Term
| What is a common cause of Pelvic Ring injuries? |
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Definition
| MVA, Fall from Height (TRAUMA) |
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Term
| If a pt presents with painful hip, leg or foot ROM as well as pubic crepitus (griding) after a fall off their ladder, what condition should you suspect? |
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Definition
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Term
| Which organ is commonly injured with pelvic ring injuries? How do you test for it? |
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Definition
Bladder Injury
Foley - Retrograde Pyelogram or Contrast CT |
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Term
| Which test should be done if a Pelvic Ring Injury is suspected? |
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Definition
CT (Best!!)
Bladder Imaging |
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Term
| What is the best treatment for an unstable Pelvic Ring Injury? |
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Definition
| ORIF - Open Reduction Internal Fixation |
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Term
| With a pelvic injury, what is a MAJOR life-threatening concern that you must monitor? |
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Definition
|
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Term
| What does diastasis mean essentially? |
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Definition
| Dislocation (of sliding joint) |
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Term
| Where will the pain associated with Sacro-Illiac Diastasis be located? |
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Definition
| anterior/posterior pelvis |
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Term
| How is Sacro-Illiac Diastasis treated? |
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Definition
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Term
| What are the MC causes of Acetabular fractures? |
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Definition
| direct trauma with axial force (MVA, fall from height) |
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Term
| If a patient presents s/p MVA and has pelvic pain, limb shortening and protrusio, what condition should you suspect? |
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Definition
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Term
| Which x-ray view is used for Acetabular Fractures? |
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Definition
|
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Term
| What is protrusion and what injury can it accompany? |
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Definition
dislocation of femoral head through the acetabulum and into the pelvis
Acetabular Fracture |
|
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Term
| What is the treatment for protrusio? |
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Definition
|
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Term
| What type of evaluation should be done when a patient presents with acetabular fracture? |
|
Definition
Neurovascular evaluation
(Blood Loss and Sciatic Nerve) |
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Term
| What is important to note about high energy sacral fractures that needs to focus your evaluation? |
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Definition
| High energy Sacral fractures cause nerve injury 25% of the time |
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Term
| What regions of sacral fracture can cause nerve impairment and what tx should be done? |
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Definition
| 2 & 3 - Surgical fixation |
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Term
| What injury in the pelvis indicates the need for a rectal exam? |
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Definition
|
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Term
| What is the MC cause of Coccyx fractures? |
|
Definition
Fall (#1)
Childbirth and Surgical |
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Term
| What are the signs and symptoms of coccyx fractures? |
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Definition
Pain
Rectal Bleeding
Deformity |
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Term
| What is the treatment for a non-displaced coccyx fracture? |
|
Definition
NSAIDs/Pain Meds
Donut
STOOL SOFTNERS!!! (Don't forget these...) |
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Term
| What is the treatment for a displaced/deformed/anal tears caused by a coccyx fracture? |
|
Definition
Manual reduction and Surgical Repair
NSAIDs/ PAin Meds
Donut
Stool Softeners |
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Term
| What is a complication of a femoral neck fracture? |
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Definition
|
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Term
| What is the treatment for a fracture of the femoral head? |
|
Definition
Open reduction
Internal fixation
Arthroplasty |
|
|
Term
| What are the signs and symptoms of a femoral neck fracture? |
|
Definition
|
|
Term
| How does a femoral neck fracture affect mortality rate of elderly? |
|
Definition
| 20% mortality rate within 1 yr |
|
|
Term
| Where does the blood supply to the femoral head come from? |
|
Definition
|
|
Term
| What is the treatment for a femoral neck fracture? |
|
Definition
| hemiprothesis (replacement of the femoral head |
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Term
| If a pt presents with gradual onset hip pain for 4 - 6 months, a slight limp w/walk, increased pain on internal rotation and has a PMH of sickle cell disease, what condition should you suspect? |
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Definition
| Atraumatic Avascular necrosis |
|
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Term
| What is the best early diagnostic tool for avascular necrosis? |
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Definition
|
|
Term
| What is a common finding on x-ray in early and late avascular necrosis? |
|
Definition
Early - Bird's Neck deformity
Late - Key-Fit Acetabulum |
|
|
Term
| What is the ortho treatment for avascular necrosis? |
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Definition
| Disimpacting the femoral head - drill into femoral head (50% chance of improvement, but not other results) |
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Term
| If a pt presents with pain in the lateral hip that increases with running or cycling and decreases with rest, what condition should you suspect? |
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Definition
| ITBS - Iliotibular Tendonitis Band Syndrome |
|
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Term
| What is the cause of ITBS? |
|
Definition
inflammation & irritation of the distal portion of the iliotibial tendon
Caused by IT band rubbing over the lateral femoral condyle or the greater tuberosity |
|
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Term
| What is the MC cause of ITBS? |
|
Definition
| Overuse - repetitive flexion and extension of the knee |
|
|
Term
| What is the diagnostic image study of choice for ITBS? |
|
Definition
| MRI (not usually done as Hx is usually diagnostic) |
|
|
Term
| What is the treatment for ITBS? |
|
Definition
Rest
Heat before stretching; Ice after stretching
PT Consult
NSAIDS
If no improvement in 6 weeks, Ortho – injection and/or surgery |
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Term
| If a pt complains of hip pain that is increased with sitting and has tenderness w/pressure over ischial bursa, what condition should you suspect? |
|
Definition
|
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Term
| What is the treatment for Ischial Bursitis? |
|
Definition
Best - injection of steroid/lidocaine
Rest, Heat, NSAIDs |
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Term
| If a pt presents with hip pain that is increased with walking or climbing stairs and tenderness with pressure over greater trochanter bursa, what condition should you suspect? |
|
Definition
| Greater Trochanteric Bursitis |
|
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Term
| What imaging test is diagnostic for Greater Trochanteric Bursitis? |
|
Definition
| MRI - (not usually needed) |
|
|
Term
| What is the treatment for Greater Trochanteric Bursitis? |
|
Definition
BEST - Injection steroid/lidocaine
Rest/Heat/NSAIDs |
|
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Term
| If a patient presents with achy pain over the hip, pain in the anterior groin that radiates to medial knee and decreased ROM of hip (especially flexion), what condition should you suspect? |
|
Definition
| Osteoarthritis of the hip |
|
|
Term
| What is the treatment for osteoarthritis of the hip? |
|
Definition
Most Effective - Surgery
ROM Exercises, NSAIDs, Heat, Injection |
|
|
Term
| What is found on x-ray with osteoarthritis of the hip? |
|
Definition
joint space narrowing
sclerosis |
|
|
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
|
|
Term
| What is the treatment for sciatica? |
|
Definition
| massage, heat, PT, lifestyle changes |
|
|
Term
| What is the MC type of hip dislocation? |
|
Definition
|
|
Term
| What is the MC cause of posterior dislocation? |
|
Definition
|
|
Term
| What positioning is common with posterior dislocation? |
|
Definition
| Flexion, internal rotation & adduction |
|
|
Term
| What positioning is common with anterior dislocation? |
|
Definition
| External rotation, abduction & mild flexion |
|
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Term
| Which x-ray film views are needed to help in viewing a possible hip dislocation? |
|
Definition
| AP, LAteral , internal and external obliques |
|
|
Term
| What is the treatment for hip dislocation? |
|
Definition
| Ortho - Closed Reduction (unless complicated) |
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Term
| If an athlete feels a pop or pain in the posterior thigh while playing soccer, what condition do you suspect? |
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Definition
|
|
Term
| What is the treatment for hamstring strains? |
|
Definition
R.I.C.E
NSAIDs and PT Consult |
|
|
Term
| What imaging needs to be done for a hamstring strain and why? |
|
Definition
Plain films: evaluate for ischial avulsion fracture
Bone scan for stress fractures |
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