Terms and factoids to know

Question 1

a sensation of pricking, tingling, or creeping on the skin having no objective cause and usually associated with injury or irritation of a sensory nerve or nerve root

Answer 1

paresthesia

Question 2

irritation of or injury to a nerve ROOT (as from being compressed) that typically causes pain, numbness, or weakness in the part of the body which is supplied with nerves from that root

Answer 2

radiculopathy

Question 3

The surgical fixation of a joint, ultimately resulting in bone fusion

Answer 3

arthrodesis

Question 4

short-segment structural thoracolumbar kyphosis resulting in sharp angulation

Answer 4

gibbus deformity

Question 5

tearing injury to ligaments

Answer 5

sprain

Question 6

tearing injury to muscle fibers

Answer 6

strain

Question 7

~injury to ulnar collateral ligament of thumb

~weak pinching ability, pain and ecchymosis at metacarpal-phalangeal joint on ulnar aspect of thumb

Answer 7

acute: skier’s thumb

repetitive stress injury: gamekeeper’s thumb

Question 8

~injury to extensor tendon of DIP joint of finger

~results in flexor tendon being unopposed so tip of finger is flexed

Answer 8

mallet finger

Question 9

~aka flexor tenosynovitis

~after flexing the finger, patient notes a “catching” and must use opposite hand to force finger back into an extended position

Answer 9

trigger finger

Question 10

benign, painless mass in hand or wrist caused by localized leakage of joint fluid through a weakness in joint capsule

Answer 10

ganglion cyst

Question 11

painful, red, swollen soft tissue infection (bacterial, fungal, etc.) around a fingernail

Answer 11

paronychia

Question 12

~extremely painful abscess on the palmar aspect of the fingertip

~aka whitlow

Answer 12

felon

Question 13

~blunt trauma or crush injury that causes pain and discoloration of nail = _______

~severe cases may need ________ (making a hole in the nail)

Answer 13

subungual hematoma

trephination

Question 14

~a distal phalanx fracture with small pieces of bone chipped off the edge of the distal phalanx

~requires splinting for 3-6 weeks or until patient is pain-free

Answer 14

tuft fracture

Question 15

~thickened cords of the palmar fascia that cause flexion contractures of the metacarpophalangeal and proximal interphalangeal (PIP) joints

~more common in males

~strong familial tendency

Answer 15

Dupuytren contracture

Question 16

Answer 16

~no man’s land of the hand

~the fibrous sheath of the flexor tendons of the hand, specifically in the zone from the distal palmar crease to the proximal interphalangeal joint

Question 17

~Painful condition characterized by significant restriction in both active and passive range of motion of shoulder. The shoulder is characterized as being stiff when the articular surfaces are normal and the joint is stable, yet there is a restriction in range of motion

~if motion is restricted for months, fibrous arthrodesis can occur

~treatment is ROM exercises

Answer 17

frozen shoulder

Question 18

piriformis syndrome

Answer 18

~Compression of the sciatic nerve usually causes pain in the distal extremity, but irritation of the sciatic nerve from the piriformis muscle causes pain in the area of the buttocks and hamstring muscles - piriformis syndrome!

~Made worse by sitting, climbing stairs or squatting

~There may be a palpable, tender mass over the piriformis muscle, with pain in the region of the sacroiliac joint or gluteal musculature

~Hip flexion and passive internal rotation will exacerbate the symptoms

Question 19

How can you differentiate, on xray, the appearance of a new vs old fracture?

Answer 19

new: no/minimal callus; fracture edges are clear and sharp
old: much more callus formation; there is fuzziness around the edges of the fracture pieces

Question 20

Ottawa Ankle/Foot Rules

Answer 20

An ankle xray series is only required if:

1. bone tenderness at lateral or medial malleolus

OR

2. inability to bear weight

A foot xray series is only required if:

1. bone tenderness at base of 5th metatarsal or navicular bone

OR

2. inability to bear weight

Question 21

What is one radiographic difference between benign and malignant orthopedic neoplasms?

Answer 21

Benign: can see rim of periosteal bone around neoplasm

Malignant: no rim of periosteal bone around neoplasm; poorly demarcated transitional zone

Question 22

This type of testing modality is useful for providing physiologic information (rather than anatomic).

Osteoblast activity is labeled with a radioactive tracer.

A disorder that results in increased bone formation has a “hot” scan (osteoblastic activity), and a “cold” scan implies the problem is a soft tissue problem.

Answer 22

bone scan

Question 23

A type of radiography that shows internal images in REAL TIME (evaluates JOINT MOTION - used by surgeons to monitor placement of hardware)

Answer 23

fluoroscopy

Question 24

Gold standard for measuring bone density (osteoporosis)

Answer 24

DEXA scan

Question 25

This imaging modality is great for diagnosing injuries of soft tissues (muscles, tendons, ligaments, infection) as well as for determining osteomyelitis

Answer 25

MRI

Question 26

Imaging modality useful in assessment of COMPLEX fractures (fracture in multiple planes) and in evaluation of bone tumors

Answer 26

CT

Question 27

If you are prescribing opiates, what MUST you prescribe along with it?

Answer 27

stool softener/laxative/bowel stimulant

Question 28

10 yo boy complaining of pain where the patellar tendon attaches to the tibial tubercle when squatting and walking stairs. You know that this syndrome will resolve spontaneously when the physis closes at physical maturity. Until then symptomatic management is appropriate.

What is this syndrome?

Answer 28

Osgood-Schlatter syndrome

Question 29

Fancy word for ingrown toenail

Answer 29

onychocryptosis

Question 30

Pain on plantar aspect of first metatarsophalangeal joint when walking/bearing weight. Point tenderness there. May be caused by overuse, shoes…may place a short walking cast, and also provide symptomatic treatment. If 12 months of conservative treatment doesn’t provide relief, may surgically remove the affected tiny bone.

What is this condition?

Answer 30

sesamoiditis

Question 31

If you see thenar eminence atrophy, what is your diagnosis?

Answer 31

carpal tunnel syndrome

Question 32

What is a major complication that could happen after a scaphoid fracture?

Answer 32

avascular necrosis

Question 33

migratory arthritis

Answer 33

gonococcal arthritis