Digital Deformities in Podiatry
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Questions and Answers

What is the primary mechanism leading to digital deformities?

  • Flexor substitution
  • MPJ derangement
  • Extensor substitution
  • Flexor stabilization (correct)

Which of the following is NOT a type of digital deformity?

  • Tarsal tunnel syndrome (correct)
  • Clawtoe
  • Mallet toe
  • Hammertoe

What is the result of the FDL overpowering the interossei?

  • Adductovarus deformity
  • Flexor substitution
  • Mild hyperextension deformity at the MTP (correct)
  • MPJ derangement

What is the term for the condition where the short flexors fail to stabilize the middle phalanx?

<p>Clawtoe (A)</p> Signup and view all the answers

Which of the following is an underlying biomechanical etiology of digital deformity?

<p>Flexor stabilization (C)</p> Signup and view all the answers

What is the result of the quadratus plantae losing its mechanical advantage?

<p>Adductovarus deformity (A)</p> Signup and view all the answers

Which of the following is a characteristic of flexor substitution?

<p>Supinated foot (C)</p> Signup and view all the answers

What is the term for the condition where the deep posterior and peroneal muscles gain advantage as major plantarflexors?

<p>Flexor substitution (B)</p> Signup and view all the answers

What is the result of the FDB failing to stabilize the middle phalanx?

<p>Clawtoe (D)</p> Signup and view all the answers

What is the primary reason for fixed MTPJ subluxation in extensor substitution?

<p>Chronic contraction of extensor tendons (A)</p> Signup and view all the answers

Which of the following is NOT a type of digital deformity?

<p>Flexor elongation (B)</p> Signup and view all the answers

What is the term for the condition where the interossei lose the ability to stabilize the proximal phalanx?

<p>Mild hyperextension deformity (A)</p> Signup and view all the answers

What is the purpose of CFT in the evaluation and surgical work-up?

<p>To evaluate blood flow to the digits (D)</p> Signup and view all the answers

What is the primary presenting complaint in patients with digital deformity?

<p>Callus or corn (B)</p> Signup and view all the answers

What is the significance of flexible deformity in extensor substitution?

<p>It becomes rigid over time (A)</p> Signup and view all the answers

What is the significance of a pronated foot in digital deformity?

<p>It indicates flexor substitution (C)</p> Signup and view all the answers

What is the percentage of vascular compromise reported by Kramer et al (2015) in hammertoe corrections?

<p>0.6% (A)</p> Signup and view all the answers

What is the primary cause of chronic edema, also known as 'Sausage toe'?

<p>Damage to lymphatic or venous structures (C)</p> Signup and view all the answers

What is Blue Toe usually indicative of?

<p>Venous congestion or active bleeding (B)</p> Signup and view all the answers

What is the recommended management for White Toe?

<p>Monitor and prevent infection (A)</p> Signup and view all the answers

What is a risk factor for vascular compromise in hammertoe correction?

<p>Increased severity of deformity (A)</p> Signup and view all the answers

What is the recommended approach to a patient with chronic edema after hammertoe correction?

<p>Educate the patient on compression (B)</p> Signup and view all the answers

What is the primary purpose of retrograde placement of K-wire in arthroplasty or arthrodesis?

<p>To stabilize the joint for arthroplasty or arthrodesis (C)</p> Signup and view all the answers

In which digits is arthrodesis traditionally avoided?

<p>Fourth and fifth digits (B)</p> Signup and view all the answers

What is the main difference between the techniques of arthroplasty and arthrodesis?

<p>Removal of articular cartilage versus removal of the head of proximal phalanx (D)</p> Signup and view all the answers

What is the primary goal of derotational arthroplasty?

<p>To correct adductovarus deformity in the fourth and fifth toes (B)</p> Signup and view all the answers

What is the recommended post-operative course for arthroplasty with derotational surgical management?

<p>Ambulating in surgical shoe for 3-4 weeks (D)</p> Signup and view all the answers

What is the name of the procedure that involves removal of a section of skin dorsally at the level of the PIPJ?

<p>Derotational arthroplasty (D)</p> Signup and view all the answers

What is the primary goal of patient education in surgical management of digital deformities?

<p>To manage patient expectations and goals (D)</p> Signup and view all the answers

What is the contraindication for elective correction of digital deformity in a patient with a high HbA1c level?

<p>Co-morbid medical conditions (B)</p> Signup and view all the answers

What is the primary indication for Hibbs tenosuspension procedure?

<p>Hammertoe or clawtoe deformity secondary to overactive EDL (C)</p> Signup and view all the answers

What is the technique used in flexor tendon transfer to convert flexor tendons into plantarflexors of the MTPJ?

<p>Transferring the FDL and FDB tendons dorsally to the proximal phalanx (B)</p> Signup and view all the answers

What is the primary indication for extensor tendon transfer procedure?

<p>Chronic insufficiency or attenuation of the extensor tendon (D)</p> Signup and view all the answers

What is the primary goal of syndactylization procedure?

<p>To treat interdigital ulceration or persistent heloma molle (A)</p> Signup and view all the answers

What is the technique used in soft tissue contracture release procedure?

<p>Extensor tenotomy and dorsomedial capsulotomy (C)</p> Signup and view all the answers

What is the primary indication for plantar plate repair procedure?

<p>Instability, pain, and deformity stemming from the level of the MPJ (B)</p> Signup and view all the answers

What is the primary goal of arthroplasty procedure in surgical management of digital deformities?

<p>To shorten the toe and relax soft tissue (C)</p> Signup and view all the answers

What is the primary indication for metatarsal osteotomy procedure?

<p>To realign the metatarsal bone (B)</p> Signup and view all the answers

What is the radiographic appearance of a first metatarsal elevatus?

<p>A true widening angle distally of the dorsal first metatarsal cortex (C)</p> Signup and view all the answers

What is the result of structural plantarflexion of the central metatarsals?

<p>Increased pressure on the adjacent metatarsal heads (C)</p> Signup and view all the answers

What is the role of the sesamoid axial view in the evaluation of preoperative position?

<p>To evaluate the preoperative position and postoperative outcome (C)</p> Signup and view all the answers

What is the effect of hallux abductovalgus on the normal distribution of weight to the forefoot?

<p>It changes the normal distribution of weight to the forefoot (C)</p> Signup and view all the answers

What is the result of structurally dorsiflexed central metatarsals?

<p>Increased pressure on the adjacent metatarsal heads (C)</p> Signup and view all the answers

What is the relationship between transverse and frontal plane deformities of the metatarsals?

<p>They are less predictable and less obvious than the sagittal plane deformities (B)</p> Signup and view all the answers

What is the meaning of the term 'Metatarsalgia'?

<p>Pain in the foot originating from the Latin 'Meta' meaning next after, 'Tarsus' meaning of or pertaining to the ankle or instep, and 'Algia' meaning pain (B)</p> Signup and view all the answers

What is the primary cause of callusing in metatarsalgia?

<p>High levels of pressure and shear force on the skin (A)</p> Signup and view all the answers

What is the result of the positive feedback mechanism in metatarsalgia?

<p>Increased pain and breakdown of the skin (C)</p> Signup and view all the answers

What is the significance of the 'Metatarsal parabola' in metatarsalgia?

<p>It is a type of biomechanical abnormality (B)</p> Signup and view all the answers

What is the relationship between abnormal levels of pressure and shear force, and callusing in metatarsalgia?

<p>Abnormal levels of pressure and shear force lead to callusing (B)</p> Signup and view all the answers

What is the significance of 'Equinus' in metatarsalgia?

<p>It is a type of biomechanical abnormality (A)</p> Signup and view all the answers

What is typically observed in T1 MRI findings for a sesamoid fracture?

<p>Hypointensity (D)</p> Signup and view all the answers

What is the usual screw size used for single screw fixation in a linear sesamoid fracture?

<p>2.5mm (A)</p> Signup and view all the answers

What is the potential consequence of sesamoidectomy?

<p>Hallux varus (D)</p> Signup and view all the answers

What is the purpose of the dorsal drawer test in evaluating a patient with suspected turf toe?

<p>To evaluate the stability of the first metatarsophalangeal joint (C)</p> Signup and view all the answers

What is the clinical presentation of a patient with turf toe?

<p>Painful great toe with localized edema and ecchymosis (C)</p> Signup and view all the answers

What is the indication for sesamoidectomy?

<p>All of the above (D)</p> Signup and view all the answers

What is the primary goal of treatment for stress fractures?

<p>To allow for healing by ceasing harmful motion (C)</p> Signup and view all the answers

What is the indication for surgical intervention in metatarsal base fractures?

<p>Displacement &gt;4mm or angulation &gt;10 degrees (B)</p> Signup and view all the answers

What is the approach for metatarsal fracture repair?

<p>Dorsal approach for complex fractures of the shaft or base (D)</p> Signup and view all the answers

What is the consideration when designing the incisional approach for metatarsal ORIF?

<p>Avoiding neurovascular anatomy (C)</p> Signup and view all the answers

What is the significance of height-differential information to the patient?

<p>It informs the patient about the post-operative shoe wear (C)</p> Signup and view all the answers

What is the primary goal of immobilization in stress fracture treatment?

<p>To allow for healing by ceasing harmful motion (D)</p> Signup and view all the answers

Why is it necessary to incise the periosteum during metatarsal ORIF?

<p>To visualize the fracture line and evacuate any hematoma (D)</p> Signup and view all the answers

What is the primary purpose of temporary stabilization with a clamp or wire during metatarsal ORIF?

<p>To align the fracture fragments and hold them in place (C)</p> Signup and view all the answers

Why is it important to ensure that the plate and heads of the screws are not prominent against the skin during metatarsal ORIF?

<p>To allow for easier wound closure (A)</p> Signup and view all the answers

What type of plating is required for complex comminuted fractures such as the third metatarsal fracture?

<p>Bridge plating (A)</p> Signup and view all the answers

What is the purpose of retracting tendons during metatarsal ORIF?

<p>To identify and protect tendons during the procedure (D)</p> Signup and view all the answers

Why is it necessary to check the position of the plate with intraoperative fluoroscopy during metatarsal ORIF?

<p>To verify that the fracture fragments are properly aligned (A)</p> Signup and view all the answers

What is the primary goal of immobilization in the treatment of sesamoiditis?

<p>To reduce pain and inflammation (A)</p> Signup and view all the answers

What is the significance of a naturally bipartite sesamoid in the diagnosis of sesamoid fracture?

<p>It is a normal variant that can be found on the contralateral foot (B)</p> Signup and view all the answers

What is the purpose of turf toe taping/strapping in the treatment of sesamoiditis?

<p>To support the great toe (C)</p> Signup and view all the answers

What is the primary goal of treatment for stress fractures?

<p>To promote bone healing (B)</p> Signup and view all the answers

What is the significance of callusing in metatarsalgia?

<p>It is a sign of abnormal levels of pressure and shear force (B)</p> Signup and view all the answers

What is the primary goal of surgical intervention in turf toe repair?

<p>To restore the position of the sesamoids and repair the plantar plate tear (B)</p> Signup and view all the answers

What is the characteristic of a stress fracture on an MRI?

<p>A cortical breach with marrow edema (D)</p> Signup and view all the answers

What is the purpose of taping/strapping in conservative care of turf toe?

<p>To prevent dorsiflexion and stabilize the hallux (A)</p> Signup and view all the answers

What is the recommended approach to a patient with turf toe and a medial-only tear?

<p>An isolated medial approach (C)</p> Signup and view all the answers

What is the significance of the sesamoid axial view in the evaluation of preoperative position?

<p>It helps in assessing the position of the sesamoids (A)</p> Signup and view all the answers

What is the primary goal of immobilization in stress fracture treatment?

<p>To allow the fracture to heal (A)</p> Signup and view all the answers

What is the significance of a positive dorsal drawer test in a patient with suspected turf toe?

<p>It indicates instability of the MTPJ (C)</p> Signup and view all the answers

What is the primary indication for sesamoidectomy in the treatment of sesamoid fractures?

<p>Infected sesamoid bones (C)</p> Signup and view all the answers

What is the typical MRI finding in a patient with a sesamoid fracture?

<p>T1: hypointensity, T2: hyperintensity (D)</p> Signup and view all the answers

What is the purpose of single screw fixation in the treatment of linear sesamoid fractures?

<p>To promote bone healing (C)</p> Signup and view all the answers

What is the typical clinical presentation of a patient with turf toe?

<p>Hyperextension trauma with localized edema and ecchymosis (A)</p> Signup and view all the answers

What is the recommended management for stress fractures in the foot?

<p>Immobilization and weight-bearing modification (A)</p> Signup and view all the answers

What is the primary reason for performing an intermetatarsal neurectomy in Morton's neuroma?

<p>To remove the intermetatarsal nerve and the associated fibrotic tissue (D)</p> Signup and view all the answers

What is the characteristic of a Morton's neuroma on ultrasound?

<p>Hypoechoic and non-compressible (C)</p> Signup and view all the answers

What is the purpose of injecting 4% sclerosing alcohol in the treatment of Morton's neuroma?

<p>To atrophy the fibrotic tissue around the nerve (C)</p> Signup and view all the answers

What is the radiographic feature of Morton's neuroma on X-ray?

<p>A divergence of the toes (Sullivan's sign) (C)</p> Signup and view all the answers

What is the typical MRI appearance of a Morton's neuroma?

<p>Barbel-shaped and hypointense on T2-weighted images (C)</p> Signup and view all the answers

What is the goal of conservative treatment in Morton's neuroma?

<p>To relieve pain and alleviate pressure (D)</p> Signup and view all the answers

What is the indication for surgical intervention in Morton's neuroma?

<p>No response to conservative treatment (C)</p> Signup and view all the answers

What is the benefit of using ultrasound-guided injections in Morton's neuroma treatment?

<p>Improved accuracy and reduced complications (A)</p> Signup and view all the answers

What is the significance of the 'Vulcansalute sign' in Morton's neuroma?

<p>A variation of Sullivan's sign (D)</p> Signup and view all the answers

What is the primary benefit of cryogenic denervation in Morton's neuroma treatment?

<p>Minimally invasive procedure (D)</p> Signup and view all the answers

What is the primary indication for surgical intervention in metatarsal base fractures?

<p>Displacement &gt;4mm (C)</p> Signup and view all the answers

Which approach is used for more complex fractures of the metatarsal shaft or base?

<p>Dorsal (C)</p> Signup and view all the answers

What is the purpose of informing the patient about height-differential?

<p>To ensure proper fitting of postop shoe (C)</p> Signup and view all the answers

What is the mainstay of treatment for stress fractures?

<p>Immobilization (A)</p> Signup and view all the answers

What is the significance of radiographic evaluation in metatarsal fracture repair?

<p>All of the above (D)</p> Signup and view all the answers

What is the primary goal of treatment for metatarsal fractures?

<p>To allow for proper healing (B)</p> Signup and view all the answers

What is a characteristic of intermetatarsal bursitis that distinguishes it from intermetatarsal neuroma?

<p>It is compressible on ultrasound (D)</p> Signup and view all the answers

What is a common complication of neurectomy?

<p>All of the above (D)</p> Signup and view all the answers

What is the purpose of an MRI in the evaluation of forefoot pain?

<p>To identify soft tissue abnormalities (B)</p> Signup and view all the answers

What is the role of ultrasound in the diagnosis of intermetatarsal neuroma?

<p>To distinguish neuroma from bursitis (D)</p> Signup and view all the answers

What is the purpose of X-ray in the evaluation of forefoot pain?

<p>To diagnose stress fractures (D)</p> Signup and view all the answers

What is a common feature of intermetatarsal neuroma on MRI?

<p>It appears as a mass (D)</p> Signup and view all the answers

What is the primary goal of ordering an MRI for a patient with a suspected plantar plate injury?

<p>To visualize the plantar plate and surrounding soft tissue (A)</p> Signup and view all the answers

Which imaging modality is most useful for diagnosing intermetatarsal neuroma?

<p>Ultrasound (D)</p> Signup and view all the answers

What is the primary indication for ordering an arthrogram for a patient with a suspected plantar plate injury?

<p>To visualize the joint space and surrounding soft tissue (C)</p> Signup and view all the answers

What is the primary benefit of using ultrasound-guided injections in the treatment of Morton's neuroma?

<p>Increased accuracy of injection (A)</p> Signup and view all the answers

What is the primary characteristic of a stress fracture on an MRI?

<p>A high signal on T2-weighted images (D)</p> Signup and view all the answers

What is the primary role of the sesamoid axial view in the evaluation of preoperative position?

<p>To assess the alignment of the sesamoid bones (B)</p> Signup and view all the answers

What is the most likely diagnosis in a patient with a swollen and tender third metatarsal-phalangeal joint with redness and difficulty moving the joint?

<p>Septic arthritis (A)</p> Signup and view all the answers

What is the primary purpose of ordering an MRI in a patient with suspected plantar plate rupture?

<p>To assess the soft tissue structures of the foot (A)</p> Signup and view all the answers

What is the significance of a positive digital Lachman's test in a patient with suspected plantar plate rupture?

<p>It suggests a rupture of the plantar plate (C)</p> Signup and view all the answers

What is the primary advantage of using musculoskeletal ultrasound in the diagnosis of Morton's neuroma?

<p>It allows for dynamic imaging of the foot (B)</p> Signup and view all the answers

What is the primary indication for ordering a TC-99 scan in a patient with suspected plantar plate rupture?

<p>To diagnose a plantar plate rupture when MRI is negative (C)</p> Signup and view all the answers

What is the primary purpose of ordering an X-ray in a patient with suspected metatarsal fracture?

<p>To visualize the bony anatomy of the foot (C)</p> Signup and view all the answers

What is the primary benefit of using an Arthrogram in the diagnosis of plantar plate tears?

<p>Allows for tracking of contrast into the tendon sheath indicating a PP tear/rupture (A)</p> Signup and view all the answers

What is the significance of 'slices' in an MRI?

<p>They measure thicker than the width of the injury, which can lead to missed diagnosis (C)</p> Signup and view all the answers

What is the primary indication for ordering further tests in a patient with a suspected plantar plate tear?

<p>Clinical suspicion, despite a negative MRI (B)</p> Signup and view all the answers

What is the purpose of injecting contrast into the joint during an Arthrogram?

<p>To track the contrast into the tendon sheath, indicating a PP tear/rupture (A)</p> Signup and view all the answers

What is the significance of edema on an MRI?

<p>It is a sign of plantar plate disruption (C)</p> Signup and view all the answers

What is the primary benefit of using a plantar approach in plantar plate repair?

<p>It allows for easier access to the plantar plate (B)</p> Signup and view all the answers

What is a characteristic of late-stage Predislocation syndrome?

<p>Subluxation of the MTPJ (A)</p> Signup and view all the answers

What is the anatomical structure that inserts into the plantar plate?

<p>Deep transverse intermetatarsal ligaments (A)</p> Signup and view all the answers

What is the imaging modality that may be useful in determining plantar plate tears dynamically?

<p>Ultrasound (C)</p> Signup and view all the answers

What is the result of a blood pool phase Tc-99 scan in a patient with a plantar plate tear?

<p>Positive radiotracer uptake (D)</p> Signup and view all the answers

What is the characteristic of the plantar plate in anatomy?

<p>A shallow cavity fibrocartilaginous structure (A)</p> Signup and view all the answers

What is the surgical treatment for plantar plate tears in late-stage Predislocation syndrome?

<p>Plantar plate repair (C)</p> Signup and view all the answers

What is a common underlying factor that contributes to capsulitis/synovitis?

<p>All of the above (D)</p> Signup and view all the answers

What is the primary function of reducing the sesamoid complex with traction during an open first MTPJ reduction?

<p>To gain leverage and properly reduce the joint (C)</p> Signup and view all the answers

What is a characteristic symptom of capsulitis/synovitis?

<p>Pain and swelling about the forefoot (D)</p> Signup and view all the answers

Why is it essential to check the reduction of the sesamoid complex during an open first MTPJ reduction?

<p>To confirm reduction of the sesamoid complex (D)</p> Signup and view all the answers

What is often seen on plain film radiographs in patients with inflammatory arthropathies, such as psoriatic arthritis?

<p>Peri-articular erosions of the bones (D)</p> Signup and view all the answers

What is a common presentation of patients with capsulitis/synovitis?

<p>Pain and swelling about the forefoot (B)</p> Signup and view all the answers

What is the primary characteristic of Predislocation Syndrome stage II?

<p>Moderate Edema and noticeable deviation of the digit (B)</p> Signup and view all the answers

What is the purpose of Digital Lachman's test in Predislocation Syndrome?

<p>To test for dorsal translocation of the digit (C)</p> Signup and view all the answers

What is the radiographic finding often seen in Predislocation Syndrome?

<p>Splayfoot deformity (D)</p> Signup and view all the answers

What is the primary difference between Predislocation Syndrome stage II and stage III?

<p>Degree of deviation of the digit (A)</p> Signup and view all the answers

What is the clinical significance of noticing loss of toe purchase in Predislocation Syndrome?

<p>It indicates a moderate condition (B)</p> Signup and view all the answers

What is the primary reason for performing Digital Lachman's test on the contralateral side?

<p>To compare with the affected side (A)</p> Signup and view all the answers

What is the typical appearance of joint degeneration in the early stages of Psoriatic Arthritis?

<p>Nonspecific (A)</p> Signup and view all the answers

What is the radiographic feature associated with Psoriatic Arthritis?

<p>Gull wing pattern at the DIPJ (B)</p> Signup and view all the answers

What is Freiberg's infarction?

<p>Avascular necrosis of the second metatarsal head (C)</p> Signup and view all the answers

What is the percentage of PA patients with nail psoriasis?

<p>Up to 70% (C)</p> Signup and view all the answers

What is the characteristic clinical finding of Psoriatic Arthritis?

<p>Swelling of the digits (D)</p> Signup and view all the answers

What is the response of stiffness to increased activity in Psoriatic Arthritis?

<p>Stiffness decreases (B)</p> Signup and view all the answers

What is the typical age range of female patients most commonly affected by Freiberg's infarction?

<p>13-18 (C)</p> Signup and view all the answers

What is the ratio of female to male patients affected by Freiberg's infarction?

<p>4:1 (C)</p> Signup and view all the answers

In which metatarsal bone is Freiberg's infarction most commonly seen?

<p>Second metatarsal (B)</p> Signup and view all the answers

What is the basis of Smille's staging system for Freiberg's infarction?

<p>Intraoperative findings (D)</p> Signup and view all the answers

What is the characteristic of Stage 2 in Freiberg's staging system?

<p>Sinking of the articular surface (C)</p> Signup and view all the answers

At which stage can joint-sparing surgery no longer be performed in Freiberg's infarction?

<p>Stage 4 (D)</p> Signup and view all the answers

What is the radiographic appearance of a joint with capsulitis/synovitis?

<p>Normal appearance (A)</p> Signup and view all the answers

What is the primary association with capsulitis/synovitis?

<p>All of the above (D)</p> Signup and view all the answers

What is the purpose of taking radiographs during an open first MTPJ reduction?

<p>To ensure the sesamoid complex is appropriately reduced (B)</p> Signup and view all the answers

What is the typical presentation of a patient with capsulitis/synovitis?

<p>Pain and swelling about the forefoot (A)</p> Signup and view all the answers

What is the significance of tenderness with passive toe ROM in capsulitis/synovitis?

<p>Is a common finding in capsulitis/synovitis (B)</p> Signup and view all the answers

What is the difference between capsulitis and synovitis?

<p>Capsulitis is inflammation of the joint capsule, while synovitis is inflammation of the synovial membrane (B)</p> Signup and view all the answers

What is the significance of a high ANA titer in a patient's blood?

<p>It is a nonspecific marker of autoimmune disorders (C)</p> Signup and view all the answers

What is the purpose of measuring Rheumatoid Factor in a patient's blood?

<p>To diagnose Rheumatoid Arthritis (D)</p> Signup and view all the answers

What is the normal range for ESR in adults?

<p>0-10mg/L (D)</p> Signup and view all the answers

What is the significance of a low CRP titer in a patient's blood?

<p>It indicates a low level of inflammation in the body (B)</p> Signup and view all the answers

What is the purpose of performing an Anti-CCP antibody analysis?

<p>To detect autoimmune disorders directed at human tissue (C)</p> Signup and view all the answers

What is the significance of a high Anti-CCP antibody level in a patient's blood?

<p>It is a definitive diagnosis for Rheumatoid Arthritis (A)</p> Signup and view all the answers

In rheumatoid arthritis, which laboratory test must be normal prior to surgical intervention?

<p>CRP (D)</p> Signup and view all the answers

What is the primary purpose of ordering a C-spine X-ray in patients with rheumatoid arthritis?

<p>To evaluate for atlanto-axial subluxation (A)</p> Signup and view all the answers

Which laboratory test is used to diagnose and monitor rheumatoid arthritis?

<p>Rheumatoid Factor (RF) testing (A)</p> Signup and view all the answers

What is the significance of a high ESR in rheumatoid arthritis?

<p>Indicates active inflammation (B)</p> Signup and view all the answers

What is the role of Anti-CCP antibody analysis in rheumatoid arthritis?

<p>To diagnose rheumatoid arthritis (D)</p> Signup and view all the answers

What is the primary benefit of CRP testing in rheumatoid arthritis?

<p>To monitor disease activity (D)</p> Signup and view all the answers

What is the primary purpose of Anti-CCP antibody analysis in inflammatory arthritis?

<p>To diagnose rheumatoid arthritis (D)</p> Signup and view all the answers

What is the normal range for ESR in women?

<p>0-29 mm/hour (A)</p> Signup and view all the answers

What is the purpose of CRP testing in inflammatory arthritis?

<p>To monitor disease activity and response to treatment (D)</p> Signup and view all the answers

What is the significance of a positive ANA test in inflammatory arthritis?

<p>It indicates the presence of an autoimmune disease (B)</p> Signup and view all the answers

What is the significance of an elevated ESR in a patient with inflammatory arthritis?

<p>It indicates the presence of inflammation or tissue damage (C)</p> Signup and view all the answers

What is the purpose of Rheumatoid Factor diagnosis in inflammatory arthritis?

<p>To diagnose rheumatoid arthritis (C)</p> Signup and view all the answers

What is the approximate percentage of patients with rheumatoid arthritis who present with rheumatoid nodules at diagnosis?

<p>Up to 7% (A)</p> Signup and view all the answers

What is the most common non-skin location of rheumatoid nodules?

<p>Lung (C)</p> Signup and view all the answers

What is the characteristic histopathology of rheumatoid nodules?

<p>Central area of necrosis surrounded by palisading epithelioid macrophages (C)</p> Signup and view all the answers

What is the preferred treatment for symptomatic rheumatoid nodules?

<p>Intra-lesional steroid injections with triamcinolone acetonide (C)</p> Signup and view all the answers

What is the appearance of rheumatoid nodules on ultrasound?

<p>Ill-defined, heterogeneous mass (D)</p> Signup and view all the answers

What is the significance of multiple rheumatoid nodules in patients with known rheumatoid arthritis?

<p>It is diagnostic of rheumatoid arthritis (B)</p> Signup and view all the answers

What adjunct procedure could have been utilized to provide more stability while walking in a 69-year-old male patient with a history of rheumatoid arthritis who underwent a Hoffman pan-metatarsal head resection?

<p>Clayton procedure (B)</p> Signup and view all the answers

What additional diagnostic must be ordered prior to surgical intervention in patients with rheumatoid arthritis?

<p>C-spine X-ray (D)</p> Signup and view all the answers

What is the primary goal of the Hoffman procedure in patients with rheumatoid arthritis?

<p>To alleviate pain (C)</p> Signup and view all the answers

What is the significance of the Nijmegen criteria in patients with rheumatoid arthritis?

<p>To diagnose early rheumatoid arthritis (B)</p> Signup and view all the answers

What is the role of the Clayton procedure in the management of rheumatoid arthritis?

<p>To alleviate pain in the forefoot (D)</p> Signup and view all the answers

What is the purpose of the Hoffman pan-metatarsal head resection in patients with rheumatoid arthritis?

<p>To alleviate pain in the forefoot (A)</p> Signup and view all the answers

What is the primary purpose of the Nijmegen classification system?

<p>To classify the severity of metatarsophalangeal joint deformity in patients with rheumatoid arthritis (C)</p> Signup and view all the answers

What is the characteristic of Grade 1 in the Nijmegen classification system?

<p>Decrease in MTPJ mobility with some erosive changes and/or joint space narrowing on X-rays (A)</p> Signup and view all the answers

What is the significance of the Nijmegen classification system in surgical pre-planning?

<p>It assists in deciding between joint-sparing surgery and more aggressive surgery (A)</p> Signup and view all the answers

What is the typical finding on X-rays in patients with rheumatoid arthritis, according to the Nijmegen classification system?

<p>Peri-articular erosions on the radial side of the MCP and plantar MTPJ (C)</p> Signup and view all the answers

What is the correlation between staging and pain level in patients with rheumatoid arthritis, according to the initial study on the Nijmegen classification system?

<p>There is a clear correlation between staging and pain level (C)</p> Signup and view all the answers

What is the typical location of peri-articular erosions on X-rays in patients with rheumatoid arthritis, according to the Nijmegen classification system?

<p>The 4th and 5th MTPJ (A)</p> Signup and view all the answers

What is the primary advantage of the plantar approach in HoffmanClayton procedure?

<p>Good visualization and relocation of plantar fat pad (D)</p> Signup and view all the answers

Which of the following surgical approaches has a higher incidence of skin slough?

<p>Dorsal linear 5 incision (B)</p> Signup and view all the answers

What is the primary disadvantage of the dorsal linear 3 incision approach?

<p>Limited surgical exposure (A)</p> Signup and view all the answers

Which of the following surgical approaches is considered technically difficult and requires meticulous dissection?

<p>Lazy S approach (C)</p> Signup and view all the answers

What is the primary advantage of the dorsal linear 5 incision approach?

<p>Good exposure to MPJ's and soft tissue (C)</p> Signup and view all the answers

What is the primary consideration for the pan-metatarsal head resection procedure?

<p>All of the above (D)</p> Signup and view all the answers

What is the orientation of the bone cut during PAN met head resection?

<p>30 degrees to the long axis of the metatarsal (B)</p> Signup and view all the answers

What is the purpose of longitudinally dividing the EDL and EDB tendons during PAN met head resection?

<p>To facilitate the resection of the metatarsal head (A)</p> Signup and view all the answers

Why is it important to free the soft tissue attachments to the head of the metatarsal during PAN met head resection?

<p>To facilitate the removal of the metatarsal head (A)</p> Signup and view all the answers

What is the purpose of using a bone rasp to smooth down the remaining metatarsal during PAN met head resection?

<p>To smooth down any prominent remaining metatarsal (D)</p> Signup and view all the answers

What is the advantage of using a midline incision for met heads 2/3, and 4/5?

<p>It allows for easier access to the metatarsal head (A)</p> Signup and view all the answers

What is the purpose of reflecting the soft tissue attachments to the head of the metatarsal during PAN met head resection?

<p>To facilitate the removal of the metatarsal head (B)</p> Signup and view all the answers

What is the primary approach to resecting the metatarsal heads during a Pan Met Head Resection?

<p>Resecting the lesser metatarsal heads working from medial to lateral (B)</p> Signup and view all the answers

What is the purpose of bending the wire and capping it after pinning the toes during a Pan Met Head Resection?

<p>To prevent the wire from sticking out of the toe (A)</p> Signup and view all the answers

What is the recommended depth of resection of the head of the proximal phalanx during a Pan Met Head Resection?

<p>About 5mm (B)</p> Signup and view all the answers

What is the primary goal of developing the first MTPJ incision during a Pan Met Head Resection?

<p>To fuse the first MTPJ (C)</p> Signup and view all the answers

What is the significance of the 'sharp part' being placed medial and dorsal during a Pan Met Head Resection?

<p>To reduce pressure on the toe pulp (A)</p> Signup and view all the answers

What is the purpose of using a Rongeur or reciprocating saw during a Pan Met Head Resection?

<p>To decompress the PIPJ (D)</p> Signup and view all the answers

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