|
SUGGESTED READINGS
ORTHO I
- Bernstein, J., Musculoskeletal Medicine, 2003
- Greis, Patrick, MD. “Meniscal Injury: I. Basic Science and Evaluation”
- Schranz, M, MD. “MRI of the Knee, Shoulder, and Ankle”
OBJECTIVES
ORTHO I
- Describe the usual presentation and management of shoulder dislocation and rotator cuff injury.
- Describe the common clinical presentation and management of patients with acute low back pain versus herniated nucleus pulposus. Know when radiographic studies are appropriate.
- Discuss the usual clinical presentation and radiographic findings of osteoarthritis and the clinical indications for total joint replacement of shoulder, hip, and knee. Discuss the pathophysiology of articular cartilage degeneration.
- Describe the mechanisms of injury, usual presentation and management of ligamentous injuries of the knee, including dislocation.
- A 45-year-old man was helping his friend move some furniture when the friend slipped and fell while they were carrying a sofa bed. After a couple of beers, the friend was fine, but the man who did not fall noticed some discomfort in his shoulder. In addition to the pain, he could not lift his arm above his head without the assistance of the uninjured arm. The next day he was unable to do his regular job of installing ceilings. He now is in your office for an examination.
- What do you expect to find on physical examination?
- What’s your differential diagnosis?
- What diagnostic studies would be helpful?
- What would be your initial treatment?
- A 50-year-old is in your office with complaints of hip pain. She denies any injury. She tells you that her pain goes from her hip to her foot, and sometimes she has tingling in her toes.
- Your physical exam shows completely normal motion in her hip and knee.
- What other portions of the physical exam would be helpful?
- What further history would you like to know?
- What diagnostic studies should be arranged?
- A 40-year old male asthmatic has noted a progressive onset of pain in his thigh and groin. He denies any injury. He has aching at night that sometimes keeps him awake. He does not notice any loss of motion in his hip or knee. Swimming or cycling does not seem to affect his condition one way or another.
- What questions regarding his history would help you make a diagnosis?
- What diagnostic studies would be important in his treatment plan?
- What would be your differential diagnosis?
- What could you tell him regarding his prognosis?
- A 24-year-old female was working out at the gym when she flexed her knee and felt something pop when she tried to stand from the squatting position. Her knee felt a little sore but she continued her workout. The next day her knee was swollen and she was unable to fully extend it. She went to work where the knee became more uncomfortable throughout the day. She took some Motrin and felt a little better. A few days later she still could not fully extend her knee and presents to your clinic for an evaluation.
- What questions should you ask her?
- What is your working diagnosis?
- What diagnostic studies do you request and why?
- What is your treatment plan?
- A 68-year-old woman is in your office with complaints of decreased motion in her knee and recurrent swelling of that knee. She denies any injury. She has problems walking on uneven ground. Pain and stiffness limit her activity for a few hours each morning.
|
