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Clinical Methods - MSK/Rheum
Terms in this set (27)
What are contraindications to a joint aspiration?
Circumstances that would facilitate seeding of bacteria into the joint (burns, infected skin, arthroplasty)
Relative: anticoagulation out of therapeutic range
Where do you draw a line before a joint aspiration?
Lateral margin of patella to intersect with the line of the superior patellar margin
What are the characteristics of septic synovial fluid?
PMN Leukocytes: >75
What are the most common steroids used in injections?
Triamcinolone (moderate onset, intermediate acting)
Betamethasone (fast onset, long duration, most potent)
What are the general recommendations on how many injections?
Large joints: limit 4/year, max 10
Small joints: limit 3/year, max 4
What is a post-injection flare?
Reaction caused by development of steroid crystals
Occurs 6-24 hours after injection
Usually resolves in 48 hours
Consider aspiration to rule out infection if persists over 4 days
How deep must you insert the needle on a knee injection?
1.5-2 inches to get past the fat pad
(medial femoral condyle, medial tibial plateau, fat pad)
Do you use epinephrine before a toenail removal?
When does cautery need to be avoided in subungual hematoma trephination?
What is the most common complication of subungual hematoma trephination?
Permanent nail deformity
What Salter Harris type is a fracture straight through the epiphyseal plate?
What Salter Harris type is a fracture through the epiphyseal plate and metaphysis?
What Salter Harris type is a fracture through the epiphyseal plate and the epiphysis?
What Salter Harris type is a fracture through the epiphyseal plate, metaphysis, and epiphysis?
What Salter Harris type is a crush injury of the epiphysis?
What is a distal radius fracture with posterior/dorsal angulation?
What is a distal radius fracture with ventral/anterior angulation?
What is the most common cause of a shoulder dislocation?
Fall on outstretched arm in abduction and extension
What is the Stimson Technique used for?
Reduction of shoulder dislocation
What type of splint is used for a scaphoid fracture?
Thumb Spica Splint
(immobilizes wrist and thumb)
When are casts contraindicated? What should be used instead?
Acute injury phase (3-4 days) for swelling
Known soft tissue infection/open wound would be concealed
Use splint instead! Allows for swelling and checking on wounds/signs of infection
What is the most serious complication of casting?
(build up of pressure within soft tissues that can cut off blood supply)
What is the most predictive symptom of compartment syndrome?
Pain that increases over time and is out of proportion to the severity of the injury
What is the treatment for compartment syndrome?
Bivalving the cast
IV fluids, oxygen, analgesics
What is the post cast application assessment?
Position of function
Extent of immobilization
Who is a T score or Z score used for when assessing DEXA scan results?
T score (osteoporosis): postmenopausal, men
Z score (relative to healthy young control): pre-menopause
What T score is diagnostic for osteoporosis?
≤ - 2.5
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