Upper Extremity complaint Flashcards
sudden stretch to the inside of the elbow
medial collateral ligament sprain or compressive injury to radial head
supracondylar fracture should ALWAYS be considered with the history of a:
FOOSH injury
direct fall onto the tip of the elbow with elbow flexed
olecranon fracture or olecranon buritis
sudden traction on the forearm of a young child may result in radial head entrapment called:
Nursemaid’s elbow
repetitive flexion and medial elbow pain are suggestive of
medial epicondylitis
repetitive extension and lateral elbow pain are associated with
lateral epicondylitis
weakness at the elbow without associated pain suggests
biceps tendon rupture
restricted passive flexion or extension coupled with trauma suggests
joint effusion or fracture
nontraumatic restriction to passive extension suggests
tight biceps or anterior capsule
nontrauatic restriction to passive flexion suggests
tight triceps or posterior capsule adhesion
locking or crepitus in young pt suggests
osteochondritis desiccans
locking or crepitus in older pt suggests
degenerative changes
swelling of elbow suggests
fracture, bursitis, or gout
Mill’s test is for
lateral epicondylitis
reverse Mill’s test is for
medial epicondylitis
Cozen’s test is for
lateral epicondylitis
Tinel’s test is for
ulnar nerve irritation
lateral pain on resisted wrist extension and/or passive flexion of the wrist with the elbow extended and forearm pronated and/or resisted finger extension
lateral epicondylitis
medial pain on resisted wrist flexion with the elbow extended and/or passive wrist extension with the elbow extended and forearm supinated and/or resisted finger flexion
medial epicondylitis
lateral elbow pain worsened by resisted wrist extension and gripping
lateral epicondylitis
often referred to as tennis elbow, 40-60 years old, may cause inability to lift or hold objects
lateral epicondylitis
medial elbow pain following a repetitive activity, golfer’s elbow, inticing activity usually involve wrist flexion and pronation
medial epicondylitis
elevated anterior fat pad produces
sail sign
elevated anterior and posterior fat pads in elbow for adults means
radial head fracture
elevated anterior and posterior fat pads in elbow for kids means
supracondylar fracture of humerus
ulnar shaft fracture with associated proximal dislocated radius
Monteggia fracture
fracture distal radius and dislocated distal radial ulnar articulation
Galeazzi fracture
incomplete fracture of forearm
greenstick/torus
distal radial fracture with dorsal and radial angulation
Colles fracture
distal radial fracture with volar/palmar angulation
Smith’s fracture
most common carpal fractured
scaphoid
70% of scaphoid fractures involve this area
the waist
scaphoid fracture is most common site for
occult fracture
pain in the anatomic snuffbox after fall on the outstretched hand
scaphoid fracture
AVN of lunate
Kienbock’s disease
radial or dorsal wrist pain following a fall on outstretched hand
scapholunate disassociation
increased space between the lunate and scaphoid referred to as
Terry Thomas sign
with scapholunate disassociation, the scaphoid assumes a more vertical orientation and appears as:
signet ring sign
pie sign is
anterior lunate dislocation
radial wrist pain, pain is reproduced with resisted thumb extension in the wrist and radial deviation
De Quervain’s Tenosynovitis
test for de quervain’s tenosynovitis
Finkelstein’s
most common nerve entrapment syndrome
carpal tunnel
pain and numbness in palmar surface of thumb and radial 2 1/2 fingers, symptoms worse at night
carpal tunnel
median nerve issues in wrist could be
carpal tunnel, pronator syndrome
ulnar nerve issues in wrist could be
cubital tunnel syndrome, tunnel of Guyon
radial nerve issues in wrist could be
radial tunnel syndrome
volar forearm pain, no history of trauma, history of repetitive pronation
pronator syndrome
pain and paresthesia in medial forearm and ring and little finger, history of activities that medially stretch the elbow, usually due to valgus force of the elbow
cubital tunnel syndrome
complaint of numbness and tingling or pain in the 4th and 5th digits
tunnel of guyon
complaint of dull aching pain over the lateral forearm, tenderness distal to the lateral epicondyle
radial tunnel syndrome
when numbness, tingling, or weakness is reported in finger and thumb it is likely
peripheral nerve entrapment
avulsion of extensor digitorum tendon in hand
mallet finger
oblique intra-articular fracture at base of thumb with radial deviation of distal fragment
bennett’s fracture
partial or complete disruption of ulnar collateral ligament of 1st MCP articulation
gamekeeper’s thumb
marginal erosions of DIP’s and PIP’s, tuft erosions with sharpened pencil appearance, 30-50 year olds, pannus, enthesopathic changes
psoriatic arthritis
asymmetrical small joint involvement, most common in DIP, peripheral erosions (mouse ear erosions), central erosions (pencil and cup erosions), soft tissue swelling
psoriatic arthritis
young female in 20-40’s, wrist and finger pain, warm swollen tender joints, bilaterally in MCP and PIP joints, uniform loss of joint space and bare area erosions
rheumatoid
most common inflammatory arthritis, seropositive, pannus, elevated ESR, positive RA factor
RA
arthritis mutilans
severe joint deformity
enlargement of gastrocnemius bursa
Baker’s cyst
deformity of fingers that has PIP flexion and DIP extension
Boutonniere deformity
soft tissue swelling at MCP
Haygarth’s nodes
