APEA 3P Orthopedics Exam Study Guide

Comprehensive vocabulary flashcards generated from the APEA 3P Orthopedics exam study guide covering arthritis differential features, joint maneuvers, laboratory and imaging findings, and pharmacological treatments.

Osteoarthritis

Non-inflammatory cartilage wear and osteophyte formation causing asymmetric pain in weight-bearing joints, DIP, and PIP that worsens with use and improves with rest, accompanied by morning stiffness under $30\,\text{minutes}$.

Rheumatoid arthritis

Autoimmune synovitis with pannus and erosions causing symmetric joint pain in MCP, PIP, and wrists (sparing DIP) that improves with activity, accompanied by morning stiffness over $1\,\text{hour}$, systemic features, and positive anti-CCP/RF.

Heberden nodes

Bony enlargements located at the distal interphalangeal (DIP) joints, characteristic of osteoarthritis.

Bouchard nodes

Bony enlargements located at the proximal interphalangeal (PIP) joints, characteristic of osteoarthritis.

Methotrexate

A folate antagonist DMARD dosed weekly with folic acid for rheumatoid arthritis; carries risk of liver, marrow, and lung toxicity, is teratogenic, and requires monitoring CBC and LFTs.

Hydroxychloroquine

A DMARD used in rheumatoid arthritis that carries a risk of retinal toxicity and requires yearly eye exams.

TNF inhibitors

Biologic DMARDs used for rheumatoid arthritis that require screening for tuberculosis (TB) prior to initiation and avoidance of live vaccines.

Gout

Inflammatory joint disease caused by monosodium urate crystal deposition due to hyperuricemia (mostly under-excretion); characterized by needle-shaped, negatively birefringent crystals.

Podagra

Acute gouty arthritis presentation classically affecting the first metatarsophalangeal (MTP) joint, causing sudden red, hot, exquisitely tender joint inflammation, often at night.

Tophi

Deposits of monosodium urate crystals seen in soft tissues in patients with chronic gout.

Allopurinol

A xanthine oxidase inhibitor used for chronic gout prevention targeting uric acid under $6\,\text{mg/dL}$; started low and requires caution due to rash and Stevens-Johnson syndrome risk in patients with HLA-B*5801.

Supraspinatus

The rotator cuff tendon most commonly affected by tendinopathy or tearing, susceptible to impingement under the acromion.

Painful arc sign

Pain experienced during shoulder abduction between $60^\text{o}$ and $120^\text{o}$, characteristic of rotator cuff tendinopathy or impingement.

Meniscal tear

Knee injury caused by twisting on a planted foot or age-related degeneration, presenting with joint-line tenderness, locking, catching, giving way, and delayed swelling over hours; evaluated with McMurray, Apley, and Thessaly tests.

ACL tear

Knee ligament injury characterized by an audible pop sound and immediate swelling, evaluated clinically using the Lachman and anterior drawer tests.

Sprain

An injury affecting a ligament (e.g., anterior talofibular ligament injury in ankle inversion).

Strain

An injury affecting a muscle or a tendon.

Anterior talofibular ligament

The ligament most commonly injured during an ankle inversion sprain.

Ottawa ankle rules

Clinical guidelines indicating X-ray imaging if there is bone tenderness at the posterior edge or tip of either malleolus, navicular, or base of the fifth metatarsal, or an inability to walk $4$ steps.

Shopping cart sign

Relief of buttock and leg pain upon sitting or bending forward, characteristic of spinal stenosis.

Spinal stenosis

Degenerative narrowing of the spinal canal compressing nerve roots in individuals over age $60$, causing buttock and leg pain when standing or walking that is relieved by sitting or bending forward.

Cobb angle

A radiographic measurement used in scoliosis, defining a lateral spinal curve of $10^\text{o}$ or more with rotation.

Adams forward bend test

A clinical examination maneuver for scoliosis that reveals a rib hump.

Osteosarcoma

A malignant osteoid-producing bone tumor occurring in teens during growth spurts in the metaphysis of the distal femur or proximal tibia, presenting with night pain and X-ray showing a sunburst pattern and Codman triangle.

Codman triangle

A classic radiographic finding on X-ray indicating periosteal elevation, associated with osteosarcoma.