Foot Loose
Enlarged DIP joints are called this and associated with this diagnosis.
Heberden's nodes associated with OA
There is a 75 y/o retired postal worker complaining of knee pain that has worsed over the past 2 years with activity and morning stiffness. Xrays show subchondral sclerosis and cystic changes with joint space narrowing and osteophyte formation.
knee osteoarthritis
You are seeing a 25 year old who recently "rolled their ankle" while playing pickleball several days ago. List immobilization options.
Walking boot, splint, ankle brace, stirrup brace, short leg cast
Name the 4 immobilization options for UE wrist and forearm injuries and what motion it prevents.
Volar splint/ short arm cast- stabilized wrist flex/ extension
Thumb spica splint/ cast- stabilizes thumb ROM in addition to wrist flex/ extension
Ulnar gutter splint/ cast- stabilizes ulnar sided digit and MC fractures
Sugar tong/long arm cast- stabilizes midshaft forearm fractures preventing forearm rotation
You are evaluating an athlete who twisted their knee during a basketball game and was unable to continue playing due to the pain. Their knee is visibly swollen despite icing the knee overnight. Demonstrate the different physical exam special tests you would perform.
Balloon (mild- mod effusion) vs Ballottement (mod to large effusion)
Lachman vs Anterior Drawer (ACL)
What digit deformity resembles water fowl and is described flexion of the DIP joint and hyperextension of the PIP joint due to trauma or RA?
Swan-neck deformity
Describe the physical exam special test for the foot that you will perform if your patient complains of pain, numbness after wearing high heels to a wedding last week and continues to bother her in any shoes.
Mulder's sign. squeeze MT heads together to elicit trapped or irritated nerve commonly located between the 3rd and 4th MT heads.
You are seeing a 50 y/o patient in the office for a follow up after a fall. He continues to have diffuse pain and weakness trying to tuck the back of his shirt into his pants. Explain a special test and what a positive indicates.
Empty Can- supraspinatus
Lift off/ Gerbers Sign- subscapularis
You are called to the ER to evaluate a 78 y/o female who suffered a fall and complaining of hip pain and cannot ambulate. You order these xrays views which are read as a femoral neck fracture. What is next on your a/p?
a/p, lateral, pelvis
possible CT scan, consult ortho
Hip Arthroplasty, Hip ORIF
Plantar Fascia/ Plantar fasciitis
This weekend warrior is complaining of thumb pain after falling on an outstretched hand playing goalie during a pick up soccer match. He has difficulty with gripping anything even his toothbrush. You suspect this structure might be injured and use this special test borrowed from the knee and elbow and have THIS positive finding.
Thumb- ulnar collateral ligament
special test- valgus test of MCP joint and positive finding is laxity and pain.
Describe and draw common fracture findings/ patterns.
simple- transverse, oblique, spiral, nondisplaced
displaced- angulated, comminuted, spiral
intra-articular vs extra- articular
SALTER-
You are seeing a 3 y/o pediatric patient who is complaining of mild pain in their elbow after jumping off the couch and landing into a pile of pillows on the floor. Today the parents are noticing their child is not using the affect arm to play. Their xrays are negative for fracture or a fat pad sign. Describe this injury and treatment.
Nursemaids elbow; reduction.
Weaking of bones combined with trauma/ fall and patient is presents with acute onset of back pain is associated with this spinal fracture
Compression fracture and treated with kyphoplasty
You are evaluating an 11-year-old boy c/o progressive, localized thigh pain, a palpable soft-tissue mass, and an unexplained fever. An X-ray reveals an aggressive, permeative lesion with a classic lamellated "onion-skin" periosteal reaction in the diaphysis of the femur.
Ewings Sarcoma
Name 2 mechanical injuries/ deformities of the finger where the patient loses the ability to actively extend the digit. (not neurologically involved)
Boutoneire deformity- hyperextension of the DIP joint and flexion of the PIP joint; cannot extend the PIP joint
Mallet finger- rupture of the extensor tendon at DIP joint; cannot extend the DIP joint
You are in the ER evaluating a roofer who fell from a second story roof and complaining of LE leg pain with the sheet touching their ankle. they are POD #1 after tibial ORIF. This orthopedic emergency is on your differential and what testing is needing
compartment syndrome (compartment pressure and 5Ps) vs DVT (duplex u/s, pulses)
You are seeing a patient back for this IMAGING follow up who was complaining of knee pain after getting up from a seated position and had a positive McMurrays test.
MRI- eval soft tissue/ meniscus injury
Your patient had a total knee replacement and is now complaining of knee pain and swelling that began shortly after their dentist appointment last week. Describe your a/p.
Aspirate and send cultures.
Begin oral antibiotics.
Schedule wash out and poly exchange and IV antibiotics.
This is an uncommon but painful midfoot injury that has subtle xray findings of deformity/ gap/ malalignment around the tarsal/ metatarsal joints.
Lisfranc injury
This is an Eastern European genetic disease that affects the connective tissue in the hands leading to debilitating flexion contractures. Name this disease and as well as a mechanical correctable flexion disorder.
Duputreyen's.
Trigger Finger.
This is the most COMMON malignant bone tumor often described on xray as Sunburst appearance or Codman's triangle.
OsteoSarcoma
You performed the sensation test on a patient who was complaining of weakness in their lower leg as well numbness around the inside of their knee. This is the location where you found the deficit and the strength testing that had weakness 4/5 with knee extension and now suspect injury around this nerve root?
L3 nerve root impingement
Your patient complains of wrist deformity and pain after FOOSH injury earlier today. Draw and describe the two common distal radius fracture patterns and recommended treatment for each?
Colles fracture- dinner fork deformity, distal portion is displaced dorsally
Smith Fracture- reverse colles' distal portion displaced volarly
ORIF