Lecture Notes: Orthopaedics and Rheumatology Review

Comprehensive vocabulary flashcards covering orthopaedic terminology, fracture classifications, metabolic bone diseases, rheumatology, and pediatric conditions based on the lecture notes.

Osteotomy

The surgical cutting of a bone or removal of a piece of bone.

Arthrodesis

The surgical immobilization of a joint by fusion of the adjacent bones.

Neurapraxia

A mild peripheral nerve injury with burning, stinging, and pain characterized by reversible damage.

Axonotmesis

A moderate nerve injury affecting the axon and the myelin sheath.

Neurotmesis

A severe nerve injury involving the complete transection of the nerve.

Rule of two’s

The x-ray protocol requiring two views, two joints, two limbs, two injuries, and two occasions.

Avulsion Fracture

A fracture pattern where a muscle, ligament, or tendon pulls off a fragment of bone.

LARA

A mnemonic for fracture displacement: Length, Angulation, Rotation, Apposition, and Translation.

Fracture Consolidation

The stage of healing where woven bone replacement occurs until the fracture is solidly united.

Salter-Harris Classification

A system used for identifying injuries of the growth plate in pediatric patients (Types I-V).

Meralgia parasthetica

Entrapment of the lateral femoral cutaneous nerve under the inguinal ligament causing anterior and lateral thigh pain.

Piriformis Syndrome

Compression of the sciatic nerve at the level of the piriformis muscle or ischial tuberosity.

Tinel sign

Tingling and pricking over the affected nerve distribution upon percussion.

Tarsal Tunnel Contents

Components include the Tibial nerve, Posterior tibial artery, FHL tendon, FDL tendon, and Tibialis posterior tendon.

Mulders click

Subluxation of a neuroma between metatarsal heads, associated with Morton's neuroma.

ORIF

Open Reduction Internal Fixation; a surgical method to stabilize fractures using plates and screws.

Intracapsular Hip Fractures

Fractures proximal to the intertrochanteric line (head and neck) that disrupt femoral circumflex arteries and carry a high risk of avascular necrosis.

Schatzker Type I

A pure split of the lateral tibial plateau.

Bipartite patella

An incomplete fusion of the patella, which must be ruled out during x-ray for patellar fractures.

Meniscus Blood Supply

Supplied by the genicular artery, moving from the periphery to the central region.

McMurray Test

A test for meniscus lesions involving internal rotation and varus stress (LM) or external rotation and valgus stress (MM) while extending a flexed knee.

Apley’s Grinding Test

A meniscus test performed prone with the knee flexed at $90^{\circ}$, involving rotation with distraction then compression force.

Delayed Onset Muscle Soreness (DOMS)

Muscle pain caused by tissue breakdown products that sensitize pain receptors following exercise.

Gower’s sign

A clinical indicator of proximal muscle weakness where a patient must 'climb up' their own body to stand; seen in Duchenne Muscular Dystrophy.

Duchenne Muscular Dystrophy

An X-chromosome linked recessive disorder caused by a defect in the dystrophin gene, leading to muscle fibrosis and pseudohypertrophy of the calves.

Parathyroid Hormone (PTH)

A hormone that finetunes serum levels to $\uparrow$ calcium and $\downarrow$ phosphorus.

Calcitonin

A hormone from the parafollicular cells of the thyroid that lowers blood calcium levels in children.

Hypercalcaemia Clinical Mnemonic

Known as 'stones, bone, groans (abdominal, psychic)' including renal stones and muscle weakness.

Osteons

The fundamental unit of compact bone (Haversian systems) containing type I collagen with hydroxyapatite.

Wolff’s Law

The principle that bone grows and remodels in response to the forces and mechanical stresses put on it.

Supraspinatus

A rotator cuff muscle responsible for initiating arm abduction from $0-15^{\circ}$.

Painful Arc Syndrome

A clinical sign where pain occurs during active abduction between $60^{\circ}-120^{\circ}$.

Adhesive Capsulitis

Commonly known as Frozen Shoulder; characterized by progressive pain and stiffness that resolves in $18-24$ months.

Cubitus Varus

A 'gun stock' deformity of the elbow usually caused by a supracondylar fracture.

De Quervain’s tenosynovitis

Stenosing tenosynovitis of the first dorsal compartment, resulting in positive Finkelstein test results.

Heberden’s Nodes

Bony swellings at the distal interphalangeal (DIP) joints associated with osteoarthritis.

Erb’s Palsy

A brachial plexus injury (C5, C6) resulting in a 'waiter’s tip' limb position (shoulder adduction and internal rotation).

Developmental Dysplasia of Hips (DDH)

A disorder of hip development in infants involving instability or dislocation, identified by Ortolani or Barlow tests.

Loder’s Classification

A system for Slipped Upper Femoral Epiphysis (SUFE) categorized into stable and unstable slips.

Legg-Calve Perthe’s Disease

Osteonecrosis of the femoral epiphysis, typically occurring in children aged $5-8$ years.

Clubfoot CAVE Mnemonic

Clinical components including Cavus (high arch), Adduction (midfoot), Varus (hindfoot), and Equinus (plantar flexed).

Spina Bifida Occulta

Unfused vertebral arches especially at $L5$ and $S1$, often associated with a tuft of hair or skin discoloration.

Kocher’s Criteria

Diagnostic markers for septic arthritis: fever ($> 38.5^{\circ}C$), inability to bear weight, ESR $> 40$, and WBC $> 12\,000$.

Cobb Angle

A measurement used to determine the size of the curve in scoliosis $\text{Standing AP x-ray}$.

Pott’s Disease

Tuberculosis of the spine initiated by haematogenous spread, leading to vertebral destruction or a Gibbus deformity.

Autonomic Dysreflexia

A syndrome characterized by sudden exaggerated reflex hypertension in response to stimuli below a spinal cord injury site, common above $T6$.

Colle’s Fracture

A dorsally displaced distal radial fracture commonly seen in post-menopausal women.

Kanavel’s Four Signs

Clinical hallmarks of flexor tendon sheath infections: tenderness along the sheath, fusiform swelling, finger held in flexion, and pain with passive extension.

Z-deformity

A rheumatoid arthritis deformity of the thumb involving hyperextension of the IP joint and MCP flexion.

Podagra

A typical gout attack occurring at the 1st metatarsophalangeal (MCP) joint.

Phemister Triad

Radiological signs of hip TB: periarticular osteoporosis, femoral head/neck erosions, and decreased joint space.

Sequestrum

A piece of dead, necrotic bone that has separated from living tissue during osteomyelitis.

Involucrum

A layer of new bone growth that forms from the deep surface of the stripped periosteum during chronic osteomyelitis.

Gustilo-Anderson Type 3c

An open fracture classification involving extensive soft tissue damage and arterial damage requiring repair.