Term
| What is a navicular fracture, how does it happen & how do you assess for it? |
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Definition
| Acute wrist pain on deep palpation of the anatomical snuffbox that occurs after a hx of trauma (i.e., falling forward with hyperextension of the wrist to break the fall). |
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Term
| How does hip fracture present? |
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Definition
| Hx of slip/fall, anterior groin and thigh pain - may radiate to knee. Affected leg may be shorter. External rotation of the hip/leg (abduction). |
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Term
| How does pelvic fracture present & what's the possible sequelae? |
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Definition
| Hx of high-energy trauma (MVA). S/s depend on degree of injury to pelvis, nerves, blood vessels, pelvic organs. May c/o diff in ambulation, pain w/ hip movement, bladder and/or fecal incontinence. Severe hemorrhage can result in shock. May be life-threatening. |
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Term
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Definition
| Hyperextension or backward curvature of the knees. |
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Term
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Definition
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Term
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Definition
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Term
| In the 1st 48 hours after injury/inflammatory exacerbation of joint, what should not be done? |
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Definition
| Exercise, even isometric (can exacerbate inflammation). No heat application (hot showers, tub baths, hot packs). |
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Term
| What are the benefits of isometric exercise? |
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Definition
| Useful during the early phase of recovery before reg active exercise. It's less stressful than joints (remember it's non-weight-bearing, so it's not useful for osteoporosis). |
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Term
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Definition
| a test for knee stability (can be done on ankles as well). Bent leg, thumbs above tibial tuberosity, forward, then backward pressure. |
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Term
| Define De Quervain tenosynovitis. |
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Definition
| Inflammation of the tendon and its sheath that is located at the base of the thumb. |
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Term
| Define a positive McMurray test. |
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Definition
| Knee pain and a "click" sound - suggests injury to the medial meniscus. (cradle leg, invert foot, roll leg around). |
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Term
| Describe a positive Lachman test. |
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Definition
| Knee joint laxity, suggests anterior cruciate legament of the knee - tear and instability. |
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Term
| In assessing musculoskeletal injury, why would MRI be used? |
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Definition
| Best for soft tissue injuries, such as tendons and cartilage. |
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Term
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Definition
| Arthritis occurs when cartilage covering articular surface of joints become damaged. |
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Term
| What are risk factors for DJD/OA? |
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Definition
| older age, overuse of joints, positive family hx. |
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Term
| What are 3 goals of tx w/ DJD/OA? |
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Definition
| 1) Pain relief, preserve joint mobility and function, 2) Strengthen supporting muscles (decreases stress over joints), 3) Decrease stress on the affected joint(s). |
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Term
| Describe a classic case of DJD/OA. |
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Definition
| Early morning joint stiffness with inactivity. Shorter duration compared to RA symptoms, which last hours to days. Absence of systemic symptoms. Commonly affects large weight-beearing joints (hips and knees). |
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Term
| Describe Heberdeen nodes. |
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Definition
| Bony nodules on the distal interphalangeal joints (DIP). Remember- "deen" - like DIP. |
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Term
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Definition
| Bony nodules on the proximal interphalangeal joints (PIP). |
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Term
| What type of analgesics are preferred for use in DJD/OA? |
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Definition
| mild analgesics if pain & no inflammation (tylenol). If inflammation present, then short-acting NSAIDs (ibuprofen, naproxen). |
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Term
| If the DJD/OA patient is high-risk for stomach ulcer, what drug should be used for pain management? |
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Definition
| Celecoxib (celebrex) (Cox2 inhibitor) |
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Term
| What should exercise be done in the DJD/OA patient? |
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Definition
| When inflammation is not present. |
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Term
| How should steroids be used in the management of DJD/OA? |
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Definition
| joint injection, not oral.. |
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Term
| What differentiates treatment modalities of DJD/OA vs RA? |
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Definition
| They're identical, except RA includes systemic corticosteroids, antimalarials (plaquinil), and antimetabolites (methotrexate). |
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Term
| What drug class is plaquinil? |
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Definition
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Term
| What musculoskeletal condition can plaquinil be used to treat? |
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Definition
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Term
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Definition
| Systemic autoimmune disorder that is more common in women (8:1). Mainly manifested through multiple joint inflammation and damage. Patients are at higher risk for other autoimmune disorders, Graves dz, pernicious anemia, others. |
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Term
| Describe a classic case of RA. |
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Definition
| Adult female complains of gradual onset of symptoms over months with daily fatigue, low-grade fever, generalized body aches, and myalgia. Complaints of generalized aching joints, which usually involves the fingers/hands and wrist. Morning stiffness last longer than DJD's with painful, warm and swollen joints. |
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