Musculoskeletal System Crash Course: Comprehensive Flashcards

Flashcards covering key terms, clinical diagnostic tests, pathology, and management protocols for upper limb, lower limb, spine, and rheumatologic conditions.

DEXA Scan

Dual-energy X-ray absorptiometry; the definitive diagnostic test for bone mineral density in osteoporosis and osteopenia that reports a T-score.

Osteoporosis Diagnostic Threshold

A DEXA scan $T\text{-score} \le -2.5$.

Osteopenia Diagnostic Threshold

A DEXA scan $T\text{-score}$ between $-1.0$ and $-2.5$.

Bisphosphonates

First-line pharmacologic class for osteoporosis (e.g., alendronate/Fosamax) that must be taken first thing in the morning on an empty stomach with a full glass of water, followed by remaining upright for at least $30\,\text{minutes}$ to prevent esophageal irritation.

Thiazide Diuretics (in Osteoporosis)

Antihypertensive medication that is advantageous in patients with co-occurring hypertension and osteoporosis because it stimulates osteoblasts and reduces renal calcium excretion.

FRAX

Fracture Risk Assessment Tool that integrates age, sex, bone density, and clinical risk factors to estimate a $10\text{-year}$ probability of major osteoporotic and hip fractures in patients with osteopenia.

Osteoarthritis (OA)

A degenerative "wear-and-tear" joint disease characterized by gradual onset, asymmetrical joint involvement, pain exacerbated by activity and relieved by rest, and morning stiffness that improves within $30\,\text{minutes}$.

Rheumatoid Arthritis (RA)

A chronic autoimmune disease targeting the synovial lining of joints, presenting with symmetrical joint involvement, elevated ESR and CRP, and morning stiffness lasting $> 1\,\text{hour}$.

Heberden's Nodes

Bony enlargements at the distal interphalangeal (DIP) joints specific to Osteoarthritis.

Bouchard's Nodes

Bony enlargements at the proximal interphalangeal (PIP) joints that can occur in both Osteoarthritis and Rheumatoid Arthritis.

Methotrexate

The initial DMARD and first-line drug of choice for Rheumatoid Arthritis; requires folic acid supplementation and routine monitoring for bone marrow suppression, hepatotoxicity, and nephrotoxicity.

Allopurinol

A maintenance drug used to lower uric acid levels to prevent gout flares; it should not be initiated during an acute flare and carries a risk of bone marrow suppression.

Gout Diagnostic Test

Joint aspiration with synovial fluid analysis to identify crystals; serum uric acid levels may be normal during an acute flare.

Thiazide Diuretics (in Gout)

Antihypertensive agents that must be avoided in patients with gout because they can elevate serum uric acid levels and precipitate acute flares.

Fibromyalgia

A condition characterized by widespread body pain at classic tender points, persistent fatigue, and sleep disturbances, with regular physical activity as first-line management.

CELF Mnemonic

A memory aid for pharmacologic agents used in fibromyalgia: Cymbalta (duloxetine), Elavil (amitriptyline), Lyrica (pregabalin), and Flexeril (cyclobenzaprine).

Drop Arm Test

A provocative physical examination maneuver for rotator cuff tears where a patient slowly lowers an abducted arm; sudden dropping indicates a positive test.

Supraspinatus (Jobe/Empty Can) Test

Assessment for supraspinatus muscle or tendon pathology performed with the arm abducted to $90^\circ$ and fully internally rotated while resistance is applied to downward pressure.

Phalen Sign

A test for Carpal Tunnel Syndrome where flexing the wrists ("backward prayer hands") reproduces median nerve numbness, pain, and tingling.

Tinel Sign (Wrist)

Percussion/tapping over the median nerve at the inner wrist that elicits paresthesias in Carpal Tunnel Syndrome.

Lateral Epicondylitis

An overuse injury affecting the outer aspect of the elbow, commonly referred to as tennis elbow.

Medial Epicondylitis

An overuse injury affecting the inner aspect of the elbow, commonly referred to as golfer's elbow.

Scaphoid Fracture

A wrist fracture caused by falling on an outstretched hand (FOOSH), presenting with anatomical snuff box tenderness; often unrevealed on initial X-rays for approximately $2\,\text{weeks}$.

Finkelstein Test

Diagnostic test for De Quervain Tenosynovitis where ulnar deviation of the wrist with the thumb tucked inside the fist reproduces sharp pain over the radial styloid.

Septic Olecranon Bursitis

An infection of the olecranon bursa, most commonly caused by Staphylococcus aureus, presenting with swelling, erythema, warmth, fever, and severe tenderness.

Straight Leg Raise Test

A physical test for lumbar radiculopathy (sciatica) where elevating a straight leg in a supine patient reproduces radicular pain along the $L5$ to $S1$ nerve distribution.

Shopping Cart Sign

Relief of spinal stenosis pain when leaning forward or sitting, which flexes the lumbar spine and widens the diameter of the spinal canal.

Bamboo Spine

A classic radiographic finding in advanced Ankylosing Spondylitis resulting from syndesmophyte formation and vertebral fusion along the axial skeleton.

Cauda Equina Syndrome

A surgical emergency caused by severe compression of lumbosacral nerve roots, presenting with severe low back pain, bilateral leg weakness, saddle anesthesia, and new-onset bowel or bladder dysfunction.

McMurray Test

Physical examination maneuver used to detect meniscal tears in the knee, indicated by a palpable or audible "pop" or "click."

Lachman Test

The most sensitive and reliable clinical physical examination maneuver for evaluating an Anterior Cruciate Ligament (ACL) tear.

Sprain vs. Strain

A sprain is an injury to a ligament, whereas a strain is an injury to a muscle or tendon (mnemonic: "T" in sTrain for Tendon).

RICE Protocol

Standard initial treatment protocol for Grade $1$ and Grade $2$ sprains and strains consisting of Rest, Ice, Compression, and Elevation.

Hallux Valgus

Medical term for a bunion, characterized by lateral deviation of the great toe and medial deviation of the $1\text{st}$ metatarsal bone at the $1\text{st}$ MTP joint.

Plantar Fasciitis

Inflammation of the plantar fascia causing sharp heel pain that is classic for being most severe during the first steps taken in the morning.

Morton's Neuroma

A benign thickening of interdigital nerve tissue between the $3\text{rd}$ and $4\text{th}$ toes, causing burning pain, numbness, and the sensation of "having a pebble in one's shoe."

Prescription Drug Monitoring Program (PDMP)

A required state database that clinicians must check before prescribing controlled substances like opioids to evaluate a patient's prescription history.