Term
| Give 13 differential diagnosis for back, leg and hip pain. |
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Definition
• Simple low back pain
• Osteoarthritis
• Prolapsed intervertebral disc
• Degenerative disc disease
• Inflammatory spondyloarthropathy
• Vertebral crush fracture
• Spinal stenosis
• Spondylolisthesis
• Malignancy
• Discitis
• Avascular necrosis of the hip
• Trochanteric Bursitis
• Paget's Disease |
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Term
| What does acute low back pain without radiation suggest? |
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Definition
| Mechanical low back pain. |
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Term
| How is mechanical low back pain often described? |
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Definition
| As a band across the back. |
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Term
| Give 7 red flag signs of sinister back pain. |
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Definition
○ Age of onset <20 or >55
○ History of malignancy
○ Persistent, non-mechanical pain
○ Night pain
○ Fever/Unexplained weight loss
○ Bladder/Bowel dysfunction
○ Progressive neurology, abnormal gait, saddle anaesthesia |
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Term
| Back pain combined with weight loss and night sweats may indicate 2 things, what are they? |
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Definition
| Malignancy or tuberculosis. |
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Term
| What is back and leg pain suggestive of? |
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Definition
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Term
| Describe how true sciatica radiates. |
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Definition
| From the lower back, down the back of the leg and into the foot. |
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Term
| What is the pain from sciatica like? |
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Definition
|
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Term
| Does sciatica normally settle over time? |
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Definition
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Term
| Give three things that may aggrevate sciatica |
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Definition
| Standing straight, sneezing, coughing. |
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Term
| Back pain with leg pain that comes on after walking suggests what? |
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Definition
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Term
| Back or leg pain that is relieved on leaning forward is suggestive of what? |
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Definition
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Term
| Aching back pain that radiates into the leg but not below the knee is indicative of what? |
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Definition
| Facet Joint Osteoarthritis |
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Term
| Where is true hip pain felt? |
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Definition
|
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Term
| Can a prolapsed intervertebral disk present with just leg pain? |
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Definition
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Term
| Gradual onset leg pain or weakness, felt with a constant aches suggests what? |
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Definition
| Muscular dystrophy or myositis |
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Term
| Crampy leg pain on walking that is relieved by rest suggests what? |
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Definition
| Peripheral vascular disease |
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Term
| Can OA of the hip produce leg pain distally? |
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Definition
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Term
| What disturbances is it essential to ask about in any patient with back pain? |
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Definition
| Urinary or bowel disturbance |
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Term
| What does incontinence with back pain suggest? |
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Definition
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Term
| What does back pain combined with numbness, pins and needles and weakness of the foot suggest? |
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Definition
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Term
| What investigation should not be done for mechanical lower back pain? |
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Definition
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Term
| What investigation is the investigation of choice in a young patient with suspected back or sacroiliac pathology. |
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Definition
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Term
| What does winking owl sign indicate |
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Definition
| Destruction of the pedicle, indicating malignancy. |
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Term
| What are 9 differential diagnosis for knee pain? |
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Definition
• Meniscal injuries
• Ligament injuries
• Osteochondritis
• Bursitis
• OA
• Septic Arthritis
• RA or other inflammatory arthritis
• Anterior knee pain/patellofemoral disorders
• Referred from hip or spine. |
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Term
| What does sudden onset of knee pain suggest? |
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Definition
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Term
| Spontaneous knee pain over a few days suggests what? |
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Definition
| Septic or crystal arthritis, or possibly an inflammatory flare-up. |
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Term
| What kind of pain do meniscal injuries often produce? |
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Definition
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Term
| What kind of pain is arthritic pain, normally? |
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Definition
|
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Term
| CLassically, what makes OA worse? |
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Definition
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Term
| Classically, when is patellofemoral pain worse? |
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Definition
| When walking up or down stairs. |
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Term
| Knee pain that is worse on full flexion or twisting hints at? |
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Definition
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Term
| Extremely intense pain exacerbated by movement suggests what? |
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Definition
| Acute crystal or septic arthritis. |
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Term
| What action makes prepatellar bursitis pain worse? |
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Definition
|
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Term
| What does pain affecting the joint in general suggest? |
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Definition
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Term
| What does anterior knee pain suggest? |
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Definition
| Patellogemoral pain, prepatellar bursitis or infrapatellar bursitis. |
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Term
| What does posterior knee pain suggest? |
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Definition
| A Bakers cyst or bursitis. |
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Term
| What does medial or lateral knee pain suggest? |
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Definition
| Meniscal tears or colateral ligament sprain. |
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Term
| What does localised pain to the medial knee joint line, combined with varus knees indicate? |
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Definition
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Term
| What does pain down the front of the thigh and into the knee suggest? |
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Definition
|
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Term
| Where could pain down the back of the knee be referred from? |
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Definition
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Term
| What does a history of locking of the knee suggest? |
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Definition
| Meniscal injury or loose body. |
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Term
| In a painful knee, what is an MRI useful for? |
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Definition
| Confirming ligamentous or meniscal pathology. |
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Term
| What kind of imaging is useful for confirming ligamentous or meniscal pathology? |
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Definition
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Term
| In a painful knee, what is a CT useful for? |
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Definition
| Giving detailed information on bony structures and visualising patellar tracking. |
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Term
| What kind of imaging is good at giving detailed information on bony structures and visualising patellar tracking. |
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Definition
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Term
| When might you use an isotope bone scan for a painful knee? |
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Definition
| If you were unsure as to the diagnosis. |
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Term
| if a knee is swollen and the synovial fluid is straw/yellow in colour, what is it likely to be? |
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Definition
| A simple effusion, or possibly crystal arthropathy. |
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Term
| if a knee is swollen and the synovial fluid is green or dirty in colour, what is it likely to be? |
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Definition
| Pus and hence septic arthritis |
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Term
| if a knee is swollen and the synovial fluid is bloody in colour, what is it likely to be? |
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Definition
| A haemarthrosis following injury or as a result of a bleeding disorder/being on warfarin |
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Term
|
Definition
| Using keyhole surgery to look into the joint to see if there is any pathology. |
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Term
| What does recurrent self limiting foot or ankle pain suggest? |
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Definition
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Term
| Chronic pain in the foot with soft tissue swelling indicates what? |
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Definition
| Inflammation or infection. |
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Term
| What might coldness or pallor in the foot be due to? |
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Definition
| Peripheral vascular disease. |
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Term
| Give three conditions associated with paraesthesia or burning pain in the foot. |
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Definition
Morton neuroma
Painful diabetic neuropathy
tarsal tunnel syndrome |
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Term
| What does discomfort on the sole of the foot suggest? |
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Definition
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|
Term
What is plantar fasciitis associated with?
What should you ask about as a result? |
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Definition
spondyloarthropathies
Psoriasis and IBS |
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Term
| What might a recent illness or initiation of diuretic therapy trigger? |
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Definition
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|
Term
| In foot pain, what are nerve conduction studies useful for? |
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Definition
| Confirming the diagnosis of tarsal tunnel syndrome or peripheral neuropathy. |
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