Upper Limb

Question 1

calcific tendonitis

Answer 1

calcium laid down within the rotator cuff that can rupture out of the tendon & into the glenohumeral joint

Question 2

treatment of calcific tendonitis

Answer 2

steroid injection into the subacromial space after infection has been ruled out

Question 3

shoulder impingement

Answer 3

syndrome

pain on movement (painful arc)

Question 4

treatment of shoulder arthritis is

Answer 4

conservative

Question 5

traumatic shoulder instability

Answer 5

unilateral

bankart lesion

Question 6

treatment of traumatic shoulder instability

Answer 6

bankart repair/laterjet

Question 7

bankart lesion

Answer 7

an injury of the anterior (inferior) glenoid labrum of the shoulder due to anterior shoulder dislocation. When this happens, a pocket at the front of the glenoid forms that allows the humeral head to dislocate into it.

Question 8

atruamatic shoulder instability

Answer 8

multidirectional
bilateral
inferior capsular shift
soft tissue problems

Question 9

carpal tunnel syndrome

Answer 9

parasthesiae in median nerve distribution due to compression of median nerve at carpal tunnel, night time disturbance common

Question 10

cubital tunnel syndrome

Answer 10

parasthesiae in the ulnar nerve distribution due to compression of the ulnar nerve where it runs round the medial epicondyle of the below

Question 11

what are the indications for nerve decompression

Answer 11

Failed conservative treatment
Constant numbness
Weakness

Question 12

what are the possible causes of upper limb arthritis

Answer 12

Degenerate (OA)
Inflammatory (RA, psoriasis, gout)
Post-traumatic
Septic

Question 13

what are the basic treatment principles of upper limb arthritis?

Answer 13

Nothing
Rest/analgesia/splintage
Steroid injections
Replace
Fuse
Excise

Question 14

how does cuff tear arthropathy come about

Answer 14

Rotator cuff centres humeral head on glenoid
If torn, deltoid pulls head upwards
Abnormal forces on gleaned leads to OA
Anatomic shoulder replacement will fail

Question 15

shenton’s line

Answer 15

smooth inferior curve of joint in shoulder & hip, loss of this line means there’s a fracture/dislocation

Question 16

mucous cyst

Answer 16

outpouching of synovial fluid from DIDPJ OA

Question 17

which pulley is most commonly affected by trigger finger

Answer 17

A1

Question 18

what happens in trigger finger

Answer 18

swelling on tendon leads to irritation causing more swelling & the tendon then gets caught on the edge of a pulley leading to stick of finger, usually in flexion

Question 19

dequervain’s tenosynovitis

Answer 19

inflammation of the sheath of the extensor compartment
spontaneous
painful!
swollen/red
Finklestein’s test

Question 20

management of dequervain’s tenosynovitis

Answer 20

NSAIDS
splint
rest

steroid injection

surgery- decompression

Question 21

finklesteins test

Answer 21

make patient make a fist with thumb inside & ask them to adduct their wrist. bit sore in normal people so positive test is very sore.

Question 22

paronychia

Answer 22

infection within nail fold often in children & can be associated with nail biting

Question 23

management of paranychia

Answer 23

make patient make a fist with thumb inside & ask them to adduct their wrist. bit sore in normal people so positive test is very sore.

Question 24

subungual haematoma

Answer 24

bruise under nail, can cause pressure which can cause pain. nail may eventually fall off.

Question 25

what can you give a patient if he subungual haematoma is causing pain?

Answer 25

trephine