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</p> Signup and view all the answers

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

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

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

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

    Which of the following is a characteristic of flexor substitution?

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

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

    <p>Clawtoe</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</p> Signup and view all the answers

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

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

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

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

    What is the significance of flexible deformity in extensor substitution?

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

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

    <p>It indicates flexor substitution</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%</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</p> Signup and view all the answers

    What is Blue Toe usually indicative of?

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

    What is the recommended management for White Toe?

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

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

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

    In which digits is arthrodesis traditionally avoided?

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

    What is the primary goal of syndactylization procedure?

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

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

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

    What is the primary indication for metatarsal osteotomy procedure?

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

    What is the result of structurally dorsiflexed central metatarsals?

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

    What is the significance of 'Equinus' in metatarsalgia?

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

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

    <p>Hypointensity</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</p> Signup and view all the answers

    What is the potential consequence of sesamoidectomy?

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

    What is the indication for sesamoidectomy?

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

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

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

    What is the primary goal of treatment for stress fractures?

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

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

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

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

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

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

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

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

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

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

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

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

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

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

    <p>Dorsal</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</p> Signup and view all the answers

    What is the mainstay of treatment for stress fractures?

    <p>Immobilization</p> Signup and view all the answers

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

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

    What is the primary goal of treatment for metatarsal fractures?

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

    What is a common complication of neurectomy?

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

    What is a common feature of intermetatarsal neuroma on MRI?

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

    Which imaging modality is most useful for diagnosing intermetatarsal neuroma?

    <p>Ultrasound</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</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</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</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</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</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</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</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</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</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</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</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</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</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</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</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</p> Signup and view all the answers

    What is a characteristic of late-stage Predislocation syndrome?

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

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

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

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

    <p>Ultrasound</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</p> Signup and view all the answers

    What is the characteristic of the plantar plate in anatomy?

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

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

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

    What is a characteristic symptom of capsulitis/synovitis?

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

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

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

    What is the radiographic finding often seen in Predislocation Syndrome?

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

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

    <p>Nonspecific</p> Signup and view all the answers

    What is the radiographic feature associated with Psoriatic Arthritis?

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

    What is Freiberg's infarction?

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

    What is the percentage of PA patients with nail psoriasis?

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

    What is the characteristic clinical finding of Psoriatic Arthritis?

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

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

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

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

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

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

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

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

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

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

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

    What is the primary association with capsulitis/synovitis?

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

    What is the normal range for ESR in adults?

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

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

    <p>CRP</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</p> Signup and view all the answers

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

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

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

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

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

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

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

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

    What is the normal range for ESR in women?

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

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

    <p>To diagnose rheumatoid arthritis</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%</p> Signup and view all the answers

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

    <p>Lung</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</p> Signup and view all the answers

    What is the preferred treatment for symptomatic rheumatoid nodules?

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

    What is the appearance of rheumatoid nodules on ultrasound?

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

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

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

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

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

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