Orthopedic Conditions Quiz

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Questions and Answers

What is the primary treatment method for olecranon bursitis?

Surgical intervention

Compression bandage and NSAIDs (correct)

Physical therapy

Steroid injection

In cases of cervical spondylosis, which imaging technique is preferred if a patient exhibits neck pain and is over 50 years old?

X-ray of the cervical spine

CT of the cervical spine

Ultrasound of the cervical spine

MRI of the cervical spine (correct)

What symptom would suggest neurogenic claudication in a patient with lumbar spinal stenosis?

Increased pain when leaning forward

Palpable peripheral pulses

Back pain that worsens when going downhill (correct)

Pain relieved by walking

Which imaging technique should be employed to assess atlantoaxial subluxation before surgery in a patient with RA?

Flexion/extension x-rays of the cervical spine Signup and view all the answers

Which demographic is most at risk for developing cervical spondylosis?

Patients over 50 years old Signup and view all the answers

What symptom indicates C7-T1 cervical foraminal stenosis?

Weakness of hand muscles and loss of sensation in the little finger Signup and view all the answers

What is the primary cause of neurogenic claudication in patients with lumbar spinal stenosis?

Nerve root compression Signup and view all the answers

Which condition is characterized as degeneration of the pars interarticularis component of the vertebral body?

Lumbar spondylolysis Signup and view all the answers

What is the mechanism behind Osgood-Schlatter disease?

Repeated stress on the growth plate of the tibia Signup and view all the answers

What would typically indicate a diagnosis of Morton neuroma?

Pain between the 2nd and 3rd metatarsals when wearing high-heel shoes Signup and view all the answers

What is the first step in the diagnosis of foot disorders like Morton neuroma?

X-ray to rule out arthritis or fractures Signup and view all the answers

Which ligament is most commonly injured during an ankle inversion injury?

Anterior talofibular ligament Signup and view all the answers

Which of the following describes the condition known as a neurogenic joint?

Characterized by lack of joint sensation due to peripheral neuropathy Signup and view all the answers

What are the Ottawa criteria used to assess?

Probability of ankle fracture and necessity of X-ray Signup and view all the answers

What is the treatment protocol suggested for conditions like Morton neuroma?

Orthotics and steroid injection Signup and view all the answers

What characterizes an ankle sprain?

Injury to ligaments holding bones together Signup and view all the answers

Which type of fracture is characterized by bending and breaking on one side, resembling a green branch?

Greenstick fracture Signup and view all the answers

What is the most common type of skull fracture associated with epidural hematoma?

Linear skull fracture Signup and view all the answers

What injury is characterized by bruising over the eyes and mastoid process?

Base of skull fracture Signup and view all the answers

What is the expected complication for a female long-distance runner with a metatarsal stress fracture?

Osteoporosis Signup and view all the answers

What is the common cause of a clavicular fracture?

Fall on outstretched hand Signup and view all the answers

What treatment is commonly used for a scaphoid fracture to prevent avascular necrosis?

Thumb-spica cast Signup and view all the answers

Which type of fracture would likely show a negative X-ray acutely?

Scaphoid fracture Signup and view all the answers

What presents with pain in the central palm following a fall on an outstretched hand, with no pain in the snuffbox?

Lunate fracture Signup and view all the answers

What is the most appropriate diagnosis for a 13-year-old boy with a painful gait and no mention of weight?

Slipped capital femoral epiphysis Signup and view all the answers

What X-ray finding is commonly associated with slipped capital femoral epiphysis?

Ice cream falling off the cone Signup and view all the answers

Which condition is indicated by 'contracted capital femoral epiphysis' seen in a 5-year-old patient?

Legg-Calvé-Perthes disease Signup and view all the answers

What is a key distinguishing feature when diagnosing juvenile idiopathic arthritis (JIA) compared to septic arthritis?

Intermittent or episodic pain Signup and view all the answers

What is the most specific antibody to be ordered for JRA?

Anti-cyclic citrullinated peptide (anti-CCP) Signup and view all the answers

Which laboratory finding is commonly associated with juvenile idiopathic arthritis?

Anemia of chronic disease Signup and view all the answers

What is the typical treatment for slipped capital femoral epiphysis?

Surgical pinning Signup and view all the answers

What would be observed in an arthrocentesis of a patient with juvenile idiopathic arthritis?

Leukocytes Signup and view all the answers

What condition can an indirect inguinal hernia be corrected by applying pressure at the deep inguinal ring?

Indirect inguinal hernia Signup and view all the answers

Which of the following describes a thyroglossal duct cyst?

Painless midline neck lump that moves with swallowing Signup and view all the answers

What is the first-line treatment for a hydrocele in a child under the age of one?

Observation Signup and view all the answers

In a newborn with a lateral neck mass that may be idiopathic, what is the likely diagnosis related to forceps delivery?

Branchial cleft cyst Signup and view all the answers

What adverse effect of bisphosphonates is often misunderstood among students preparing for exams?

Osteonecrosis of the jaw Signup and view all the answers

What embryological origin is associated with a thyroglossal duct cyst?

Endoderm of foramen cecum Signup and view all the answers

What is the mechanism of action of bisphosphonates in treating osteoporosis?

Inhibit osteoclasts Signup and view all the answers

What symptom can a lingual thyroid potentially cause in individuals?

Dysphagia Signup and view all the answers

Study Notes

Olecranon Bursitis

Treatment for olecranon bursitis is compression bandage and NSAIDs.
Steroid injections are not the correct treatment.

Cervical Spondylosis

Degeneration of the cervical spine, presenting as neck pain in patients over 50 years old.
Degenerative changes of the cervical spine are identifiable via MRI.
Can also occur in the lumbar spine.
Technically defined as degeneration of the pars interarticularis component of the vertebral body.
Increased mobility between the first (atlas) and second (axis) vertebrae.
High-yield topic for 2CK Surgery and Neurology exam forms, particularly in those with rheumatoid arthritis.

Atlantoaxial Subluxation

Must perform CT or flexion/extension x-rays of the cervical spine before surgery in patients requiring intubation.
MRI of the cervical spine is indicated when a patient with RA presents with upper limb paresthesias, implying atlantoaxial subluxation is already occurring.
Narrows the spinal canal.

Lumbar Spinal Stenosis

Presents as lower back pain in patients over 50, exacerbated by walking downhill, standing, or walking for extended periods.
Pain improves when leaning forward.
Can cause "neurogenic claudication", mimicking intermittent claudication, but with normal peripheral pulses.
Technically an osteoarthritic change of the spine, thus increased risk in obesity.

Cervical Foraminal Stenosis

Presents as difficulty fastening buttons, weakness of hand muscles, and loss of sensation in the little finger.
Classic presentation involves C7-T1 foraminal stenosis.

Osgood-Schlatter Disease

Inflammation of the patellar ligament at the tibial tuberosity.
Caused by repeated stress on the growth plate of the superior tibia.

Plantar Fasciitis

Presents as severe heel pain, worst when first getting out of bed in the morning.

Morton Neuroma

Abnormal growth between the 2nd and 3rd metatarsals, often exacerbated by high heels.
Benign growth/tumor of intertarsal nerve, cause is idiopathic.
Diagnosis confirmed by ultrasound showing thickening of interdigital/intertarsal nerve.
Treatment involves orthotics and steroid injection.

Neurogenic Joint

Also known as Charcot joint.
Joint injury caused by lack of joint sensation due to peripheral neuropathy.
Commonly seen in diabetes, also possible in neurosyphilis.
X-ray showing "disorganization of the tarsometatarsal joints" in diabetic patients.

Ankle Sprains

Sprain refers to ligament injury.
Anterior talofibular ligament is on the lateral side, injured with foot inversion.
Deltoid ligament is on the medial side, injured with ankle eversion.
Ottawa criteria are high-yield for family medicine, used to determine need for x-ray or supportive care.

Greenstick Fracture

Incomplete fracture in children's bones, bending and splintering on one side only.

Linear Skull Fracture

Most common type of skull fracture.
Associated with epidural hematoma.
Presents with Battle sign, raccoon eyes, rhinorrhea, and otorrhea.

Base of Skull Fracture

Presents as pain in the metatarsal area of the foot in long-distance runners with low BMI.

Metatarsal Stress Fracture

Long-distance runners with low BMI at risk of developing osteoporosis.

Clavicular Fracture

Occurs with fall on outstretched hand, or handlebar injury.
Most common fracture site is the middle-third of the clavicle.
Treatment involves a Figure-of-8 sling.

Scaphoid Fracture

Presents as pain over the anatomic snuffbox with fall on outstretched hand.
X-ray often negative acutely.
Requires thumb-spica cast to prevent avascular necrosis.

Lunate Fracture

Presents as pain in the central palm without pain over the anatomic snuffbox with fall on outstretched hand.

Hook of Hamate Fracture

Cause of distal ulnar nerve injury/Guyon canal syndrome.

Slipped Capital Femoral Epiphysis (SCFE)

Common in adolescents with painful gait.
X-ray shows “ice cream falling off the cone.”

Legg-Calve-Perthes Disease (LCP)

Affects children with contracted capital femoral epiphysis.
X-ray shows “ice cream slipping off its cone.”

Juvenile Idiopathic Arthritis (JIA)

Formerly juvenile rheumatoid arthritis.
Presents like adult RA but in children.
Differentiated from septic arthritis based on intermittent or episodic nature.
May present with low-grade fever, warm, red, painful joints.
Low-grade fever can occur in autoimmune flares.
"Salmon-pink" maculopapular rash present in approximately 50% of cases.
Anemia of chronic disease may present with low MCV.
Can be associated with serous pericarditis.
Arthrocentesis shows elevated leukocytes.
Anti-cyclic Citrullinated Peptide (anti-CCP) more specific than rheumatoid factor.
Management focuses on symptom control and disease progression.

Indirect Inguinal Hernia

Passes through the deep inguinal ring, can be reduced with pressure or a finger over the ring.

Direct Inguinal Hernia

Does not pass through the deep inguinal ring, will not reduce with pressure over the ring.
Treatment involves elective hernia repair.

Hydrocele

Observation is the treatment for children under 1 year old.

Thyroglossal Duct Cyst

Presents as painless, midline neck lump in children, moving upward with swallowing or tongue protrusion.
Located inferior to the hyoid bone.
Demonstrates uptake on Technetium-99 scan.
Embryologically arises from endoderm of foramen cecum.

Sternocleidomastoid Injury

Nodular mass in the lateral neck of an infant born with forceps delivery.

Branchial Cleft Cyst

Idiopathic lateral neck mass in infants, may or may not have an opening to the skin.

Lingual Thyroid

Presents as hypothyroidism and a midline neck lump located high in the neck.
May cause dysphagia, dysphonia, or dyspnea.

Alendronate

Bisphosphonate, inhibiting osteoclasts.
Used for osteoporosis after calcium and vitamin D supplementation.
Pamidronate, not alendronate, used for hypercalcemia after normal saline administration.
Osteonecrosis of the jaw is a rare side effect.

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Description

Test your knowledge on common orthopedic conditions such as olecranon bursitis, cervical spondylosis, and atlantoaxial subluxation. This quiz covers treatment options, diagnostic imaging, and important clinical considerations for these conditions. Perfect for medical students and healthcare professionals preparing for exams.