Rosh Review- Musculoskeletal
What presents with middle-aged man, complaining of acute onset of pain in the first
MTP?
Dx and TX? - ANS-PODAGRA (Gouty Arthritis)
Dx:
Labs:
NEEDLE-SHAPED crystal NEGATIVE birefringence
URIC ACID CRYSTALS
TX:
Acute: NSAID's!!!
May have nodular tophi accumulations at joints
What is is lice infestation characterized by superficial pruritus and secondary skin
infection? - ANS-Pediculosis
Tx:
Permethrin 1%
What is vitamin B3 (niacin) deficiency, characterized by diarrhea, dermatitis and
dementia? - ANS-Pellagra
What presents with pain, paresthesias, and numbness to volar aspect of fingers 1-4?
Dx and Tx? - ANS-Carpal Tunnel!
Affects Median Nerve
Dx:
Phalens--> Dorsal flexed hands for 60 seconds
Tinnel's --> Tapping volar aspect
, TX:
VOLAR splint in Neutral position, NSAIDs
Steroid injection
What presents with pain with brushing hair or teeth, pain at night when rolling onto
shoulder, baseball pitchers?
Pain with hands over head
Dx and Tx? - ANS-Rotator Cuff Tear
Dx:
Neer + Hawkin test
Tx:
Surgery
What are muscles of rotator cuff? - ANS-Supraspinatous, Infraspinatous, Subscapularis,
and Teres Minor
What presents with Women in 20s/30s, aIl destruction of synovial joints, morning
stiffness lasting > 30 minutes, MCP, PIP, Bilateral ulnar deviation at MCP, Baker's cyst
and Systemic sx?
Dx and Tx? - ANS-Rheumatoid Arthritis!
Involves MCP and PIP, all over systemic pain in joints
DX:
Lung: interstitial fibrosis, effusions
Spine: atlantoaxial joint subluxation; cord/vertebral artery compression
Anemia
Tx:
NSAIDs
What signs and symptoms are consistent with a L5 radiculopathy? - ANS-Pain radiates
down lateral aspect of the leg into the foot
Weakness with foot dorsiflexion
What presents with middle-aged man, complaining of acute onset of pain in the first
MTP?
Dx and TX? - ANS-PODAGRA (Gouty Arthritis)
Dx:
Labs:
NEEDLE-SHAPED crystal NEGATIVE birefringence
URIC ACID CRYSTALS
TX:
Acute: NSAID's!!!
May have nodular tophi accumulations at joints
What is is lice infestation characterized by superficial pruritus and secondary skin
infection? - ANS-Pediculosis
Tx:
Permethrin 1%
What is vitamin B3 (niacin) deficiency, characterized by diarrhea, dermatitis and
dementia? - ANS-Pellagra
What presents with pain, paresthesias, and numbness to volar aspect of fingers 1-4?
Dx and Tx? - ANS-Carpal Tunnel!
Affects Median Nerve
Dx:
Phalens--> Dorsal flexed hands for 60 seconds
Tinnel's --> Tapping volar aspect
, TX:
VOLAR splint in Neutral position, NSAIDs
Steroid injection
What presents with pain with brushing hair or teeth, pain at night when rolling onto
shoulder, baseball pitchers?
Pain with hands over head
Dx and Tx? - ANS-Rotator Cuff Tear
Dx:
Neer + Hawkin test
Tx:
Surgery
What are muscles of rotator cuff? - ANS-Supraspinatous, Infraspinatous, Subscapularis,
and Teres Minor
What presents with Women in 20s/30s, aIl destruction of synovial joints, morning
stiffness lasting > 30 minutes, MCP, PIP, Bilateral ulnar deviation at MCP, Baker's cyst
and Systemic sx?
Dx and Tx? - ANS-Rheumatoid Arthritis!
Involves MCP and PIP, all over systemic pain in joints
DX:
Lung: interstitial fibrosis, effusions
Spine: atlantoaxial joint subluxation; cord/vertebral artery compression
Anemia
Tx:
NSAIDs
What signs and symptoms are consistent with a L5 radiculopathy? - ANS-Pain radiates
down lateral aspect of the leg into the foot
Weakness with foot dorsiflexion
