Podcast
Questions and Answers
What may indicate a specific neurological disorder in a patient experiencing muscle weakness?
What may indicate a specific neurological disorder in a patient experiencing muscle weakness?
Which of the following gait types is typically associated with muscle weakness, particularly seen in conditions like foot drop?
Which of the following gait types is typically associated with muscle weakness, particularly seen in conditions like foot drop?
What examination method begins with observing the patient's appearance and posture?
What examination method begins with observing the patient's appearance and posture?
What is a potential consequence of a history of a twisted ankle many years ago?
What is a potential consequence of a history of a twisted ankle many years ago?
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Which of the following deformities can result from muscle imbalance or joint instability?
Which of the following deformities can result from muscle imbalance or joint instability?
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Which symptom is least likely to be considered as the most common in orthopaedics?
Which symptom is least likely to be considered as the most common in orthopaedics?
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Which grading of pain indicates that it can be easily ignored?
Which grading of pain indicates that it can be easily ignored?
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What type of stiffness is typical of osteoarthritis?
What type of stiffness is typical of osteoarthritis?
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Which test is NOT typically included in orthopaedic examination methods?
Which test is NOT typically included in orthopaedic examination methods?
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In orthopaedics, pain that is referred is likely to be described as:
In orthopaedics, pain that is referred is likely to be described as:
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Study Notes
Orthopaedics
- Concerned with bones, joints, muscles, tendons, nerves, the skeletal system, and movement.
- Diagnosis involves understanding the anatomy, pathology, history, examination, special tests, and differential diagnosis.
History
- Key symptoms include pain, stiffness, swelling, deformity, instability, weakness, altered sensibility, and loss of function.
- Pain should be characterized by location, onset, progression, and aggravating/relieving factors.
- Pain can be localized or referred, mild to severe, aching, burning, throbbing, stabbing, or variable.
- Stiffness can be transient, persistent, or sudden.
- Swelling can occur rapidly or slowly, be painful, constant, or intermittent.
- Muscle weakness can be associated with joint dysfunction or neurological disorders.
- Instability can be caused by muscle weakness or ligamentous deficiency.
- Tingling or numbness signifies nerve impairment.
- A detailed social history can provide valuable insights into a patient's lifestyle and support network.
Examination
- Begins with observing the patient's appearance, posture, and gait.
- Gait abnormalities can indicate specific conditions (e.g., foot drop, antalgic gait, scissor gait).
- Examination of the affected part involves looking, feeling and moving.
- Look: Observe skin, shape, and position of the affected limb. Deformities can result from congenital, traumatic, or acquired causes.
- Feel: Assess skin temperature, sensation, soft tissue lumps/pulses, bone and joint tenderness and fluid.
- Move: Assess active and passive range of motion, noting any limitations or types of stiffness.
Neurological Examination
- Examine general appearance, motor function (tone, power, reflexes), and sensory function (superficial and deep).
- Assess muscle power using the Medical Research Council (MRC) scale.
Diagnostic Imaging
- Plain radiography is still the most useful diagnostic tool for musculoskeletal disorders.
- Computed tomography (CT) provides cross-sectional images with higher resolution.
- Magnetic resonance imaging (MRI) offers better tissue differentiation and contrast resolution.
- Diagnostic ultrasound is a non-invasive technique that uses sound waves to visualize soft tissues.
- Radionuclide imaging utilizes radioactive isotopes to assess tissue activity.
Laboratory Tests
- Common blood tests include hemoglobin, differential count, ESR, c-reactive protein, gamma globulin, rheumatoid factor, and HLA-AG typing.
- Arthrocentesis, the aspiration of fluid from a joint, is useful for diagnosis and therapeutic purposes.
- Bone biopsy helps confirm benign or malignant tumor types.
- Electrodiagnosis (nerve conduction studies and electromyography) assesses nerve and muscle function.
Non-Operative Treatments
- Rest is essential for many musculoskeletal conditions, including spinal and limb pathologies.
- Support devices, such as braces and orthoses, provide stability and control.
- Physiotherapy can be active, passive, or a combination of both, utilizing various techniques to improve mobility and function.
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