Rheumatology ( and bones )

Question 1

Fractures of the distal radius ?

(3)

Answer 1

1- colles - dorsal angulation of the distal fragment ( hand is outwards)
2-Smith - Volar angulation of the distal fragment (hand is inwards )
3- Galeazzi fracture ( dislocation of the radioulnar joint ) at the wrist

Question 2

Monteggia fracture

Answer 2

FOOSH
- Proximal 1/3 of Ulna
- dislocation of the radial head

Question 3

Osgood -Schlatter’s disease

Answer 3

knee pain in young teenage boys
associated with growth spurt ,microfracrures in the patella tendon

1) analgesia
2)NSAIDS short term
3) stretching and exercise modification

Question 4

Carpal tunnel syndrome
features and treatment

Answer 4

numbness and tingling in median nerve
WORSE at night
conservative measure : wrist splitting and NSAIDS

Question 5

Scaphoid fracture

Answer 5

tenderness in anatomical snuff box, they are hard to read so they should repeat X-RAY in 10 days
serious complication : Avascular necrosis

Question 6

common perineal nerve palsy
vs L5 radiculopathy

Answer 6

1) CPNP - foot drop and weakness in eversion
2) L5- inversion weakness , pain radiation down leg and sensory loss along lateral leg

Question 7

ACL injury

Answer 7

sudden POP in knee , made when making a change of direction

Question 8

Lateral epicondylitis

Answer 8

TENNIS LESSONS = Lateral epicondylitis
- pain on outer elbow
worse with gripping and wrist extension

Question 9

Medial epicondylitis

Answer 9

Golfers elbow
- inner aspect of elbow

Question 10

Hip fractures

• how does leg look
• how to manage intracapsular ( in place , displaced in old and young )
• Extracapsular ?

Answer 10

leg is shortened and externally rotated

1) intracapsular ( high risk of avascular necrosis ) –> non displaced = screw fixation

2) Extracapsular fractures ->Dynamic hip screws

3) displaced Intracapsular fracture-> hemiarthroplasty

4) Displaced intracapsular fractures in young patients -> Total hip replacement

Question 11

septic arthiritis treatment

Answer 11

FLUCLOXACILLIN

Question 12

Rheumatoid arthritis joint aspiration

Answer 12

yellow , polymorphs

Question 13

SUFE ?

Answer 13

femoral head slips off the neck of femur , seen in adolescents
Obesity

Question 14

Perthes disease

Answer 14

avascular necrosis of the femoral head in children
+ limp and pain
+ ages 4-8