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CMS II Final Comprehensive Review - Ortho
Winter Semester 2011
200
Medical
Graduate
03/27/2011

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Cards

Term
Which rotator cuff test tests for AC impingement? What is a positive test?
Definition
Neer’s Impingement Test - Positive Test = pain with forward flexion
Term
Which rotator cuff test tests for AC impingement and the supraspinatus? What is a positive test?
Definition
Hawkins-Kennedy Impingement Test
Positive Test - Pain with 60 degree arm flexion
Term
What nerve is important to check with shoulder dislocations?
Definition
Axillary n. (check sensation on mid-deltoid)
Term
What are the signs and symptoms of proximal humeral fracture?
Definition
Pain & swelling around shoulder joint
Ecchymosis, elbow to neck
Pain w/ ROM
Pt supporting/guarding arm
Term
What is a common mechanism that results in proximal humeral fractures?
Definition
Elderly fall on out stretched hand
Term
What classification is used to describe proximal humeral fractures? What are the 4 parts?
Definition
Neer Classification
1 - Humeral Head
2 & 3 - Lateral and medial tuberosities
4 - Shaft
Term
How is a clavicular fracture treated?
Definition
Ortho
Protected: 4-6 wks – children, 8 wks -adult
Term
What physical tests are used to diagnose Thoracic Outlet syndrome?
Definition
Adson test
Roos test
Halstead test
Term
What are the three components of thoracic outlet syndrome and what are their symptoms?
Definition
Nerve - numbness, tingling, decreased strength, burning
Artery - pallor, decreased pulses, claudication of forearm m.
Vein - abnormal swelling of affected side
Term
What is the MC cause of humeral fractures?
Definition
Major trauma - MVA, motorcycles, falls from heights, pedestrian accidents
Term
What is a patient with a humeral fracture at a highest risk for?
Definition
NV compromise is high with displaced fractures/high energy fractures
-Radial Nerve
-Brachial Artery
Term
What is the treatment for humeral fractures?
Definition
Ortho – consult
Ice
Closed reduction
Sugar tong splint
Sling
NSAIDS
Most are managed non-operatively
Term
When repositioning any fractures, what is one type of deformity that the body cannot tolerate?
Definition
Rotational
Term
What is the MC cause of elbow fractures?
Definition
Fall on outstretched hand
Term
What is important to do in your physical assessment with an elbow fracture?
Definition
Neurovascular competence
Term
How is an elbow fracture treated?
Definition
Undisplaced: sling or sling w/ posterior splint 7-10d
Ice
NSAIDS
PT - early ROM
Ortho surgery – all w/ neuro/vascular compromise
Term
When does a fracture of the radial head require surgical repair?
Definition
If pronation or supination is physically impeded or if there is a large separation of the radial head
Term
What is the MC cause of olecranon fractures?
Definition
Fall on flexed arm
Term
What is the MC treatment for olecranon fracture?
Definition
Surgery due to attachment of the triceps tendon
Term
What does a fat pad sign indicate in adults?
Definition
subtle radial head fx
Term
What does a fat pad sign indicate in children?
Definition
supracondylar fx of humerus
Term
What is a fracture to the proximal 1/3 of ulna & dislocation of radial head called?
Definition
Monteggia Fracture
Term
How is a Monteggia Fracture treated in children? In adults?
Definition
Children – closed reduction
Adults – open reduction w/ internal fixation
Term
What is a fracture to the Distal 1/3 of radius is fx with disruption of DRUJ commonly called?
Definition
Galeazzi Fracture
Term
How is a Galeazzi Fracture treated?
Definition
Ortho - surgery
Term
What is the MC wrist injury?
Definition
Colle's fracture
Term
What type of fracture is commonly caused by a fall on outstretched hand?
Definition
Colle's Fracture
Term
What type of fracture is described as a distal radius fx w/ dorsal displacement and shortening?
Definition
Colle's fracture
Term
What nerve can be affected with a Colle's fracture? How can you prevent permanent damage?
Definition
Median n
Immediate reduction
Term
What is the treatment for a colle's fracture?
Definition
If closed reduction shortly after fx – local anesthesia
Cast x6 weeks
Ice
F/U in 1-2 weeks repeat xray – occassionally loss of reduction
Surgery
Advantages to surgery: Quicker RTF, Less risk of nonunion, Return to normal anatomy
Term
What is a flexion fracture of the radius or a distal radius fracture with vular displacement called?
Definition
Smith's fracture
Term
What is the classic test used to asses for De Quervain's Tenosynovitis?
Definition
Finkelstein’s test
Term
If a patient presents with pain/tenderness to the posterior lateral aspect of the wrist?
Definition
De Quervain's Tenosynovitis
Term
What risk factors can lead to Carpal tunnel syndrome?
Definition
Repetitive hand work
Working on keyboards
Thyroid disorder
Pregnancy
Trauma
Alcoholism
DM
Gout
Term
Which signs are helpful in indicating carpal tunnel syndrome?
Definition
Tinel's sign
Phalen's sign
Term
What condition should you suspect if the pt complains of Paresthesia in median nerve distribution, Weakness in the hand, Awaken from sleep w/ pain?
Definition
Carpal Tunnel Syndrome
Term
What is the best study for assessing Carpal Tunnel Syndrome?
Definition
EMG Studies
Term
What is the treatment for carpal tunnel syndrome?
Definition
OT consult
Cock-up wrist splint (worn at work & sleep) x3-4 months
NSAIDS
Ortho - Steroid injection
Ortho – Surgical release
Term
What muscular sign can be found in patient's with carpal tunnel syndrome?
Definition
Thenar atrophy
Term
What is the MC missed wrist fracture?
Definition
Scaphoid Fracture
Term
What is the common sign of a scaphoid fracture?
Definition
"snuffbox" tenderness
Term
How is a boxer's fracture treated?
Definition
Closed vs open reduction
Ulnar gutter cast (very important to splint)
Term
What is important about the ulnar gutter cast?
Definition
fingers splinted at 90 degrees so that the extensor hood doesn't take over and cause the patient not to be able to move their fingers after casting is removed
Term
What is a fracture of the distal 5th metacarpal known as?
Definition
Boxer's Fracture
Term
What is a boutonniere deformity?
Definition
Flexion of the proximal interphalangeal joint
Extension of the distal interphalangeal joint
Term
What are the two important parts of a boutonniere deformity?
Definition
Loss of active extension secondary to central slip tear
Unopposed finger flexion with migration of lateral bands
Term
What condition is characterized by Hyperextension of PIP, Flexion of DIP and the volar plate is unable to prevent hyperextension?
Definition
Swan Neck deformity
Term
What are the risk factors for herniated discs?
Definition
Frequent Heavy Lifting (with poor technique)
Diving into pool
Cigarette Smoking
Obesity
Term
What are the S & S of a Herniated neck Disc?
Definition
Neck Pain, Shoulder pain, UE weakness, pain or paresthesias
Term
What may be the findings on physical exam of a patient with a herniated disc in the neck?
Definition
+ Spurling test
Possiblbe + Babinski's reflex
Decreased sensation and reflexes (esp in UE)
Term
What is the treatment for osteoarthritis?
Definition
NSAIDS
PT: ROM exercises
Ortho or Neurosurgeon Consult
Term
What is the MC musculoskeletal condition?
Definition
Back Pain
Term
What are the risk factors for a pt developing back pain?
Definition
Smoking
Manual labor
Obesity
Accidents
M > F
Term
What are the S & S of back pain?
Definition
Back stiffness
Low back discomfort
Numbness
Paravertebral muscle spasm
Motor weakness
Decreased DTR
Decease nerve sensation
Term
What imaging should be done if the CC of a pt is back pain? Why?
Definition
Plain films – NL
CT – NL
MRI – r/o disc herniation
Term
What is the treatment for back pain?
Definition
Rest 1-2 bed rest, then light activity (back to work)
Heat – NO sleeping with heating pad
NSAIDS x4-6 weeks – drug of choice
Muscle relaxant
PT – walking, recumbent bike, swimming
Lifting & back care training (sitting & lumbar support)
Term
What are Weddell sign's used for?
Definition
Method to identify malingering or non-organic back pain.
Term
What are the "Can't Miss" with back pain?
TUNA FISH
Definition
Trauma: loss of strength or balance
Unexplained weight loss or night sweats
Neurological signs: incontinence, night pain
Age > 50

Fever, malaise
Intravenous drug use
Steroids for long time
History of cancer or malignancy
Term
If a pt complains of low back pain, bowel or bladder incontinence and saddle anesthesia, what condition should you suspect?
Definition
Cauda Equina Syndrome
Term
How is Cauda Equina Syndrome treated?
Definition
It is a Surgical ER
Term
What is the MC cause of Brown-Sequard's Syndrome?
Definition
Penetrating Trauma
Term
If a pt has a penetrating trauma and has S & S including Low back pain, Loss of motor function, position, vibratory, & light touch of the affected side, Sharp & temperature lost on opposite side, what condition should you suspect?
Definition
Brown-Sequard's Syndrome
Term
How is Brown-Sequard's treated?
Definition
It is a surgical emergency
Term
How many degrees of curvature is pathologic for scoliosis?
Definition
>10 degrees
Term
Where is a herniated disc more common?
Definition
In the lower back
Term
What are the S & S of a herniated disc in the lower back?
Definition
Low back pain
Decreased motor strength
Decreased reflex
Decreased sensory
Term
How is a diagnosis of a herniated disc confirmed with imaging?
Definition
MRI
Term
A failure of what part of the vertebrae causes Spondylolisthesis?
Definition
Par Interarticularis
Term
What is the MC cause of Spondylolisthesis?
Definition
Most common cause is long standing spondylolysis
Term
What gradeon the Meyerding's scale is a slippage of 25% - 50%?
Definition
Grade II
Term
What grade on the Meyerding's scale is a slippage of < 25%?
Definition
Grade 1
Term
What grade on the Meyerding's scale is a slippage of 51% - 75%?
Definition
Grade III
Term
What grade on the Meyerding's scale is a slippage of 76% - 99%?
Definition
Grade IV
Term
What grade on the Meyerding's scale is a complete displacement?
Definition
Grade V
Term
What part of the skeleton does ankylosing spondylitis most commonly affect?
Definition
Axial skeleton
Term
What is the MC presentation of ankylosing spondylitis?
Definition
Sacroiliitis
Term
If a pt presents with signs and symptoms including Pain > 3 months, Insidious onset, Stiffness w/o pain, Malaise, Fatigue, Pain – in hips or buttocks 1st, AM pain that improves with exercise, Kyphosis, what condition should you suspect?
Definition
Ankylosing Spondylitis/Marie-Strumpell arthritis
Term
What is the treatment for ankylosing spondylitis?
Definition
Indomethacin – drug of choice
Term
What are the signs and symptoms of spinal stenosis?
Definition
Back pain, increased w/ sitting
Flexion decreases pain
Sciatica
Term
If a pt has symptoms including Pain with weight bearing or joint motion, Stiffness, Loss of function (heavy work, tie shoes, walking), what condition should you suspect?
Definition
Osteoarthritis
Term
What is the treatment for osteoarthritis?
Definition
NSAIDS
PT – activity modification
Surgery
Term
If a pt presents with c/o hip pain that radiates down posterior aspect of leg and is worsened with sitting for long periods of times, what condition should you suspect?
Definition
Sciatica
Term
What is the treatment for sciatica?
Definition
massage, heat, PT, lifestyle changes
Term
What is genu valgum?
Definition
tibia (distal knee) goes away from midline ("knocked knee")
Term
What is genu varus?
Definition
tibia (distal knee) goes towards midline ("bowed leg")
Term
What is the ACL responsible for?
Definition
Responsible for limiting forward translation of the tibia and prevents hyperextension
Term
What is the MOI (Mechanism of Injury)?
Definition
Planted foot with twisting motion of body
Term
If a pt presents with pain in the knee, hemarthrosis, hx of a "POP" with trauma, and on physical exam there is a + Lachman's test, what condition should you suspect?
Definition
ACL tear
Term
What is the appropriate work-up for an ACL tear?
Definition
Eval for other injuries (PCL, Meniscal, CL)
Exam
MRI
Arthrocentesis (If hemarthrosis present)
Term
What are the causes of a chronic ACL tear?
Definition
Missed dx
Failed non-operative treatment
Term
What are the causes of a chronic ACL tear?
Definition
Missed dx
Failed non-operative treatment
Term
What are the complications of a chronic ACL tear?
Definition
Increased knee instability/laxity
Meniscal tears
Term
What is the positioning of the ACL in the knee joint?
Definition
Connects the posterior femur to the anterior tibia
Term
What is the BEST physical exam test for an ACL tear?
Definition
Lachman’s Test
Term
Which ACL test is described as Pt supine, w/ knee flexed at 30 degrees, Femur stabilized w/ one hand and tibia is pulled anterior w/ the other hand?
Definition
Lachman's Test
Term
Why is a PCL injury much less common than an ACL tear?
Definition
Much stronger than ACL
Other structures aid in the PCLs function
Term
What is the MOI for a PCL?
Definition
MOI usually direct force if isolated injury
Term
If you have a PCL tear, what other conditions should you suspect?
Definition
ACL, CL (Knee Dislocation)
Term
If a pt presents with knee pain, history of direct knee injury, an on exam you observe a posteriorly subluxed resting tibia, what condition should you suspect?
Definition
PCL Tear
Term
What knee stability test is described as Pt supine, hip flexed, knee flexed at 45 degrees, Pt foot stabilized by examiner sitting on foot, Examiner “pushes” tibia posterior?
Definition
Posterior Drawer Test
Term
What type of stress does the MCL resist against?
Definition
Medical or Valgus stress
Term
What type of stress does the LCL resist against?
Definition
Lateral or Vargus stress
Term
If a pt presents with pain along the medial joint line of the knee and pain with valgus stress, what condition should you suspect?
Definition
MCL injury
Term
What imaging should be used for knee ligament injuries?
Definition
MRI
Term
Which physical exam tests should be used to evaluate a MCL injury?
Definition
Valgus Stress Test
Apley's Distraction Test
Term
What nerve can be injured with a LCL tear?
Definition
Peroneal n.
Term
What is the MC ligament that is injured in the body?
Definition
MCL
Term
A LCL tear is not usually an isolated injury, what injury is usually associated with it?
Definition
Usually associated with cruciate and posteriorlateral corner injury
Term
Which physical diagnosis test is used to evaluate an LCL tear?
Definition
Varus Stress Test
Apley's Apprehension test
Term
Which physical diagnosis test is described as Pt supine on the table, leg abducted, Examiner applies force in the lateral direction to the ankle from the medial aspect and force in the medial direction of the knee from the lateral aspect?
Definition
Valgus Stress Test
Term
Which physical diagnosis test is described as Pt supine on the table, leg abducted, Examiner applies force in the medial direction to the ankle from the lateral aspect and force in the lateral direction of the knee from the medial aspect?
Definition
Varus Stress Test
Term
What does a MCL or LCL injury usually result in?
Definition
Usually results in significant stiffness or residual instability
Term
Which part of the Meniscus is the MC to be injured?
Definition
Medial injuries more frequent than lateral injuries
Term
What is the MOI for Meniscal Tears?
Definition
twisting injury
Term
If a pt presents with knee pain, popping, locking or giving way, and on physical exam there is joint line tenderness, a positive McMurray's test and and a positive Apley's compression test, what condition should you suspect?
Definition
Meniscal Injury
Term
What is the BEST diagnostic test for Meniscal Injuries?
Definition
MRI
Term
Which physical diagnosis is described as Pt lies supine w/ knee completely flexed (foot to buttocks), Examiner medially (internally) rotates foot and tibia, and extend leg/knee?
Definition
McMurray Test – lateral meniscus
Term
Which physical diagnostic test is described as Pt lies supine w/ knee completely flexed (foot to buttocks), Examiner laterally (externally) rotates foot and tibia, and extend leg/knee?
Definition
McMurray Test – medial meniscus
Term
Which physical diagnostic test is described as Pt in prone position, knee flexed to 90 degrees, Examiner applies pressure to (pushes on) the heel and then medial and laterally rotates the leg/foot?
Definition
Apley’s compression test
Term
If the patient has a + Apley's on the medial side, where is the Meniscal tear?
Definition
Medial Meniscal injury
Term
If the patient has a + Apley's on the lateral side, where is the Meniscal tear?
Definition
Lateral Menisicus
Term
What condition is caused by extrusion of synovial fluid through the meniscal tear, accumulating outside the joint capsule?
Definition
Meniscal Cysts
Term
What imaging is appropriate for meniscal cysts?
Definition
MRI
Term
What is the treatment of a Meniscal cyst?
Definition
Excision/Drainage and repair or removal of meniscus
Term
Which bursas are MC affected in the knee with bursitis?
Definition
Suprapatellar bursa
Subcutaneous prepatellar bursa
Term
What should you be highly concerned about with femur shaft fractures? What should you do to prevent this concern?
Definition
hemovascular compromise; Stabilization Device (splint, screw etc)
Term
What is the MOI for femur shaft fracture?
Definition
high energy trauma - MVA, Gunshot wounds, falls from heights
Term
What is the treatment for femur shaft fracture?
Definition
hemovascular stabilization (Type and cross match)
Stabilization device
Ortho
Term
What is the biggest concern with tibial plateau fractures? How can you prophylactically address these concerns?
Definition
Compartment syndrome; faciaotomy (spelling?)
Term
What is used to classify a tibial plateau fracture?
Definition
Schatzker (1 - 6 the higher the # the more difficult the surgical repair)
Term
What does a small avulsion fracture of the lateral ligament indicate?
Definition
Usually signals a severe joint injury (LCL and ACL)
Term
If a pt presents with complaints of trauma, acute knee pain, swelling and an inability to extend the knee, what condition should you suspect?
Definition
Patellar fracture
Term
What are the risk factors for a patellar dislocation?
Definition
excessive Q angle, ligament laxity, Pes Planus
Term
Which physical diagnosis test is described as Pt supine, legs flat on table, quadriceps relaxed, Try to dislocate the patella laterally?
Definition
Patellar Apprehension Test
Term
What is the treatment for a patellar dislocation?
Definition
Reduction (Grab big toe)
Ortho consult (Disrupts the patellar femoral retinaculum)
NSAIDs/Pain Meds
Term
What is the treatment for Tibiofemoral dislocation?
Definition
Ortho and Vascular surgery Emergency (literally 1 hr before limb death occurs)
Term
If a pt presents with a severe knee deformity s/p MVA and pulselessness in the ankle, what condition should you suspect?
Definition
KNEE DISLOCATION (ER!!!)
Term
If the pt presents s/p injury to their knee w/ acute pain and swelling and inability to extend knee, and on physical exam the patella is located proximally over femur head ("riding up"), what condition should you suspect?
Definition
Patellar tendon rupture
Term
If a pt presents with knee pain and stiffness and decreased ROM, what condition should you suspect?
Definition
Osteoarthritis
Term
What is the cause of Patellofemoral Syndrome
(Chondromalacia)?
Definition
overuse or excessive Q angle
Term
If a pt presents with Anterior knee pain worse w/ stair climbing or prolong sitting, and on physical exam you note + patellar tenderness & swelling and + apprehensive test, what condition should you suspect?
Definition
Patellofemoral Syndrome
(Chondromalacia)
Term
What is the treatment for Patellofemoral Syndrome
(Chondromalacia)?
Definition
PT consult
R.I.C.E & NSAIDS
Ortho consult if needed – diagnose chondromalacia
Term
What are the WBC levels for an inflammatory effusion?
Definition
2000-80000
Term
What are the WBC levels for an septic effusion?
Definition
>80000
Term
What is the neutrophil % in an inflammatory effusion?
Definition
25-75%
Term
What is the neutrophil % in a septic effusion?
Definition
>75%
Term
Which ligament is the most important medial stabilizer?
Definition
Deltoid Ligament - composed of anterior tibiotalar
tibionavicular
tibiocalcaneal
posterior tibiotalar
Term
If a pt presents with flat feet (lost of longitudinl arch) and foot or knee pain, what condition should you suspect?
Definition
Pes Planus
Term
What ligament failure is involved in Pes Planus?
Definition
Failure of PTT (Posterior Tib Tendon)
Term
What is the treatment for congenital pes planus?
Definition
PT – arch support
Ortho or Podiatry - surgery
Term
What is the treatment for adult onset pes planus?
Definition
PT consult – ROM exercise
No arch supports (do not help)
NSAIDS
Ortho or Podiatry (Surgery) if ADLs are affected or If skin breakdown or ulceration is present
Term
What is Pes Cavus almost always related to?
Definition
Some type of nervous disorder (Polio, burns, compartment syndrome)
Term
If a pt presents with elevated longitudinal arch, with fixed platar flexion of the forefoot, what condition do you suspect?
Definition
Pes Cavus
Term
What is the MC injury in sports? Which mechanism is the MC?
Definition
Ankle Sprains; Inversion sprain
Term
What are the Ottowa Rules used to assess?
Definition
The need to x-ray an ankle sprain or not
Term
What are the Ottawa Rules?
Definition
The distal 6 cm of the posterior edge of the tibia
Tip of the medial malleolus
The distal 6 cm of the posterior edge of the fibula
Tip of the lateral malleolus
Inability to bear weight both immediately and in the emergency department for four steps.
Term
What is the MC cause of Ankle Fractures/Dislocations?
Definition
History trauma – fall, misstep or sports injury
Term
Which grade of ankle sprain is described as partial tear of anterior talofibular ligament?
Definition
Grade 1
Term
Which grade of ankle sprain is described as partial to complete tear of anterior talofibular ligament & partial tear calcaneofibular ligament?
Definition
Grade 2
Term
Which grade of ankle sprain is described as complete rupture of the anterior talofibular ligament & calcaneofibular ligament?
Definition
Grade 3
Term
If a patient presents post-trauma with obvious pain and swelling of the ankle, and deformity and inability to bear weight, what condition do you suspect?
Definition
Ankle Fracture/Dislocation
Term
What leads to a unstable ankle?
Definition
Any disruption of mortis or syndesmosis
Term
If a runner presents with pain in the morning with 1st step, heel pain and tenderness on palpation, what condition should you suspect?
Definition
Plantar Fasciitis
Term
What is the treatment for plantar fasciitis?
Definition
PT – stretching and toe curls for strengthening (MOST IMPORTANT!)
NSAIDS & ice
Ortho – steroid injections
Term
If a pt presents with heel pain w/walking and complains of a constant stone in their shoe, what condition should you suspect?
Definition
Heel Spurs
Term
What is the treatment for heel spurs?
Definition
NSAIDS & ice
Heel pad
PT Stretching
Ortho – injection or surgery
Term
What is the treatment for heel spurs?
Definition
NSAIDS & ice
Heel pad
PT Stretching
Ortho – injection or surgery
Term
If a pt presents s/p trauma from fall, with heel pain, ecchymosis as well as heel widening, what condition should you suspect?
Definition
Calcaneus Fracture
Term
If a pt has a painful toenail, swelling and discharge from the toe, what condition should you suspect?
Definition
Ingrown Toenail
Term
What is the MC cause of ingrown toenails?
Definition
incorrect nail trimming, cleaning nails non-sterile tools, improper fitting shoes
Term
What is the treatment for MILD Ingrown toenails?
Definition
warm soaks, antibiotics and correct cause
Term
What is the treatment for moderate ingrown toenail?
Definition
Partial nail removal
Term
What is the treatment for SEVERE or chronic Ingrown toenails?
Definition
Complete nail removal/Ablation of nail bed if chronic?
Term
If a pt presents with thickened, brittle, crumbly or ragged toenails that are distorted in shape, are dull with no luster or shine, what condition should you suspect?
Definition
Onchomycosis caused by Tinea Unguium
Term
What is the treatment for Onchomycosis?
Definition
Get baseline LFT and one after 4 weeks of treatment.
Treat with Antifungal medication - Terbinafine (Lamisil) x 4 months
Term
Which joint(s) does hammertoe involve?
Definition
PIP
Term
Which joint(s) does clawtoe involve?
Definition
PIP and DIP or just the DIP
Term
What is the treatment for hammer toes?
Definition
Surgery - release of ligaments
Taping of hammertoes
Term
What is the treatment of claw toe?
Definition
Release of the extensors
Term
When is amputation with a claw toe deformity necessary?
Definition
If skin uncontrolled breakdown of skin or osteomyelitis risk
Term
If a pt presents with lateral deviation of great toe with an enlarged medial eminence with pain?
Definition
Hallux Valgus and Bunions
Term
What is the treatment for Hallux Valgus?
Definition
Conservative – braces, no heels no pointed toes
Ortho or Podiatry - Surgery
Term
If a pt present with severe burning pain in their foot between the 3rd and 4th metatarsal that increases with activity, may increase with tight shoes, what condition should you suspect?
Definition
Morton’s Neuroma
Term
What physical diagnosis test is described as pt lie supine, examiner grabs around metatarsal head and squeezes heads together? What is a positive test?
Definition
Morton's Test

resulting in pain between 3rd & 4th metatarsal head
Term
How is a Lisfranc Injury that is less than 2 mm dislocation, how is it treated?
Definition
the fracture can be managed with casting for 6 weeks, the patient's injured limb cannot bear weight during this period (6 wks)
Term
What is a major concern with a lisfranc injury?
Definition
Development of compartment syndrome
Term
If a patient present post MVA and has foot pain and tenderness at the tarsometatarsal joint, what condition do you suspect?
Definition
If a patient present post MVA and has foot pain and tenderness at the tarsometatarsal joint, what condition do you suspect?
Term
If a pt presents with foot pain, and Dislocation of the mid-tarsal (talonavicular and calcaneocuboid) joints of the foot, what condition is suspected?
Definition
Chopart’s Fracture-Dislocation
Term
Which fracture is known as Oblique, comminuted fx of distal tibia that extends through the tibiotalar articular surface and usually occurs s/p trauma?
Definition
Pilon Fracture
Term
What are the major complications of a Pilon Fracture?
Definition
arthritis, skin breakdown
Term
What is the rule with surgical fixation of metatarsal fractures?
Definition
If 1st and 5th metatarsal are intact and 2-4 are not displaced to much, you do not need to fix.
Term
What is a fracture of the 5th metatarsal commonly called?
Definition
Jones fracture
Term
If a dancer presents with pain and tenderness over the head of 5th metatarsal after a inversion trauma, what condition do you suspect?
Definition
Jones’ Fracture
Term
If patient presents with Heat insensitivity in the foot
Loss of sensation in the foot , Swelling of the foot and ankle, Dislocated foot joints, Weak foot muscles, Foot ulcers and Calluses, what condition should you suspect?
Definition
Charcot’s Disease
Term
What condition are Charcot’s Disease associated with?
Definition
Chronic hyperglycemia
Diabetes mellitus
Originally Syphillis
Term
In which pts is achilles tendonitis MC?
Definition
Frequent in athletes
Term
What is the treatment for achilles tendinitis?
Definition
Rest – short leg walking cast
NSAIDS
PT consult
1 cm heel lift
Ortho – steroid injections
Term
If a pt can't stand on tip toes on affected side and has a + Thompson test, what condition should you suspect?
Definition
Ruptured Achilles Tendon
Term
What is the treatment for a Ruptured Achilles Tendon?
Definition
Surgery and casting
Term
Which physical diagnosis test is described as pt laying prone, squeezing calf causes plantar flex or none if test is positive?
Definition
Thompson's Test
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