Upper Extremity Clinical Correlation Flashcards
Identify
Pancoast tumor
Identify
Fabella
Identify
calcific tendonitis
The calcifications in the attached image are commonly found in what syndrome?
Crest Syndrome
Identify
Soft tissue hemangiomas
Identify
Lipohemarthrosis
In which joint type is effusion generally most easily identified?
knee
Identify
Jones fracture
(fracture of the base of the 5th metatarsal)
Identify
Rolando fracture
(base of the 1st metacarpal @ CMC joint)
Identify
intertrochanteric fracture
Identify
avuslion fracture
Identify
Segond fracture
Identify
tophi (gout)
Name (6) modalities commonly used for musculoskeletal imaging
- Radiographs (plain film x-ray)
- Fluoroscopy
- Ultrasound
- Computed tomography (CT)
- Magnetic resonance imaging (MRI)
- Nuclear imaging (ex: PET)
Name and describe (3) major categories of fracture
- Acute: due to sudden impact or force exceeds the strength of bone
- Stress: due to repetitive submaximal stresses
- Pathologic: due to otherwise normal stresses on diseased bone
Give (3) major examination signs of fracture
Deformity
Bony point tenderness
Pain with loading -> best identified with indirect loading
Name (4) indirect loading tests for fracture
- axial
- bump test
- hop test
- fulcrum test
Why might use of NSAIDs be contraindicated in bone fracture?
NSAIDs may interfere with prostaglandin roles in bone healing
Name three bones that are especially vulnerable to avascular necrosis in the event of a fracture
- Scaphoid
- Talus
- Femoral head and neck
The femoral head and neck are chiefly supplied by what vessel?
medial circumflex femoral artery
What is post-traumatic arthritis?
Arthritis developed following dislocation, usually chronic dislocation
Name some historical (Hx) and examination (Ex) features found with arthritis
Hx:
- stiffness, especially after rest
- progressive pain, worse especially after use
Ex:
- Joint line tenderness
- deformity
- mild swelling
- pain evoked on passive and active movement
Name (3) major risk factors for capsulitis
- Injury
- Diabetes
- Thyroid disease
Name and describe the three (3) major phases of capsulitis
- Freeze: painful with decreasing range of motion (ROM)
- Frozen: non-painful with stable/minimal ROM
- Thawing: non-painful with increasing range of motion
Identify
Long head biceps tendon rupture
What are the key considerations when weighing treatment options for musculotendinous ruptures?
- Impact of missing muscle
- Presence of alternative muscles
- Functional requirements of the patient
Define: enthesopathy
Disorder of the bony attachment of a muscle or tendon
Define: tendinitis
Acute inflammation of a tendon
traumatic: pull or blow
Define tendinosis
Chronic degeneration of a tendon
possibly due to repetitive submaximal irritation
What is a strain?
What are its symptoms?
Damage to muscle from overstretching, usually during eccentric loading of the muscle
Sx: stiffness, bruising, swelling, soreness
Acromioclavicular (AC) sprain…
Give the common etiology, presentation, and exam findings
Etiology:
- fall directly onto the shoulder
Presentation:
- pain with overhead motions
- visible deformity of the superior shoulder
Exam findings:
- pain and deformity at AC joint
- positive cross-chest test (cross-body adduction)
- painful abduction to >150º
AC injury grading:
AC and CC tear
Grade III
AC injury grading
AC tear with CC injury
Grade II
AC injury grading:
AC injury with no CC involvement
Grade I
Define sprain
what are its primary symptoms?
ligamentous damage from overloading
Sx: instability or laxity, swelling
Sprain grading:
partial tear, significant laxity and pain
Grade II
Sprain grading:
microscopic damage, no increased laxity, increased pain with stress or load
Grade I
Sprain grading:
Complete tear, significant laxity, pain that may resolve following acute phase
Grade III
Which nerve is generally at greatest risk following an anterior shoulder dislocation?
Axillary n.
Define dislocation
Complete displacement of the joint
Define subluxation
transient, partial joint displacement
Define laxity
“looseness” of the joint
may be normal variant
What is the most common type/direction of shoulder dislocation?
Anterior (90%)
What is (are) the common etiologies of anterior shoulder dislocation?
- Direct blow to the posterior shoulder
- Forced extension, abduction, and external rotation of the arm
What is Simian (Ape) hand?
Thenar wasting associated with carpal tunnel syndrome
