PA Boards Musculoskeletal/Rheumatology Cheat Sheet

Abducted, externally rotated. Axillary nerve affected

Anterior Shoulder Dislocation

Adducted, internally rotated. Electrical injury, lightning, seizure

Posterior Shoulder Dislocation

Empty can test

Rotator Cuff Tear

Wrist drop (radial nerve)

Mid-Shaft Humerus Fracture

Middle third most commonly affected. Treat with sling

Clavicle Fracture

Children. Median nerve and brachial artery affected. Anterior sail and posterior fat pad sign. Gun stock deformity. Volkmann's contracture

Supracondylar Fracture

Posterior dislocation most

common

Elbow Dislocation

Fall to outstretched hand. Snuffbox tenderness. Thumb spica splint

Scaphoid Fracture

Median nerve. Phalen Sign. Tinel

Sign. Compression test. Thenar eminence atrophy

Carpal Tunnel Syndrome

5th metacarpal fracture. Ulnar

gutter splint

Boxer Fracture

Pregnancy. Finkelstein test

De Quervain Tenosynovitis

Smoking, decreased FEV1

Chronic Bronchitis

Young male, HLA B27, Bamboo

sign

Ankylosing spondylitis

Bowel/bladder incontinence, saddle paresthesia

Cauda Equina

Shopping cart sign (pain relieved with forward bending)

Spinal Stenosis

Femoral neck fracture, limp, frog leg lateral X-ray

Avascular Necrosis

Knee pain, avascular necrosis of hip

Legg-Calve-Perthes

Obese. X-ray: posterior displacement of the femoral epiphysis.

Slipped capital Femoral Epiphysis

Positive Ortolani and Barlow test. Palpable clunk. Pavlik harness

Developmental Hip Dysplasia

External rotation and shortening

Hip Fracture

Deceleration, hyperextension, pop, and swelling. Positive lachman or anterior drawer test

ACL

Mechanical symptoms. Baker cyst. Positive McMurray and Apley test

Meniscal Tear

Knee pain worse with exercise. Children. Tenderness over tibial tuberosity.

Osgood-Schlatter Disease

Positive Thompson test

Achilles Ankle Tear

Staph aureus

Osteomyelitis

Moth eaten pattern and onion peel appearance

Ewing Sarcoma

Knee. Bouchard (PIP) and Heberden's (DIP) nodes

Osteoarthritis

Risk factors: Smoking, glucocorticoids, amenorrhea

Osteoporosis

Sunburst pattern

Osteosarcoma

pain out of proportion. 6 Ps: pain, pressure, paresthesia, pulselessness, pallor, paralysis

Compartment Syndrome

Bilateral symmetric and progressive. Boutonniere and

Swan neck deformity. Felty syndrome: rheumatoid arthritis,

splenomegaly and neutropenia

RA

Women, depression, pain

Fibromyalgia

Calcium pyrophosphate. Positive birefringent rhomboid shaped crystals

Pseudogout

Polyarthritis, spiking fevers, salmon colored rash. Risk of

uveitis.

Juvenile RA

Hepatitis B (etiology). Livedo reticularis, mononeuritis multiplex.

Polyarteritis Nodosa

Progressive proximal muscle weakness, dysphagia

Polymyositis

Heliotrope rash, gottron papules, shawl sign. Risk of malignancy. Anti-jo-1 and Mi-2 antibodies

Dermatomyositis

> 50 years of age. Giant Cell arteritis

Polymyalgia Rheumatica

GI/GU infection, urethritis, conjunctivitis

Reactive Arthritis

Malar rash, Positive ANA, discoid rash. Double stranded DNA and anti-Smith antibodies

SLE

Fibrosis. Calcinosis, Raynaud phenomenon, GERD, sclerodactyly, telangiectasis. Anticentromere antibodies and SCL-70 antibodies

Scleroderma

Dry eyes. Positive Schirmer test. Positive anti-ro (SSA) and anti-la (SSB) antibodies. Oral candidiasis and non-hodgkin lymphoma association.

Sjogren

Monoarticular. podagra. needle shaped negatively birefringent crystals under polarized light.

Gout