The patient with MSK pain Flashcards
What are red flags for back pain?
Cauda equina/cord compression Sx, immunosuppression, trauma, history of cancer, nocturnal pain, systemically unwell (fever, weight loss, night sweats), thoracic pain (MSCC, aortic dissection, AAA, pancreatitis), abnormal gait, age < 20 or > 55
Which structures may be damaged during an inversion ankle sprain (sole of foot turns medially)?
Anterior talofibular ligament and lateral malleolus
Which structures may be damaged during an eversion ankle sprain (sole of foot turns laterally)?
Damage to structures around medial malleolus and medial ligaments
According to Ottawa Ankle Rules, when should an X-ray be ordered for ankle/foot?
Patient is unable to walk 4 steps in ED or immediately after the injury OR bony tenderness over:
A) Posterior edge or tip of lateral malleolus
B) Base of 5th metatarsal
C) Posterior edge or tip of medial malleolus
D) Navicular
Tenderness over A or B = Ankle X-ray
Tenderness over C or D = Foot X-ray
How are hip fractures categorised according to location?
Intracapsular - neck of femur (common in elderly)
Extracapsular - femur below the hip joint. Either intratrochanteric or subtrochanteric
What is the Garden classification of hip fractures?
Stage 1: Undisplaced incomplete fracture
Stage 2: Undisplaced complete fracture
Stage 3: Complete fracture, incompletely displaced
Stage 4: Complete fracture, completely displaced
What is the appearance of the leg following an intratrochanteric fracture?
Affected leg is shortened and externally rotated
Which direction of shoulder dislocation is most common?
Anterior dislocation
What is the appearance of anterior shoulder dislocation on X-ray?
Humeral head lies anterior to glenoid and inferior to coracoid process
What is the appearance of posterior shoulder dislocation on X-ray?
Contour of humeral head is said to resemble a lightbulb. Gleno-humeral joint is widened.
