
227
PT test for cubital tunnel syndrome
tinel
228
tx for CTS
night splint
steroid injxn
surgical decompression
229
pain and sweling at base of thumb that radiates into radial aspect of forearm
de quervain's tenosynovitis
230
PE test for de quervain's tenosynovitis
finkelstein
231
tx for de quervain's tenosynovitis
thumb spica splint x 3 weeks
NSAIDs
steroid injxn
PT
232
injury from fall on an abducted thumb
laxity/pain w. valgus stretch
thumb collateral ligament injury (gamekeeper/skier injury):
gamekeeper = chronic
skier = acute
233
tx for thumb collateral ligament injury
XR to evaluate for avulsion injury
thumb spica x 4-6 weeks
234
-benign fibroproliferative disorder chracterized by contracture of palms and palmar nodules mc in 4th and 5th digit
-painless nodules on palms
duputyren contracture
235
what disease is associated w. dupuytren contracture associated w.
alcoholic cirrhosis
236
PE test for duputyren contracture
tabletop
237
tx for duputyren contracture
injected collagenase or steroid
fasciotomy vs fasciectomy
238
tear at DIP joint
avulsion of extensor tendon -> can't straighten distal finger
mallet finger
239
what is this showing
bony avulsion of distal phalanx -> mallet finger
240
tx for mallet finger
splint DIP -> uninterrupted extension x 6 weeks
surgical pinning
241
tear at PIP joint - jammed finger
PIP flexion and DIP hyperextension
boutonniere deformity
242
PE test for boutonniere deformity
elson
243
tx for boutonniere deformity
splint PIP in extension x 4-6 weeks
244
soft tissue infxns to know
cellulitis
paronychia
felon
herpetic whitlow
245
2 pathogens associated w. cellulitis
staph
strep
246
what is this showing
paronychia -> infxn next to fingernail
247
causes of paronychia: acute vs chronic
acute: bacterial
chronic: fungal
248
what is this showing
felon -> abscess in the tip of the finger
249
what is this showing
herpetic whitlow -> herpes infxn around the fingernail (thumb sucking)
250
benign, asymptomatic, mucin filled synovial cyst mc on dorsal aspect of wrist
ganglion cyst
251
PE test to perform for ganglion cyst
allen's test
*to ensure radial and ulnar artery flow*
252
shoulder injuries to know
AC separation
biceps tendonitis
rotator cuff tear/tendinopathy
adhesive capsulitis
subacromial impingement
subacromial bursitis
glenohumeral joint OA
253
what is this showing
step off deformity -> AC separation
254
PE test for AC separation
cross chest testing
255
imaging for AC separation
XR w. pt holding a weight
*assess level of injury to joint*
256
anterior shoulder pain
pain w. resisted supination of elbow
biceps tendonitis
257
what is this showing
pop eye deformit -> biceps tendon rupture
258
MRI finding of biceps tendonitis
increased T2 signal around biceps tendon
259
PE tests for biceps tendonitis
speed's
yergason's
260
elbow flexed at 90 degrees, wrist supination against resistance
yergason's test
261
muscle mc injured w. rotator cuff tear/tendinopathy
supraspinatus
262
pain associated w. rotator cuff injury
pain w. overhead activity
pain w. lying down at night
263
what is this showing
loss of subacromial space -> rotator cuff injury
*due to upward migration of humeral head*
264
when is surgery indicated for rotator cuff tear
failure of 3-6 months of conservative tx
265
what are the SITS muscles
supraspinatus
infraspinatus
teres minor
subscapularis
266
3 PE tests suggestive of supraspinatus injury
empty can
full can
arm drop
267
PE test associated w. subscapularis injury
lift off
268
PE test associated w. teres minor/infraspinatus injury
elbow at 90 degrees -> rotate laterally against resistance
269
-insidious onset shoulder stiffness/pain at rest
-decreased active and passive ROM
-may mimic rotator cuff injury
adhesive capsulitis
270
PE test for adhesive capsulitis
scratch test
271
pain w. reaching/lifting and w. overhead motion
subacromial impingement
272
PE tests for subacromial impingement
neer
hawkins
drop arm
273
knee injuries to know
prepatellar bursitis
patellar tendinitis
ACL
MCL
LCL
PCL
meniscal
274
pain w. direct pressure on knee
swelling over patella
wrestlers
prepatellar bursitis
275
swelling over tendon
tenderness at inferior border of patella
patellar tendinitis
276
what tx is contraindicated for patellar tendinitis
why?
steroid injxn
due to risk for tendon rupture
277
popping/swelling w. instability and feeling of knee giving out after plant and twist injury
ACL tear
278
PE tests for ACL tear
anterior drawer
**lachman's**
279
most sensitive test. forACL tear
lachman's
280
indications for surgery for ACL tear
young
active
281
valgus stress injury - football
"pop"
MCL tear
282
PE test for MCL tear
valgus
283
indiacation for surgery for MCL tear
chronic instability
284
rare knee injury associated w. trauma to the medial knee
LCL tear
285
indication for surgery w. LCL tear
grade III
286
PE test for LCL tear
varus
287
blow to the knee while flexed or bent
landing hard during sports fall
dashboard injury
PCL tear
288
PE test for PCL tear
posterior drawer
289
what is. this showing
sag sign -> PCL tear
290
indications for surgery for PCL tear
PCL + ACL
PCL + grade III MCL or LCL
291
twist injury w. locking
feeling of knee giving out
effusion 6-24 hr after injury
meniscal tear
292
triad of meniscal tear
joint line pain
effusion
locking
293
PE tests for meniscal tear
mcmurray
apley
294
ankle/foot injuries to know
ankle sprain
achilles tendon rupture
plantar fasciitis
tarsal tunnel
bunion (hallux valgus)
morton's neuroma
295
and 85% of ankle sprains are. in which ligament and via what moi
atfl
inversion
296
which ankle ligament is injured with ankle eversion
deltoid
297
PE tests for ankle injury
anterior drawer
talar tilt
298
ottawa ankle rules for xray
malleolar zone pain
bone tenderness at lateral or medial malleolus
can't bear weight/take a few steps
299
"pop" with weakness
palpable gap w. increased resting ankle dorsiflexion in prone position w. knees bent
achilles tendon rupture
300
PE test for achilles tendon rupture
thompson
301
-pain on plantar surface of foot at calcaneal insertion of plantar fascia upon wt bearing
-worse in AM
-dancers, runners
plantar fasciitis
302
posterior tibial n compression from overuse
restrictive footear
tarasl tunnel syndrome
303
deformity of bursa over 1st metatarsal
hx poorly fitted shoes/flat feet (pes planus) or RA
pain over prominence at MTP joint
bunion (hallux valgus)
304
painful mass near tarsal heads
hx tight fitting shoes/high heels
sharp pain w. ambulation at 3rd metatarsal head
numbness/paresthesia
morton's neuroma
305
mc location of sprain
1. ankle
2. wrist
306
sprain classifications
1. first degree/mild: fibers and ligaments are stretched but intact
2. second degree/moderate: tear of ligament from a third to almost all it's fibers
3. third degree/severe: complete rupture of ligament, sometimes avulsing a piece of bone
307
tx for sprain
RICE
clinical dx vs xray vs MRI
308
mc location for strains
hamstring
lower back
309
classification of strains
1. first degree/mild: little tissue tearing, mild tenderness, pain w. full ROM
2. second degree/moderate: torn tissue, painful limited ROM, +/- swelling
3. third degree/severe: limited or no ROM, severe acute pain
310
tx for strains
RICE
PT after 7 days of rest
311
swelling and deformity in. theemergency setting indicate (2)
fracture
dislocation
312
management of fracture/dislocation
1. check vascular area distal to swelling/deformity
2. immediate reduction
