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Sportsmed > wk 2- multi discinplinary team and reflags > Flashcards

wk 2- multi discinplinary team and reflags Flashcards

1
Q

red flags

A
  1. 50+ years
  2. injury appears disproportionate to mechanism
  3. systemic symptoms (fever, chills, sick, weight loss)
  4. atypical symptoms
  5. medical risk factors (osteoporosis, immune deficiency, diabetes, etc)
  6. symptoms worse at night
  7. significant morning stiffness
  8. complex past medical history
  9. family history of inflammatory joint disease (gout, RA, OA, PsA, ankylosing spondylitis, reactive arthritis, scleroderma, lupus)
  10. multiple body systems involved (endocrine, derm, neuro, urinary)
  11. poor response to conservative treatment
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2
Q

red signs of serious pathology examples

A
  1. cauda equina syndrome
  2. fracture
  3. tumour
  4. unremitting night pain
  5. sudden weight loss (10 pounds over 3 months)
  6. bladder/bowl incontinence
  7. history of cancer
  8. saddle anaesthesia
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3
Q

orange flags examples

A

personality disorder
clinical depression

(psychiatric behaviours)

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4
Q

yellow flags examples

A

(emotional responses/ pain behaviour/ coping mechanisms/ beliefs)

poor outlook on treatment
distress
avoiding activities out of fear

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5
Q

blue flags

A

(perceptions about work and health)

work will cause further injury
unsupported at workplace

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6
Q

black flags

A

(system obstacles)

legislation restricting return to work
conflict with insurance
heavy work

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7
Q

acute injuries of the bone

A
  1. fracture (also in growth plates)
  2. periosteal contusion: dense fibrous tissue surrounding bone that is vascular and innervated. Direct blow can lead to subperiosteal haematoma which is painful and palpable lump
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8
Q

chronic injuries of bone

A
  1. overuse (stress fracture/reaction)
    2.osteitis/periositis (shin splints)
  2. apophysitis
  3. enthesopathy
  4. osteophyte/bone spur
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9
Q

overuse injury of bone

how can u diagnose

symptoms

A
  1. stress reaction
  2. stress fracture

fatigue fractures caused by repetitive mechanical loading without sufficient rest (overuse)
imbalance between bone strain (microdamage) and bone repair leading to weakness in the bone

can be diagnosed and graded using MRI

localised pain and tenderness

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10
Q

low risk bone stress injuries

A
  • posteriormedial tibia
    -fibula/ lateral mall
  • femoral shaft
  • pelvis
  • calcaneus
  • 2-4th mets
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11
Q

high risk bone stress injuries

A
  • femoral neck
    -anterior cortex of tibia
  • medial mall
  • talus (lateral process)
  • navicular
  • proximal diaphysis of 5th
  • base of 2nd
  • sesamoids
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12
Q

bone stress injury prognosis

A

dependent on bone size

Low risk BSIs
- mets 4-6weeks
- tibia/calc 6- 8weeks
- femur 10-12 weeks

stress reactions take 1/3 of the recovery time
-2 weeks
-3 weeks
-4 weeks

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13
Q

rehab for low risk BSI

A

rest and cross training to maintain condition, avoid atrophy and accelerate return to sport

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14
Q

rehab for high risk BSI

A

non weight bearing cast immobilisation for 6-8 weeks or surgery

unless
sesamoids (4 weeks)
met 2nd base (2 weeks)
femoral neck (1 week bed rest)

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15
Q

acute injuries of jointS

A
  1. Dislocation
  2. sublaxation
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16
Q

chronic injuries of joints

A

Hyaline cartilage
1. osteochondral defect
2. chondropathy/chondromalacia
3. OA

fibrocartilage
1. mensical tear
2. labral tear
3. disc herniation

capsule
1. synovitis
2. gout
3. RA etc

  1. impingement
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17
Q

ligament injuries

A
  1. sprain or tear grade 1-3
  2. inflammation
18
Q

muscle injuries

A
  1. strain
  2. tear
  3. contusion
  4. myositis ossificans -bone in muscle
  5. acute compartment syndrome - bleeding in fascial compartment - tissue ischaemia- emergency
  6. chronic compatment syndrome- raises in pressure- impaired blood supply - pain
  7. DOMS
19
Q

classifying muscle injury

A

grade 0-4

site: myofascial, musculotendinous, intratendinous

20
Q

tendon/fascia injuries

A
  1. tear
  2. tendinopathy/fasciopathy
21
Q

bursa injuries

A
  1. bursitis (acute/chronic)
22
Q

neural referred pain injuries

A
  1. radicular pain
    spinal nerve root compression
  2. somatic referred pain
    from joints and muscle, pain moves around
  3. neuropathic pain
    -nerve injury/entrapment
  4. neural mechanosensitivity
23
Q

fat pad injuries

A
  1. acute
    -bruise
    -tear
  2. chronic
    -impingement
    -inflammation
24
Q

skin injuries

A
  1. acute
    laceration
    abrasion
    wound
  2. chronic
    blistering
    callus
    haemtoma
    infection
25
Q

sensitivity

A

% of people who test positive within a sample having the
disease/condition

rule in

26
Q

specificity

A

% of people who test negative within a sample who don’t have the
disease/condition

rule out

27
Q

when do you refer out for an image

A

-diagnosis uncertain
-extent of injury affects treatment
-red flags present
-objective documentation required
-pre operative planning

28
Q

normal physiological changes that occur with exercise

A
  1. tendons show increase in vascularity on power doppler after exercise
  2. bones show transient asymptomatic marrow oedema in response to altered weightbearing
  3. muscles demonstrate 10-15% increase in volume, vascularity and diffuse increase in MRI signal after exercise
  4. asymptomatic joints and bursa show efusion on MRI and US
29
Q

pods can refer for what imaging

A

-X RAY of foot, leg, knee and femur
-US soft tissue of foot

others can be ordered but expensive and not covered by medicare

30
Q

Ottawa ankle rule chart

A

for suspected fractures

bone tenderness at posterior edge or tip of lat mall/medial mall and inability to WB for 4 steps

31
Q

ottawa foot rule chart

A

bone tenderness at base of 5th, navicular, and inability to WB for 4 steps

32
Q

what is the best imaging modaility for bone

A

X ray

then:
MRI
CT
Bone scan

33
Q

what is the best imaging moaility for myotendinous unit

A

US

then MRI

34
Q

imaging for ligaments

A

US
xray if avulsion fracture suspected

35
Q

imaging for cartilage

A

US
MRI

36
Q

imaging for synovial membrane

A

US
MRI

37
Q

imaging for nerves

A

CT scan

38
Q

compartment pressure testing what does it involve, how long, what happens if positive

A

pt needs to exercise until symptoms come on

a pressure manometer needle is inserted into the muscle

takes approx 1 hour

positive test - referral to orthopod for fasciotomy

39
Q

red flags for concussion

A

-neck pain/tenderness
-double vision
-weakness/tingling burning in arms or legs
-increasing or severe headache
-seizure
-loss of consciousness
-vomiting
-agitated

40
Q

is it okay to train with a head cold

A

yes

41
Q

okay to train with systemtic symptoms like fever, tachycardia, fatigue

A

no

42
Q
A

Sportsmed (11 decks)

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