Soft tissue conditions Flashcards
ERON stage 1 + 2 presentation
1 = no signs of systemic toxicity, no uncontrolled comorbidities 2 = systemically unwell or has comorbidity
ERON stage 3 + 4 presentation
3 = significant systemic upset 4 = sepsis/ life threatening infection
Investigations for ?cellulitis
Examine
ERON classification
ERON 1 + 2 management for cellulitis
1 = phenoxymethylpenicillin or flucloxacillin oral 2 = flucloxacillin IV but can be in community
ERON 3 + 4 management for ?cellulitis
Admit for IV abx
Flucloxacillin +- benzylpenicillin, cipro + clindamycin if severe
Tendons in rotator cuff
Supraspinatus
Infraspinatus
Teres minor
Subscapularis
S+S of rotator cuff injury
Arc of pain (pain while lowering arm)
Night pain
Weakness, instability, restricted ROM
Numbness
Diagnosis of rotator cuff tear
X ray: AP view: sclerosis, cyst formation, smaller gap between acromion + humerus Lat view: state of acromion Axillary view: humeral head position MRI / US
Management of rotator cuff tear
NSAIDs
Surgery
Physio
Which tests show impaired movement in subscapularis tear?
Gerber’s lift off
Supine napoleon
Impaired internal rotation
Which tests show impaired movement in supraspinatus tear?
Active painful arc test
Drop arm test
Jobe’s test
Impaired abduction
Which test show impaired movement in infraspinatus + teres minor tears?
External rotation test
What is a nursemaids elbow?
Dislocation of radial head in elbow joint
Causes of nursemaids elbow?
Pulling extended arm males annular ligament slip above radial head
Due to lifting/ swinging child
S+S of nursemaids elbow
Child can’t bend/ use affected arm
Inability to supinate
RF for achilles tendon rupture
30-40
Males
Obesity
Systemic corticosteroid use
S+S of achilles tendon rupture
Sudden, painful pop
Inability to walk
What tests elicit signs in achilles tendon rupture?
Calf squeeze (Simmonds/ Thompson)
Palpable gap test
Knee flexion test (Matles test)
What is the typical mechanism of injury for an ACL tear?
Twisting knee after planting foot
RF for ACL tear
Females
Valgus knees
What is the main complication of an ACL tear?
Segond fracture = avulsion fracture of lateral aspect of tibial plateau
S+S of ACL tear
Immediate pain + knee swelling
Knee may ‘give out’ when standing
Investigations for ?ACL tear
MRI
What tests elicit signs in an ACL tear?
Pivot sign, seen at heel strike phase of walking
Anterior drawer test
Lachman test
Describe the surgery for an ACL tear
Reconstruction with neighbouring patellar ligament/ semitendinosus tendon
What is the pathology + cause of iliotibial band syndrome?
Overuse injury - common in runners
ITB used in knee flexion + extension
RF for iliotibial band syndrome
Weak hip abductors/ flexors Leg length discrepance Sudden distance/ intensity increase Foot eversion when running Running in cold weather
S+S of iliotibial band syndrome
Knee pain worse at 30 flexion
Pain along lateral femoral epicondyle
What tests elicit signs in iliotibial band syndrome?
Noble compression test
Ober test
Pathology of meniscal tears
Injury to fibrocartilage knee pads
Medial > lateral
What is the typical mechanism of injury of meniscal tears?
Forceful, sudden decelerating movement while changing direction
Complications of meniscal tears
Osteoarthritis
S+S of meniscal tears
Pain + swelling
Clicking/ crepitus
Inability to full extend knee (posterior tear)
What diagnostic imaging is used for knee injuries?
MRI
What tests elicit signs in meniscal tears?
McMurray test
Apley grinding test
Thessaly test
Childress duck-waddle test
Typical mechanism of injury for patellar tendon rupture
Landing from high jump
Making sudden changes in direction at high speed
Foot/leg stuck as person falls backwards
Complications of patellar tendon rupture
Tibial tuberosity avulsion fracture
Patellar fracture/ avulsion
What is the unhappy triad?
ACL, MCL + lateral meniscus tears
Mechanism of injury for unhappy triad
Forecful blow to posterolateral aspect of knee with planted foot
