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31 Cards in this Set
- Front
- Back
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Lower back pain red flags |
Age < 20 years and > 50 years History of malignancy Night pain Trauma history Systemically unwell |
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Facet joint pain |
Worse on extension Worse in morning and on standing Acute or chronic Pain over the facets Normal straight leg raise |
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Prolapsed lumbar disc |
Dermatomal leg pain with associated neurological deficits Leg pain worse than back Pain worse when sitting |
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L3 nerve root compression |
Sensory loss - anterior thigh Weak quadriceps Reduced knee reflex Positive femoral stretch test |
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L4 nerve root compression |
Sensory loss - anterior knee Weak quadriceps Reduced knee reflex Positive femoral stretch test |
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L5 nerve root compression |
Sensory loss - dorsal foot Weakness in foot and big toe dorsiflexion Reflexes intact Positive straight leg raise |
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S1 nerve root compression |
Sensory loss - posterior lateral aspect of leg and dorsal of foot Reduced plantar flexion of foot Reduced ankle reflex Positive straight leg raise |
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Ankle reflex |
S1-S2 |
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Knee reflex |
L3-L4 |
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Biceps |
C5-C6 |
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Triceps |
C7-C8 |
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Spinal stenosis |
Gradual onset Unilateral or bilateral leg pain, numbness and weakness that is worse on walking Resolves when sits down MRI - diagnosis |
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Peroneal nerve lesion |
Foot-drop Weakness of foot eversion Weakness of extensor hallucis longus Sensory loss - lower leg and foot dorsum Wasting of anterior tibial and peroneal muscles |
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Metastatic bone cancers |
Prostate Breast Lung Kidney Thyroid |
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Cancer and symptoms for urgent MSCC |
Pain in thoracic or cervical spine Severe unremitting lower spinal pain Pain aggrevated by straining Localised spinal tenderness Nocturnal pain preventing sleep |
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Cancer and symptoms for immediate MSCC |
Neurological symptoms and signs |
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Ulnar nerve damage at wrist |
Claw hand Wasting and paralysis of hypothenar and intrinsic hand muscles Sensory loss to medial 1.5 fingers |
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Ulnar nerve damage at elbow |
Claw hand Wasting and paralysis of hypothenar and intrinsic hand muscles Sensory loss to medial 1.5 fingers Radial deviation of wrist |
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Trigger finger |
Abnormal flexion of digits |
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Lateral epicondylitis |
Tennis elbow Pain over lateral epicondyle Elbow extended - pain on wrist extension or supination Mx - rest, physio, analgesia, steroid injection |
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Radial nerve palsy |
Wrist drop Sensory loss to small area of dorsal aspect between 1st and 2nd metacarpals Triceps paralysis |
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Medial epicondylitis |
Golfers elbow Pain over medial epicondyle Pain aggrevated by wrist flexion and pronation Tingling/numbness in 4th and 5th digit if ulnar nerve involvement |
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Morton's neuroma |
Forefoot pain - 3rd metatarsal Shooting or burning pain - worse on walking Pebble in shoe Loss of sensation distally Mx - modify footwear, refer if > 3 months - steroid injection or surgery |
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Slipped upper femoral epiphysis |
Obese 10-15 year old boys Knee or distal thigh pain Loss of internal rotation of leg in flexion |
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Talipes equinovarus |
Clubfoot Inverted and plantar flexed not correctable Twice as common in males 50 % bilateral Idiopathic Associations - spina bifida, cerebral palsy, trisomy 18, oligohydramnios. |
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Ankle injury - Ottawa rule |
X-ray is only required if inability to weight bear immediately after injury and at assessment OR there is tenderness along the distal 6cm of the posterior edge of the tibia or fibula or distal tip of either malleoli. |
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Developmental dysplasia of the hip |
1-3 % newborns Risk factors - female (6x), breech, fhx, 1st borns, oligohydramnios, weight > 5kg, club foot. 20 % bilateral Barlow test - attempt to dislocate articulated femoral head Ortolani test - attempt to relocate a dislocated femoral head |
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Adhesive capsulitis |
Frozen shoulder Females and diabetics External rotation - passive and active Frozen, adhesive and recovery phases - 6 months - 2 years Mx - NSAIDS, physio, oral and intra-articular corticosteroids |
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Median nerve damage |
Wrist - carpal tunnel - paralysis and wasting of thenar eminence muscles, sensory loss to lateral 3.5 fingers Elbow - unable to pronate forearm, weak wrist flexion, ulnar deviation of the wrist. |
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Ankylosing Spondylitis |
Reduced lumbar lateral flexion Males 20-30 years Reduced forward flexion - schobers test Reduced chest explansion |
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Ankylosing Spondylitis Associated Features |
Apical fibrosis Anterior uveitis Aortic regurgitation Achilles tendonitis AV node block Amyloidosis Cauda equina syndrome Peripheral arthritis |
