ORTHOPEDIC CERTIFIED SPECIALIST
PREP (2025)LATEST UPDATE
Ottowa Ankle Rules - ANSWER -1: Inability to bear wt after injury and at ED or take 3-5
steps
-2: Bony tenderness over and distal medial malleolus
-3: Bony tenderness over and distal lateral malleolus
-4: Tenderness over base of 5th MT
Diag of ACL Tear - ANSWER -MOI of dec/acceleration w/ valgus load @ or near full
extension
-Hearing/feeling "pop"
-Hemarthrosis 0-12hrs post-injury
-Hx buckling w/ 1 or more ADLs
-+ Lachman and pivot shift
-6m SLS hop test <80% c/l limb
Diag PCL Tear - ANSWER -MOI posterior directed force on prox tib; fall on flexion knee
or hyper-ext of knee
-Localized post. knee pain w/ kneeling or decceleration
- +Posterior Sag sign
Ottowa Knee Rules - ANSWER 1. age > 55
2. isolated tenderness of the patella
3. tenderness of the fibular head
4. inability to flex knee to 90
5. inability to bear weight immediately or take 4 steps
Diag Medial Meniscus Tear - ANSWER -MOI twisting injury w/ tear sensation
-Delayed effusion (6-24hrs)
-Hx catching/locking
-Jt. line tenderness
-Pain with forced hyperextension and max knee flexion
-+McMurray's
Diag Articular Cartilage Defect - ANSWER -MOI acute trauma w/ hemarthrosis (0-2hrs)
(assoc. with osteochondral fx)
-insidious onset aggravated by repetitive impact
-intermittent pain and edema
-Hx catching/locking
-Jt. line tenderness
Diag PFP - ANSWER -Presence of retro/peri-patellar pain
, -Reproduction of pain with squatting, stairs, prolonged sitting, other rotation activities in
flexion
-AND exclusion of all other conditions
Hip OA Cluster - ANSWER - >50 years old
-Moderate ant. or lat. hip pain with WB activities
-Morning stiffness less than 1 hr.
-Hip IR rot <24 degrees OR IR rot AND hip flex <15 degrees that c/l limb
-Increased hip pain with PROM IR rot
Subacromial Impingement Syndrome Cluster - ANSWER 3 or more of the following:
-Pain with Ex rot MMT*
-+Painful arc*
-+Hawkins-Kennedy*
-+Neer
-+Jobe (empty can)
*increased LR if these are positive*
Full Thickness RTC Cluster - ANSWER -Pain with Ex rot MMT*
-+Painful arc*
-+drop arm test*
Primary SIS (Neer's Classification) Stage 1 - ANSWER Mechanical irritation of tendon
w/ OH activities; younger/athletic population
Primary SIS (Neer's Classification) Stage 2 - ANSWER Repeated episodes of
mechanical irritation, thickening of fibrosis f SubA bursa; 25-40yo
Primary SIS (Neer's Classification) Stage 3 - ANSWER Continued mechanical
compression of RTC; RTC tears and biceps tendon lesion and bony spurs; 40yo+
Secondary SIS - ANSWER Underlying instability of GH that causes associated
dysfunction of static stabilizers
TUBS - ANSWER Traumatic
Unidirectional
Bankart
Surgery
AMBRI - ANSWER Atraumatic
Multidirectional
Bilateral
Rehabilitation
Inferior capsular shift
CPG for tx manip for shoulder pain - ANSWER -Pain-free flexion <127 degrees
PREP (2025)LATEST UPDATE
Ottowa Ankle Rules - ANSWER -1: Inability to bear wt after injury and at ED or take 3-5
steps
-2: Bony tenderness over and distal medial malleolus
-3: Bony tenderness over and distal lateral malleolus
-4: Tenderness over base of 5th MT
Diag of ACL Tear - ANSWER -MOI of dec/acceleration w/ valgus load @ or near full
extension
-Hearing/feeling "pop"
-Hemarthrosis 0-12hrs post-injury
-Hx buckling w/ 1 or more ADLs
-+ Lachman and pivot shift
-6m SLS hop test <80% c/l limb
Diag PCL Tear - ANSWER -MOI posterior directed force on prox tib; fall on flexion knee
or hyper-ext of knee
-Localized post. knee pain w/ kneeling or decceleration
- +Posterior Sag sign
Ottowa Knee Rules - ANSWER 1. age > 55
2. isolated tenderness of the patella
3. tenderness of the fibular head
4. inability to flex knee to 90
5. inability to bear weight immediately or take 4 steps
Diag Medial Meniscus Tear - ANSWER -MOI twisting injury w/ tear sensation
-Delayed effusion (6-24hrs)
-Hx catching/locking
-Jt. line tenderness
-Pain with forced hyperextension and max knee flexion
-+McMurray's
Diag Articular Cartilage Defect - ANSWER -MOI acute trauma w/ hemarthrosis (0-2hrs)
(assoc. with osteochondral fx)
-insidious onset aggravated by repetitive impact
-intermittent pain and edema
-Hx catching/locking
-Jt. line tenderness
Diag PFP - ANSWER -Presence of retro/peri-patellar pain
, -Reproduction of pain with squatting, stairs, prolonged sitting, other rotation activities in
flexion
-AND exclusion of all other conditions
Hip OA Cluster - ANSWER - >50 years old
-Moderate ant. or lat. hip pain with WB activities
-Morning stiffness less than 1 hr.
-Hip IR rot <24 degrees OR IR rot AND hip flex <15 degrees that c/l limb
-Increased hip pain with PROM IR rot
Subacromial Impingement Syndrome Cluster - ANSWER 3 or more of the following:
-Pain with Ex rot MMT*
-+Painful arc*
-+Hawkins-Kennedy*
-+Neer
-+Jobe (empty can)
*increased LR if these are positive*
Full Thickness RTC Cluster - ANSWER -Pain with Ex rot MMT*
-+Painful arc*
-+drop arm test*
Primary SIS (Neer's Classification) Stage 1 - ANSWER Mechanical irritation of tendon
w/ OH activities; younger/athletic population
Primary SIS (Neer's Classification) Stage 2 - ANSWER Repeated episodes of
mechanical irritation, thickening of fibrosis f SubA bursa; 25-40yo
Primary SIS (Neer's Classification) Stage 3 - ANSWER Continued mechanical
compression of RTC; RTC tears and biceps tendon lesion and bony spurs; 40yo+
Secondary SIS - ANSWER Underlying instability of GH that causes associated
dysfunction of static stabilizers
TUBS - ANSWER Traumatic
Unidirectional
Bankart
Surgery
AMBRI - ANSWER Atraumatic
Multidirectional
Bilateral
Rehabilitation
Inferior capsular shift
CPG for tx manip for shoulder pain - ANSWER -Pain-free flexion <127 degrees
