Soft tissue injuries.
Both of these men have suffered the same injury caused by forced extension of the arm. What is it?
The biceps muscle has one short head tendon attached to the radial tuberosity. Rupture causes the "popeye" sign due to bunching of the biceps muscle. Surgery is recommended for younger active patients to preserve supination.
Which of the following best describes a "frozen shoulder"?
Unknown cause. 4 phases---Prefreezing, Freezing, Frozen and Thawing. The whole process generally takes 6mths to 2yrs. Occasionally steroid injections +/- manipulation under anaesthesia may be used. (Remind me to tell you how my wifes frozen shoulder improved after being struck by a llama in Peru).
What are the three important ligaments making up the lateral ligament complex of the ankle?
ATFL = Anterior talofibular ligament (most commonly injured). CFL = Calcaneofibular ligament. PTFL = Posterior talofibular ligament (strongest of the lateral ligaments).
Which is NOT a recognised other name for "Tennis elbow"?
Medial epicondylitis is obviously on the medial not lateral side and is known as "Golfer's elbow".
Which direction does your head go in acute adult torticollis?
Simple torticollis--say after sleeping awkwardly can be treated by NSAIDs, warm compresses and massage. The splint shown may be useful for some persistant cases where there is no significant underlying cause (eg infection).
According to the ACI which of the following is NOT in their list of "Red flags" in acute lower back pain?
Their cut off in regards to an age is <16yrs and >50yrs---which means I will be "red flagged" if I turn up in ED with back pain.
What should you suspect in a patient who has "rolled" their ankle but the pain and tenderness is maximal between the tibia and fibula above the ankle joint. They cannot weight bear.
Invariably associated with an Anterior Tibiofibular Ligament rupture. Often will need stress xrays or MRI to show it but it is important to note as it needs orthopaedic surgical review.
You suspect "compartment syndrome" in the anterior compartment of the lower leg following a crush injury. Which of the following would you expect to find?
Remember the 6Ps--Pain (especially on passive stretching), Pallor, Paresthesia, Pulselessness, Paralysis, Perishingly cold.
What injury has this man suffered?
Bench pressing is a classic way to rupture pectoralis major.
There are all sorts of variants from partial to complete tendon ruptures or bony avulsions. MRI is the imaging of choice. Often surgery is the best option especially in young fit people.
What is the name of the haematoma that can happen in the back when the skin and subcutaneous tissue is ripped off from the underlying fascia?
I had not heard of it until we recently had a patient with an extensive haematoma suprisingly from rapid flexion falling off a swing. (US shown is not hers)