Passmed/misc Flashcards
Which test are for which cruciate ligaments
Anterior draw (lachmans) for ACL integrity
Posterior draw for PCL integrity
How do you rupture an ACL and management
Sport injury
Mechanism: high twisting force applied to a bent knee
Typically presents with: loud crack, pain and RAPID joint swelling (haemoarthrosis)
Poor healing
Management: intense physiotherapy or surgery
How do you rupture a PCL
Mechanism: hyperextension injuries
Tibia lies back on the femur
Paradoxical anterior draw test
What is Chondromalacia patellae, who gets it and what are the s&s
Def: Cartilage on the undersurface of the patella(kneecap) deteriorates and softens
Demo: Teenage girls, following an injury to knee e.g. Dislocation patella
Sx: Typical history of pain on going downstairs or at rest
Sign: Tenderness, quadriceps wasting
How do you tear a meniscus
Rotational sporting injuries
Delayed knee swelling
Joint locking (Patient may develop skills to ‘unlock’ the knee
Recurrent episodes of pain and effusions are common, often following minor trauma
What is the inhereitance of marfarns
Autosomal dominant
Pagets disease: definition, S&S, management, complications
Def: Increased + uncontrolled bone turn over due to excessive osteoclastic resorption followed by increased osteoblastic activity
s&s (only 5% are symptomatic):
- the stereotypical presentation is an older male with bone pain and an isolated raised ALP
- bone pain (e.g. pelvis, lumbar spine, femur)
- classical, untreated features: bowing of tibia, bossing of skull
- raised alkaline phosphatase (ALP) - calcium* and phosphate are typically normal
- skull x-ray: thickened vault, osteoporosis circumscripta
Management
bisphosphonate (either oral risedronate or IV zoledronate)
Complications
- deafness (cranial nerve entrapment)
- bone sarcoma (1% if affected for > 10 years)
- fractures
- skull thickening
- high-output cardiac failure
