PTLE 2026 MSK LE Conditions

A comprehensive set of 100 flashcards covering lower extremity orthopedic conditions, diagnostic signs, and management protocols based on the MDPT lecture.

What is a Duverney’s fracture?

An isolated iliac wing fracture that is considered stable.

How is a Malgaigne fracture defined?

A double vertical fracture of the anterior and posterior pelvic ring that is considered unstable.

What is the muscle and site involved in an avulsion fracture of a sprinter coming out of the block?

Sartorius - ASIS ($Anterior$ $Superior$ $Iliac$ $Spine$)

Which muscle and site are associated with an avulsion fracture from a soccer player's forceful kick?

Rectus femoris - AIIS ($Anterior$ $Inferior$ $Iliac$ $Spine$)

What is the site of an avulsion fracture for a runner competing in the hurdles?

Hamstrings - ischial tuberosity

Which muscles and site are involved in an avulsion fracture for a tennis player changing directions?

Abdominals, gluteus medius, and tensor fasciae latae ($TL$) - iliac crest

What is the most common complication of pelvic fractures?

Bleeding

Which organs are commonly affected in pelvic fractures?

Urinary bladder and urethra

What is the most common complication of a femoral neck fracture?

Avascular necrosis

How is Osteitis Pubis described?

Inflammation of the symphysis pubis, occurring more in males than females.

What is a common cause of Osteitis Pubis in females?

Pregnancy due to increased relaxin.

What does an x-ray of Osteitis Pubis typically show?

A moth eaten appearance

What is the term for a ruptured ligament in the pubic area?

Diastasia Symphysis Pubis

What is the most common site of metastasis for Multiple Myeloma?

Innominate bone

What characterizes the pain in Multiple Myeloma?

Nocturnal nagging pain

What is the characteristic x-ray finding for Multiple Myeloma?

Mickey mouse lesion (punched out appearance)

What is a Hip Pointer Injury?

A contusion to the ASIS (or iliac crest) due to direct trauma.

How is true limb length discrepancy ($LLD$) measured?

From the ASIS to the medial malleolus.

How is apparent limb length discrepancy ($LLD$) measured?

From the umbilicus to the medial malleolus.

At what measurement is limb length discrepancy considered significant?

$$>2\,cm$$

In Anterior Innominate Syndrome ($ALSUP$), how does the affected leg appear in supine vs. sitting?

In supine the affected leg is longer; in sitting it is shorter.

In Posterior Innominate Syndrome ($PSSUP$), how does the affected leg appear in supine vs. sitting?

In supine the affected leg is shorter; in sitting it is longer.

What are three alternative names ($AKAs$) for Ischiogluteal Bursitis?

Boatman’s Bottom, Tailor’s Bottom, and Weaver’s Bottom.

What is Slipped Capital Femoral Epiphysis ($SCFE$)?

Downward slippage of the femoral head from the growth plate, moving downward and in external rotation ($ER$).

What is the most common hip pathology in adolescents?

Slipped Capital Femoral Epiphysis ($SCFE$)

What is Legg-Calve-Perthes Disease ($LCPD$)?

Avascular necrosis of the femoral head in children, often resulting in coxa plana.

What is Chandler’s Disease?

Avascular necrosis ($AVN$) of the femoral head in adults.

What are the typical physical characteristics of a child with $SCFE$?

Male, tall, and obese, usually aged $13-19$.

What are the typical physical characteristics of a child with $LCPD$?

Male, short, and thin, usually aged $4-8$ ($average: 7$).

What gait is associated with $LCPD$?

Psoatic gait

What gait is associated with $SCFE$?

Trendelenburg or Waddling gait

What is the best treatment duration for a $LCPD$ orthosis?

$$1-2\,yrs$$

Which orthosis for $LCPD$ is considered the most functional because it allows flexion?

Scottish Rite

In Waldenstrom Stages for $LCPD$, what is found in Stage I (Necrosis/Initial)?

Sagging rope sign (thin sclerotic line due to blood supply loss).

In Waldenstrom Stages for $LCPD$, what is found in Stage II (Fragmentation)?

Crescent sign leading to coxa plana.

What is Coxa Magna?

An enlarged femoral head.

What is Coxa Breva?

A short and broad femoral neck.

What is the purpose of Ortolani’s Test?

To evaluate a Congenital Hip Dislocation ($dislocated at birth$).

What is the purpose of Barlow’s Test?

To evaluate a Congenital Dislocatable Hip ($intact at birth but unstable$).

What is a Teratologic Hip Dislocation?

A fixed hip dislocation prenatally caused by arthrogryposis multiplex congenita.

What is Acetabular Dysplasia?

A shallow hip socket caused by an absent cotyloid ligament.

What are the movements allowed by the Pavlik Harness?

Hip flexion, abduction, and external rotation ($FABER$).

What is a dashboard injury often associated with in young patients?

Posterior hip dislocation or $PCL$ injury due to a motor vehicle accident ($MVA$).

Which THA approach is most common?

Posterolateral approach

In THA, what does $PMMA$ stand for?

PolyMethyl Meth-Acrylate

What is the weight-bearing protocol for a cemented THA?

As tolerated within $<24\,hrs$.

What is the weight-bearing protocol for a non-cemented THA?

Limited up to $3\,mos$ (at least $6\,wks$).

What are the hip precautions for a posterolateral approach THA?

No hip flexion $>90^{\circ}$, no adduction, and no internal rotation ($IR$).

What is a specific contraindication for THA if the Gluteus Medius was incised?

Abduction

What is the normal adult Neck-Shaft Angle?

$125^{\circ}$ ($range: 120-135^{\circ}$)

In Coxa Vara, how is the leg length and hip rotation characterized?

Shorter leg length with internal rotation ($IR$).

What does the mnemonic PISA stand for in relation to Coxa Valga?

Pronated foot, Internal rotation, Shorter, APT ($Anterior$ $Pelvic$ $Tilt$).

What is the normal adult Torsion Angle of the hip?

$15^{\circ}$ ($range: 8-15^{\circ}$)

What special test is used to measure the torsion angle?

Craig’s or Ryder’s Test

What knee finding is associated with hip Anteversion?

Squinting Patella

What knee finding is associated with hip Retroversion?

Frog’s Eye or Grasshopper’s Eye Patella

What is Internal Snapping Hip caused by?

A tight iliopsoas or iliofemoral ligament hitting the iliopectineal line or hip capsule.

What is the most common type of snapping hip?

External Snapping Hip (tight $ITB$ hitting the greater trochanter).

What is Meralgia Paresthetica?

Impingement of the lateral femoral cutaneous nerve at the inguinal ligament.

Which muscle is the most commonly strained in the lower extremity?

Hamstrings

What is the MOI for an adductor longus strain?

Forceful abduction

What is the most common site for a muscle contusion, also known as a 'Charlie Horse'?

Quadriceps (rectus femoris).

Where are the most common sites for Heterotrophic Ossification in SCI and Burns?

Hip for $SCI$; posterior elbow for burns.

What medication is used for Heterotrophic Ossification?

Disodium etidronate

What is Myositis Ossificans ($MO$)?

Abnormal bone growth in the muscle caused by trauma or contusion.

What is a major contraindication in the management of Myositis Ossificans?

Passive ROM, stretching, and massage.

What is Osgood-Schlatter Disease?

Inflammation of the patellar tendon at the tibial tuberosity, causing bilateral enlargement.

How is Jumper’s Knee defined?

Patellar tendinitis (inflammation of any part of the tendon), commonly in adults.

What patellar position is associated with a Patellar Tendon Tear?

Patella alta ($movable patella$).

What patellar position is associated with a Quadriceps Tendon Tear?

Patella baja ($immovable patella$).

Where is the most common site for Osteochondritis Dissecans ($OCD$)?

Lateral aspect of the medial femoral condyle.

What is Sinding-Larsen Johansson Disease?

A lesion at the inferior pole of the patella.

What is Hoffa’s Disease?

Impingement of the infrapatellar fat pad between the femur and tibia.

What is the Cinema sign (or Theater sign)?

Pain during prolonged sitting associated with Chondromalacia Patella ($PFPS$).

Which muscle weakness is targeted for strengthening in $PFPS$?

$VMO$ ($Vastus$ $Medialis$ $Obliquus$)

What is the most common deformity associated with Knee Osteoarthritis?

Genu varum

What is Pelligrini-Stieda Disease?

Ossification of the $MCL$ ($Medial$ $Collateral$ $Ligament$).

In the Unhappy Triad, which three structures are injured?

$MCL$, $ACL$, and medial meniscus.

What are the three most common mechanisms of injury for the $PCL$?

Dashboard injury, kicked in the shin, or falling on a flexed knee with a $PF$ ($plantarflexed$) ankle.

What is the 'Gold Standard' graft for $ACL$ reconstruction?

Bone-Patellar Tendon-Bone Graft

What is the strengthening protocol for an $ACL$ injury?

Hamstrings $>$ Quadriceps

What is the strengthening protocol for a $PCL$ injury?

Quadriceps $>$ Hamstrings

What is the most common cause of Genu Recurvatum?

Weak or paralyzed quadriceps (e.g., polio) or spasticity (e.g., $CVA$).

Which bursa inflammation is known as Housemaid’s Knee?

Prepatellar Bursitis

Which bursa inflammation is known as Nun’s Knee or Clergyman’s Knee?

Superficial Infrapatellar Bursitis

What are the components of Miserable Malalignment Syndrome?

Broad pelvis, increased anteversion, increased Q-angle, genu valgum, patella alta, external tibial torsion, and subtalar pronation.

What is Blount’s Disease?

Growth arrest at the medial tibial physis (media tibial shaft), also called tibia vara.

Which nerve and muscle are most commonly affected in Anterior Compartment Syndrome?

$DPN$ ($Deep$ $Peroneal$ $Nerve$) and $TA$ ($Tibialis$ $Anterior$).

What is the characteristic x-ray finding for a stress fracture?

Dreaded black line

What activity causes Medial Tibial Stress Syndrome ($MTSS$) or 'Shin Splints'?

Toe Running (overactivity of Tibialis Posterior).

What test is used to identify an Achilles tendon rupture?

Thompson Test

What is Haglund’s Disease ($Pump Bump$)?

A bony prominence at the posterior heel caused by shoes like pumps or boots.

What is Sever’s Disease?

Calcaneal Apophysitis; inflammation of the growth plate at the insertion of the Achilles tendon on the calcaneus.

What are the common symptoms of Plantar Fasciitis?

Pain with the first step in the morning and pain at the medial calcaneus.

What is the position of the foot in Talipes Equinovarus ($Clubfoot$)?

Adduction, Inversion, and Plantarflexion ($AIP$).

What is the cause of Pes Planus ($Flat foot$)?

Collapsed medial longitudinal arch ($MLA$), often due to lax spring ligament.

What is Morton’s Neuroma?

A benign tumor of the 3rd interdigital nerve, causing pain between the 3rd and 4th toes.

What monofilament gauge is used to identify a loss of protective sensation in a diabetic foot?

$5.07$ gauge ($exerts 10\,g of force$).

In the Wagner Classification of Foot Ulcers, what does Grade 3 represent?

Deep ulcer with osteomyelitis and abscess.

In the Wagner Classification of Foot Ulcers, what does Grade 4 represent?

Gangrene of the partial foot.