PT566 Exam 1

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4.2: What is the controversy of continuous passive motion machines immediately post TKA?

they significantly increase AROM flexion, decrease stay length and decrease need for post op care compared to PT alone BUT they do not appear to offer long term rehab advantage

6.4: what were the six muscles/muscle groups mentioned in the unit 6.4 lecture that were commonly targeted in lumbar stabilization treatment?

transverse abdominis multifidus erector spinae quadratus lumborum external obliques internal obliques

1LS: true or false: nociception is defined as the sensation of pain

true

6.2A: In most cases of low back pain, MRIs should not be obtained as an initial test. True False

true

6.2A: In the face of uncertainty about a specific cause of low back pain from a pathoanatomical perspective, physical therapists can utilize classification-based approached to understanding how to manage low back pain and make management decisions. False True

true

6.2A: Most low back pain injuries have unclear causation and no specific pathoanatomical impairments can be identified. True False

true

6.2A: Psychological factors are more predictive of low back pain than are physical findings. False True

true

6.2A: Some low back pain injuries are the product of specific pathoanatomical impairments. False True

true

1LS: true or false: the primary cell type active during the proliferation phase of tissue healing are fibroblasts Added: what are the the four phases of tissue healing (in order)? What is the corresponding most active cell type in each phase? What two other cell types peak in 1. early and 2. middle of the third phase?

true Coagulation: Platelets Inflammation: Neutrophils Proliferation: Fibroblasts Remodeling: Fibroblasts Peak in early proliferation: Macrophages Peak in mid proliferation: Lymphocytes

3LS: TF: A femoral head that is too large for the acetabulum is referred to as cam-type impingement.

true pincer is the acetabular head, can also have mixed

4.2: ongoing impairments and functional deficits for as long as ______ _______ post THA what is a very notable functional impairment observed with many THA and TKA recoveries?

two years gait speed

6.4: what four groups of people are most at risk for SIJ complications? Which three of these groups have a hypermobility issue? What is the only group with a hypomobility issue?

what four groups of people are most at risk for SIJ complications? pregnant women, young females, single legged trauma, ankylosing spondylitis Which three of these groups have a hypermobility issue? the first three What is the only group with a hypomobility issue? ankylosing spondylitis

1.2A: True or false: It is possible to be totally sure about a particular diagnosis provided you have a sound enough understanding of the underlying pathophysiology and conduct a thorough examination.

False: "Diagnosis is a probabilistic process, meaning we can't ever be 100% sure about anything. We can hope to have high confidence in our diagnosis, but be wary of statements based in absolutes!"

2LS: TF: Articular cartilage injuries that are severe enough to result in bleeding have worse prognosis than more superficial injuries

False Bleeding helps the damaged tissue heal more effectively, cartilage is relatively avascular

2LS: TF: Meniscal tears often result in significant intracapsular knee swelling

False Most of the meniscus is avascular except for the outer portion

3LS: TF: A patient who was treated for cervical cancer in her twenties has increased risk for DVT (deep vein thrombosis) in her 40's.

False REVIEW DVT CRITERIA PT566 NOTEBOOK PG 75

3LS: TF: A 56-year-old patient presenting with heel pain could have Sever's Disease.

False Sever's disease has to do with growth plate of calcaneus

5LS: Lumbar Discs are easily mobile and can slip out of place. True False

False bulging or protrusions commonly happen but slipping doesnt actually happen often

1.6: What medication has been linked to increased achilles (and other) tendinopathy risk? Famotidine Quinine Fluoroquinolone Fluoroestradiol

Famotidine Quinine Fluoroquinolone Fluoroestradiol

2.4A: A patient presents with reduced quadriceps muscle strength and pain in the anterior knee. Which of the following is an expected finding for this patient? Pain with active knee flexion Pain with descending hills

Pain with active knee flexion Pain with descending hills (high demand activity for the quads)

3.3A: "Sports hernia" typically involves all of the following EXCEPT Pain with ballistic movements Tears in the origin of the adductor longus Muscle imbalance between the core muscles and the adductors Tears in the conjoined tendon

Pain with ballistic movements Tears in the origin of the adductor longus Muscle imbalance between the core muscles and the adductors Tears in the conjoined tendon Why? AL origin is not inguinal region

4LS: What are common areas for apophyseal injuries?

Tibial tuberosity- osgood schlatter Calcaneus- Sever's Patella- sinding-larsen Elbow (medial) ASIS AIIS Iliac crest Shoulder where GH ligaments attach - proximal humerus

2.3: True or false: Mechanoreceptors are present in ligaments

True

3LS: TF: A patient with a stress fracture on the inferior aspect of the femoral neck can be toe-touch weight bearing.

True

4LS: A Maisonneuve fracture is a fracture of the fibula associated with a syndesmosis sprain. True False

True

2.3A: The MCL has attachment to both the medial meniscus and joint capsule. True False

True False

2LS: TF: ACL repair is an elective procedure

True Means that you can go on without an intact acl and live your life

5LS: What is surmised to be the primary cause of low back pain? a. Herniation of the intervertebral disc b. Narrowing of the spinal canal c. Degeneration of the IVD d. In 85% of cases the actual cause of LBP cannot be identified

d. In 85% of cases the actual cause of LBP cannot be identified

6Q: What is surmised to be the primary cause of low back pain? Select one: a. Herniation of the intervertebral disc b. Narrowing of the spinal canal c. Degeneration of the IVD d. In 85% of cases the actual cause of LBP cannot be identified

d. In 85% of cases the actual cause of LBP cannot be identified

6LS: A physical therapist is treating a patient with low back pain with mobility deficits who presents with a direction preference for flexion. They present with increased pain in the low back and legs with extension movements. A flexed position relieves their pain. What are possible pain generators of this patient's LBP? a. Facet joint b. Lumbar disc c. Nerve root d.All of the above

d. all of the above I was wrong I put c. Nerve root

6LS: Which of the following conditions could have radicular symptoms? a. Bone spur b. Lumbar disc herniation c. Lumbar spinal stenosis d.All of the answer choices could present with radicular symptoms

d.All of the answer choices could present with radicular symptoms

6LS: A 15-year-old female presents with knee pain. Examination negative knee findings, but reveals weak hip musculature, a leg leg-length difference of 3cm, and decreased ROM in hip IR and abduction. What is the most likely pathology? a. Legg Calve Perthes b. Posterior hip dislocation c. Mid-shaft femur fracture d.Slipped capped femoral epiphysis

d.Slipped capped femoral epiphysis

6LS: Progressive onset of pain, numbness, weakness, and tingling in the low back and buttocks of an older adult that is increased by standing and walking and eased by sitting, is a hallmark of which condition: a. Facet joint dysfunction b. Lateral stenosis c. Non-specific low back pain d.Spinal stenosis

d.Spinal stenosis lateral stenosis and facet dysfunction fit the picture but I was wrong I put b. Lateral stenosis

1LS: true or false: a patient with chronic back pain for four years might be experiencing ongoing inflammation from a bulging disc

false

1LS: true or false: pretest probability is the result of your objective exam of the patient

false

3LS: TF: Articular cartilage has ample blood flow and so gets its nutrients via trabecular bone.

false

1LS: true or false: hemostasis occurs at week three of tissue healing process

false "hemostasis is the immediate response of tissue healing"

How can you differentiate hip labral tear from FAI?

labral tear = clicking, pain with extension , more laxity, FAI = limited flexion/IR, lateral/posterior pain with ER Both: groin pain and positive impingement sign (FADIR), pain/asymmetry w/ FADER

4.3: what are the four components of a TKA and the corresponding materials each component is made out of?

patellar - polyethylene tibial tray - polyethylene femoral component - cobalt chrome alloy tibial base plate - titanium alloy

4.5: With a TSA, (ER/IR) should only be performed to neutral, which is protecting (ER,IR)

ER, IR

4LS: What are common complications after TJA?

Infection, DVT, femoral neck fracture,,

1.3A: Which stage of tissue healing is distinguished by the presence of fibroblasts and subsequent production of new collagen? Inflammation Proliferation Remodeling

Inflammation Proliferation: Remodeling "Fibroblasts proliferate and lay down new tissue in proliferation."

1.4A: Which condition is caused, in part, by traction forces transmitted through the achilles tendon? Jones fracture Bunion Equinovarus Sever's disease

Jones fracture Bunion Equinovarus Sever's disease "this is an apophysitis of the calcaneus, which is the origin of the Achilles tendon."

2.2A: A 36-year-old patient presents to a physical therapy clinic via direct access and complains of "achy" knee pain that has persisted for 3 months. The patient reports pain in the morning upon waking and again in the evening after a job that requires standing most of the day. The pain began after a hard landing during skydiving. The physical therapist finds limited joint effusion and full range of motion. The joint appears otherwise normal, and the patient denies any previous history of knee injury. What is the most likely diagnosis? Knee osteoarthritis Localized articular cartilage injury

Knee osteoarthritis Localized articular cartilage injury

6.4: What are the five primary inflammatory or systemic conditions associated with LBP?

-Ankylosing spondylitis -psoriatic spondylitis -paget's disease -Reiter's syndrome -inflammatory bowel disease

1.6: Flip card for diagnosis description (MOI, signs, OE tests/intervention), choose from diagnosis selection below. scroll down for correct answer: Plantar fasciitis Congenital talipes equinovarus / clubfoot March fracture Tibialis posterior tendinopathy Maisonneuve fracture Jones fracture (zone 2) Cuboid syndrome Fat pad syndrome Achilles tendinitis/osis (tendinopathy) Peroneal tendinopathy

. . . . . . . . . . . . . . . Achilles tendinosis/itis (tendinopathy)

1.6: Flip card for diagnosis description (MOI, signs, OE tests/intervention), choose from diagnosis selection below. scroll down for correct answer: Posterior ankle impingement Diaphyseal stress 5th MT fracture (zone 3) Achilles tendon rupture Weber A fracture Eversion sprain Grade II lateral ankle sprain Sever's disease: calcaneal apophysitis Tarsal coalition Plantar fasciitis Congenital talipes equinovarus / clubfoot March fracture

. . . . . . . . . . . . . . . Achilles tendon rupture

1.7: Flip card for diagnosis description (MOI, signs, OE tests/intervention), choose from diagnosis selection below. scroll down for correct answer: Peroneal tendinopathy Pseudo Jones / Dancer's fracture (zone 1) Morton's neuroma Weber C fracture Sesamoiditis Medial tibial stress syndrome Anterolateral ankle impingement Syndesmotic (high ankle) sprain Acute compartment syndrome Grade I lateral ankle sprain

. . . . . . . . . . . . . . . Acute compartment syndrome

1.4: Flip card for diagnosis description (MOI, signs, OE tests/intervention), choose from diagnosis selection below. scroll down for correct answer: Achilles tendinitis/osis (tendinopathy) Peroneal tendinopathy Pseudo Jones / Dancer's fracture (zone 1) Morton's neuroma Weber C fracture Sesamoiditis Medial tibial stress syndrome Anterolateral ankle impingement Syndesmotic (high ankle) sprain Acute compartment syndrome

. . . . . . . . . . . . . . . Anterolateral ankle impingement

1.5: Flip card for diagnosis description (MOI, signs, OE tests/intervention), choose from diagnosis selection below. scroll down for correct answer: Chronic ankle instability Grade III lateral ankle sprain Chronic exertional compartment syndrome Weber B fracture Tarsal tunnel syndrome (posterior tibial neuritis) Turf toe Lisfranc fracture "Shin splints Hallux valgus "bunion" Posterior ankle impingement

. . . . . . . . . . . . . . . Chronic ankle instability

1.4: Flip card for diagnosis description (risk factors, signs, OE tests/intervention), choose from diagnosis selection below. scroll down for correct answer: Grade II lateral ankle sprain Sever's disease: calcaneal apophysitis Tarsal coalition Plantar fasciitis Congenital talipes equinovarus / clubfoot March fracture Tibialis posterior tendinopathy Maisonneuve fracture Jones fracture (zone 2) Cuboid syndrome Fat pad syndrome

. . . . . . . . . . . . . . . Congenital talipes equinovarus / clubfoot

1.4: Flip card for diagnosis description (MOI, signs, OE tests/intervention), choose from diagnosis selection below. scroll down for correct answer: Tarsal coalition Plantar fasciitis Congenital talipes equinovarus / clubfoot March fracture Tibialis posterior tendinopathy Maisonneuve fracture Jones fracture (zone 2) Cuboid syndrome Fat pad syndrome Achilles tendinitis/osis (tendinopathy) Peroneal tendinopathy

. . . . . . . . . . . . . . . Cuboid syndrome

1.4: Flip card for diagnosis description (MOI, signs, OE tests/intervention), choose from diagnosis selection below. scroll down for correct answer: Hallux valgus "bunion" Posterior ankle impingement Diaphyseal stress 5th MT fracture (zone 3) Achilles tendon rupture Weber A fracture Eversion sprain Grade II lateral ankle sprain Sever's disease: calcaneal apophysitis Tarsal coalition Plantar fasciitis Congenital talipes equinovarus / clubfoot

. . . . . . . . . . . . . . . Diaphyseal stress 5th MT fracture (zone 3)

1.5: Flip card for diagnosis description (MOI, signs, OE tests/intervention), choose from diagnosis selection below. scroll down for correct answer: Achilles tendon rupture Weber A fracture Eversion sprain Grade II lateral ankle sprain Sever's disease: calcaneal apophysitis Tarsal coalition Plantar fasciitis Congenital talipes equinovarus / clubfoot March fracture Tibialis posterior tendinopathy Maisonneuve fracture

. . . . . . . . . . . . . . . Eversion ankle sprain

1.5: Flip card for diagnosis description (MOI, signs, OE tests/intervention), choose from diagnosis selection below. scroll down for correct answer: Peroneal tendinopathy Pseudo Jones / Dancer's fracture (zone 1) Morton's neuroma Weber C fracture Sesamoiditis Medial tibial stress syndrome Anterolateral ankle impingement Syndesmotic (high ankle) sprain Acute compartment syndrome Grade I lateral ankle sprain

. . . . . . . . . . . . . . . Grade I lateral ankle sprain

1.5: Flip card for diagnosis description (MOI, signs, OE tests/intervention), choose from diagnosis selection below. scroll down for correct answer: Eversion sprain Grade II lateral ankle sprain Sever's disease: calcaneal apophysitis Tarsal coalition Plantar fasciitis Congenital talipes equinovarus / clubfoot March fracture Tibialis posterior tendinopathy Maisonneuve fracture Jones fracture (zone 2) Cuboid syndrome

. . . . . . . . . . . . . . . Grade II lateral ankle sprain

. . . . . . . . . . . . . . . Grade III lateral ankle sprain

1.4: Flip card for diagnosis description (MOI, signs, OE tests/intervention), choose from diagnosis selection below. scroll down for correct answer: Tarsal tunnel syndrome (posterior tibial neuritis) Turf toe Lisfranc fracture "Shin splints Hallux valgus "bunion" Posterior ankle impingement Diaphyseal stress 5th MT fracture (zone 3) Achilles tendon rupture Weber A fracture Eversion sprain Grade II lateral ankle sprain

. . . . . . . . . . . . . . . Hallux valgus "bunion"

1.4: Flip card for diagnosis description (MOI, signs, OE tests/intervention), choose from diagnosis selection below. scroll down for correct answer: Congenital talipes equinovarus / clubfoot March fracture Tibialis posterior tendinopathy Maisonneuve fracture Jones fracture (zone 2) Cuboid syndrome Fat pad syndrome Achilles tendinitis/osis (tendinopathy) Peroneal tendinopathy Pseudo Jones / Dancer's fracture (zone 1) Morton's neuroma

. . . . . . . . . . . . . . . Jones fracture (zone 2)

1.4: Flip card for diagnosis description (MOI, signs, OE tests/intervention), choose from diagnosis selection below. scroll down for correct answer: Turf toe Lisfranc fracture "Shin splints Hallux valgus "bunion" Posterior ankle impingement Diaphyseal stress 5th MT fracture (zone 3) Achilles tendon rupture Weber A fracture Eversion sprain Grade II lateral ankle sprain Sever's disease: calcaneal apophysitis

. . . . . . . . . . . . . . . Lisfranc fracture

1.4: Flip card for diagnosis description (MOI, signs, OE tests/intervention), choose from diagnosis selection below. scroll down for correct answer: Plantar fasciitis Congenital talipes equinovarus / clubfoot March fracture Tibialis posterior tendinopathy Maisonneuve fracture Jones fracture (zone 2) Cuboid syndrome Fat pad syndrome Achilles tendinitis/osis (tendinopathy) Peroneal tendinopathy Pseudo Jones / Dancer's fracture (zone 1)

. . . . . . . . . . . . . . . March fracture

1.6: Flip card for diagnosis description (MOI, signs, OE tests/intervention), choose from diagnosis selection below. scroll down for correct answer: Achilles tendinitis/osis (tendinopathy) Peroneal tendinopathy Pseudo Jones / Dancer's fracture (zone 1) Morton's neuroma Weber C fracture Sesamoiditis Medial tibial stress syndrome Anterolateral ankle impingement Syndesmotic (high ankle) sprain Acute compartment syndrome

. . . . . . . . . . . . . . . Medial tibial stress syndrome "Shin splints"

1.6: Flip card for diagnosis description (MOI, signs, OE tests/intervention), choose from diagnosis selection below. scroll down for correct answer: Fat pad syndrome Achilles tendinitis/osis (tendinopathy) Peroneal tendinopathy Pseudo Jones / Dancer's fracture (zone 1) Morton's neuroma Weber C fracture Sesamoiditis Medial tibial stress syndrome Anterolateral ankle impingement Syndesmotic (high ankle) sprain

. . . . . . . . . . . . . . . Morton's neuroma

2LS: What condition is depicted in the image on the other side of this card? (answer is further down) Describe possible mechanisms of injury for this? How can this condition lead to a false positive on a popular knee special test?

. . . . . . . . . . . . . . . PCL tear dashboard injury (knee hyperflexed) anterior drawer test (already sagging way back --> seemingly excessive translation forward bc the knee didn't start in neurtral

. . . . . . . . . . . . . . . Peroneal tendinopathy

1.7: Flip card for diagnosis description (MOI, signs, OE tests/intervention), choose from diagnosis selection below. scroll down for correct answer: Grade II lateral ankle sprain Sever's disease: calcaneal apophysitis Tarsal coalition Plantar fasciitis Congenital talipes equinovarus / clubfoot March fracture Tibialis posterior tendinopathy Maisonneuve fracture Jones fracture (zone 2) Cuboid syndrome Fat pad syndrome

. . . . . . . . . . . . . . . Plantar fasciitis

1.4: Flip card for diagnosis description (MOI, signs, OE tests/intervention), choose from diagnosis selection below. scroll down for correct answer: Lisfranc fracture "Shin splints Hallux valgus "bunion" Posterior ankle impingement Diaphyseal stress 5th MT fracture (zone 3) Achilles tendon rupture Weber A fracture Eversion sprain Grade II lateral ankle sprain Sever's disease: calcaneal apophysitis Tarsal coalition

. . . . . . . . . . . . . . . Posterior ankle impingement

. . . . . . . . . . . . . . . Pseudo jones / dancers fracture (zone 1)

1.4: Flip card for diagnosis description (risk factors, signs, OE tests/intervention), choose from diagnosis selection below. scroll down for correct answer: Turf toe Lisfranc fracture "Shin splints Hallux valgus "bunion" Posterior ankle impingement Diaphyseal stress 5th MT fracture (zone 3) Achilles tendon rupture Weber A fracture Eversion sprain Grade II lateral ankle sprain Sever's disease: calcaneal apophysitis

. . . . . . . . . . . . . . . Sever's disease: Calcaneal apophysitis

1.5: Flip card for diagnosis description (MOI, signs, OE tests/intervention), choose from diagnosis selection below. scroll down for correct answer: Pseudo Jones / Dancer's fracture (zone 1) Morton's neuroma Weber C fracture Sesamoiditis Medial tibial stress syndrome Anterolateral ankle impingement Syndesmotic (high ankle) sprain Acute compartment syndrome Grade I lateral ankle sprain

. . . . . . . . . . . . . . . Syndesmotic (high ankle) sprain

1.4: Flip card for diagnosis description (MOI, signs, OE tests/intervention), choose from diagnosis selection below. scroll down for correct answer: Weber A fracture Eversion sprain Grade II lateral ankle sprain Sever's disease: calcaneal apophysitis Tarsal coalition Plantar fasciitis Congenital talipes equinovarus / clubfoot March fracture Tibialis posterior tendinopathy Maisonneuve fracture Jones fracture (zone 2)

. . . . . . . . . . . . . . . Tarsal coalition

1.6: Flip card for diagnosis description (MOI, signs, OE tests/intervention), choose from diagnosis selection below. scroll down for correct answer: Weber B fracture Tarsal tunnel syndrome (posterior tibial neuritis) Turf toe Lisfranc fracture "Shin splints Hallux valgus "bunion" Posterior ankle impingement Diaphyseal stress 5th MT fracture (zone 3) Achilles tendon rupture Weber A fracture Eversion sprain

. . . . . . . . . . . . . . . Tarsal tunnel syndrome (posterior tibial neuritis)

1.6: Flip card for diagnosis description (MOI, signs, OE tests/intervention), choose from diagnosis selection below. scroll down for correct answer: Sever's disease: calcaneal apophysitis Tarsal coalition Plantar fasciitis Congenital talipes equinovarus / clubfoot March fracture Tibialis posterior tendinopathy Maisonneuve fracture Jones fracture (zone 2) Cuboid syndrome Fat pad syndrome Achilles tendinitis/osis (tendinopathy)

. . . . . . . . . . . . . . . Tibialis posterior tendinopathy

1.4: Flip card for diagnosis description (MOI, signs, OE tests/intervention), choose from diagnosis selection below. scroll down for correct answer: Chronic exertional compartment syndrome Weber B fracture Tarsal tunnel syndrome (posterior tibial neuritis) Turf toe Lisfranc fracture "Shin splints Hallux valgus "bunion" Posterior ankle impingement Diaphyseal stress 5th MT fracture (zone 3) Achilles tendon rupture Weber A fracture

. . . . . . . . . . . . . . . Turf toe

1.4: Flip card for diagnosis description (MOI, signs, OE tests/intervention), choose from diagnosis selection below. scroll down for correct answer: Shin splints Hallux valgus "bunion" Posterior ankle impingement Diaphyseal stress 5th MT fracture (zone 3) Achilles tendon rupture Weber A fracture Eversion sprain Grade II lateral ankle sprain Sever's disease: calcaneal apophysitis Tarsal coalition Plantar fasciitis

. . . . . . . . . . . . . . . Weber A fracture

1.4: Flip card for diagnosis description (MOI, signs, OE tests/intervention), choose from diagnosis selection below. scroll down for correct answer: Chronic ankle instability Grade III lateral ankle sprain Chronic exertional compartment syndrome Weber B fracture Tarsal tunnel syndrome (posterior tibial neuritis) Turf toe Lisfranc fracture "Shin splints Hallux valgus "bunion" Posterior ankle impingement

. . . . . . . . . . . . . . . Weber B fracture

. . . . . . . . . . . . . . . Weber C fracture

1.7: Flip card for diagnosis description (MOI, signs, OE tests/intervention), choose from diagnosis selection below. scroll down for correct answer: Jones fracture (zone 2) Cuboid syndrome Fat pad syndrome Achilles tendinitis/osis (tendinopathy) Peroneal tendinopathy Pseudo Jones / Dancer's fracture (zone 1) Morton's neuroma Weber C fracture Sesamoiditis Medial tibial stress syndrome

. . . . . . . . . . . . . . . fat pad syndrome

. . . . . . . . . . . . . . .Maisonneuve fracture

1.7: Flip card for diagnosis description (MOI, signs, OE tests/intervention), choose from diagnosis selection below. scroll down for correct answer: Grade III lateral ankle sprain Chronic exertional compartment syndrome Weber B fracture Tarsal tunnel syndrome (posterior tibial neuritis) Turf toe Lisfranc fracture "Shin splints Hallux valgus "bunion" Posterior ankle impingement Diaphyseal stress 5th MT fracture (zone 3) Achilles tendon rupture

. . . . . . . . . . . . . . Chronic exertional compartment syndrome

1.4: Flip card for diagnosis description (MOI, signs, OE tests/intervention), choose from diagnosis selection below. scroll down for correct answer: Fat pad syndrome Achilles tendinitis/osis (tendinopathy) Peroneal tendinopathy Pseudo Jones / Dancer's fracture (zone 1) Morton's neuroma Weber C fracture Sesamoiditis Medial tibial stress syndrome Anterolateral ankle impingement Syndesmotic (high ankle) sprain

. . . . . . . . . . . . . . Sesamoiditis

2.3: Flip card for diagnosis description (MOI, signs, OE tests/intervention), choose from diagnosis selection below. scroll down for correct answer: Osgood-Schlatter lesion (tibial apophysitis) Baker's cyst Anterior knee pain (patellofemoral pain syndrome) ACL injury Osteochondritis dessicans LCL injury Anterior knee pain (fat pad/plica) MCL injury PCL injury Osteochondral lesion / defect Bipartite patella

. . . . . . . . . . . . ACL injury

5.2: Flip card for diagnosis description (MOI/risk factors, signs, confirmation /OE tests), choose from diagnosis selection below. scroll down for correct answer: Greenstick fracture Apophyseal avulsion fracture / stress reactions ALPSA lesion Little league shoulder Osteosarcoma Discoid meniscus Growth plate fracture (physeal, salter harris) Hill sachs lesion Bankart lesion Patellar instability Plica syndrome

. . . . . . . . . . . . ALPSA lesion

3.5: Flip card for diagnosis description (MOI/risk factors, signs, OE tests/intervention), choose from diagnosis selection below. scroll down for correct answer: Femoral nerve entrapment (L2-4) Septic arthritis Internal snapping hip Fatigue stress fracture Acute transient synovitis

. . . . . . . . . . . . Acute transient synovitis

3.4: Flip card for diagnosis description (MOI/risk factors, signs, OE tests/intervention), choose from diagnosis selection below. scroll down for correct answer: Femoral nerve entrapment (L2-4) Developmental dysplasia Adductor strain Quadriceps contusion Myositis ossificans Insufficiency stress fracture Osteitis pubis

. . . . . . . . . . . . Adductor strain

2.4: Flip card for diagnosis description (MOI/risk factors, signs, OE tests/intervention), choose from diagnosis selection below. scroll down for correct answer: ACL injury Quadriceps tendon rupture Interosseous bruise Osteochondral lesion / defect Patellar fracture Knee osteoarthritis Subchondral bruise/fracture Anterior knee pain (fat pad/plica

. . . . . . . . . . . . Anterior knee pain (fat pad/plica)

2.4: Flip card for diagnosis description (MOI/risk factors, signs, OE tests/intervention), choose from diagnosis selection below. scroll down for correct answer: Tibiofemoral dislocation Quadriceps tendon rupture Osgood-Schlatter lesion (tibial apophysitis) Baker's cyst Anterior knee pain (patellofemoral pain syndrome) ACL injury Osteochondritis dessicans LCL injury

. . . . . . . . . . . . Anterior knee pain (patellofemoral pain syndrome)

5.2: Flip card for diagnosis description (MOI/risk factors, signs, confirmation /intervention), choose from diagnosis selection below. scroll down for correct answer: Greenstick fracture GH instability Growth plate fracture (physeal, salter harris) Spondylolisthesis Bankart lesion Patellar instability Little leagues elbow ALPSA lesion Hill sachs lesion Osteosarcoma Apophyseal avulsion fracture / stress reactions

. . . . . . . . . . . . Apophyseal avulsion fracture / stress reaction

3.3: Flip card for diagnosis description (MOI/risk factors, signs, OE tests/intervention), choose from diagnosis selection below. scroll down for correct answer: Developmental dysplasia Hip labral tear Osteitis pubis Althetic pubalgia Septic arthritis Legg-Calve-Perthes disease Myositis ossificans

. . . . . . . . . . . . Athletic pubalgia .

2.5: Flip card for diagnosis description (MOI/risk factors, signs, OE tests/intervention), choose from diagnosis selection below. scroll down for correct answer: PCL injury Patellar tendon rupture Quadriceps tendon rupture Tibiofemoral dislocation LCL injury Sinding-Larsen-Johansson lesion (patellar apophysitis) Osteochondral lesion / defect Segond fracture Baker's cyst

. . . . . . . . . . . . Baker's cyst

5.2: Flip card for diagnosis description (MOI/risk factors, signs, confirmation /OE tests), choose from diagnosis selection below. scroll down for correct answer: Apophyseal avulsion fracture / stress reactions Bankart lesion GH instability Patellar instability Osteosarcoma ALPSA lesion Hill sachs lesion Little league shoulder Growth plate fracture (physeal, salter harris) Discoid meniscus

. . . . . . . . . . . . Bankart lesion

2.5: Flip card for diagnosis description (MOI/risk factors, signs, OE tests/intervention), choose from diagnosis selection below. scroll down for correct answer: Patellar fracture Anterior knee pain (fat pad/plica) Bipartite patella Interosseous bruise Knee osteoarthritis Subperiosteal contusion / hemotoma Anterior knee pain (patellofemoral pain syndrome) Knee prepatellar bursitis ACL injury

. . . . . . . . . . . . Bipartite patella

3.5: Flip card for diagnosis description (MOI/risk factors, signs, OE tests/intervention), choose from diagnosis selection below. scroll down for correct answer: Hip labral tear Hamstring strain Developmental dysplasia Osteitis pubis Legg-Calve-Perthes disease (pediatric avascular necrosis of hip)

. . . . . . . . . . . . Developmental dysplasia

3.3: Flip card for diagnosis description (MOI/risk factors, signs, OE tests/intervention), choose from diagnosis selection below. scroll down for correct answer: Adductor strain Hip OA Hip fracture External snapping hip Hermia

. . . . . . . . . . . . External snapping hip (less common than internal)

3.4: Flip card for diagnosis description (MOI/risk factors, signs, OE tests/intervention), choose from diagnosis selection below. scroll down for correct answer: Slipped capital femoral epiphysis (SCFE) Hamstring strain Fatigue stress fracture Obturator nerve entrapment (L2-4) Gluteus minimus and/or medius injury Insufficiency stress fracture Hip avascular necrosis

. . . . . . . . . . . . Fatigue stress fracture (hip - commonly femoral neck)

3.2: Flip card for diagnosis description (MOI/risk factors, signs, OE tests/intervention), choose from diagnosis selection below. scroll down for correct answer: Acute transient synovitis Hip bursitis Piriformis syndrome Femoral acetabular impingement Ilioinguinal nerve entrapment Quadriceps contusion Slipped capital femoral epiphysis (SCFE) Hamstring strain

. . . . . . . . . . . . Femoral acetabular impingement (FAI)

5.2: Flip card for diagnosis description (MOI/risk factors, signs, confirmation /OE tests), choose from diagnosis selection below. scroll down for correct answer: GH instability Little league shoulder Patellar instability Greenstick fracture Hill sachs lesion Bankart lesion ALPSA lesion Little leagues elbow Growth plate fracture (physeal, salter harris) Osteosarcoma

. . . . . . . . . . . . GH instability

3.4: Flip card for diagnosis description (MOI/risk factors, signs, OE tests/intervention), choose from diagnosis selection below. scroll down for correct answer: Obturator nerve entrapment Lateral femoral cutaneous nerve entrapment Femoral acetabular impingement Septic arthritis Gluteus minimus and/or medius injury Ilioinguinal nerve entrapment

. . . . . . . . . . . . Gluteus minimus and/or medius injury

5.2: Flip card for diagnosis description (MOI/risk factors, signs, confirmation /intervention), choose from diagnosis selection below. scroll down for correct answer: Growth plate fracture (physeal, salter harris) Hill sachs lesion GH instability Greenstick fracture Discoid meniscus Bankart lesion ALPSA lesion Little league shoulder Plica syndrome Patellar instability

. . . . . . . . . . . . Greenstick fracture

5.2: Flip card for diagnosis description (MOI/risk factors, signs, confirmation /intervention), choose from diagnosis selection below. scroll down for correct answer: Apophyseal avulsion fracture / stress reactions Osteosarcoma Growth plate fracture (physeal, salter harris) Discoid meniscus Bankart lesion ALPSA lesion GH instability Little leagues elbow Spondylolisthesis Greenstick fracture Patellar instability

. . . . . . . . . . . . Growth plate fracture (physeal, salter harris)

3.4: Flip card for diagnosis description (MOI/risk factors, signs, OE tests/intervention), choose from diagnosis selection below. scroll down for correct answer: Ilioinguinal nerve entrapment Quadriceps contusion Slipped capital femoral epiphysis (SCFE) Hamstring strain Fatigue stress fracture Obturator nerve entrapment Gluteus minimus and/or medius injury Insufficiency stress fracture

. . . . . . . . . . . . Hamstring strain

3.3: Flip card for diagnosis description (MOI/risk factors, signs, OE tests/intervention), choose from diagnosis selection below. scroll down for correct answer: Internal snapping hip Adductor strain Hip OA Hip fracture External snapping hip Hermia

. . . . . . . . . . . . Hernia

3.2: Flip card for diagnosis description (MOI/risk factors, signs, OE tests/intervention), choose from diagnosis selection below. scroll down for correct answer: Althetic pubalgia Septic arthritis Legg-Calve-Perthes disease (pediatric avascular necrosis of hip) Myositis ossificans Internal snapping hip Adductor strain Hip OA Hip fracture

. . . . . . . . . . . . Hip OA

3.2: Flip card for diagnosis description (MOI/risk factors, signs, OE tests/intervention), choose from diagnosis selection below. scroll down for correct answer: Obturator nerve entrapment Gluteus minimus and/or medius injury Insufficiency stress fracture Hip avascular necrosis Developmental dysplasia Hip labral tear Osteitis pubis Althetic pubalgia

. . . . . . . . . . . . Hip avascular necrosis

3.3: Flip card for diagnosis description (MOI/risk factors, signs, OE tests/intervention), choose from diagnosis selection below. scroll down for correct answer: Lateral femoral cutaneous nerve entrapment Acute transient synovitis Hip bursitis Piriformis syndrome Femoral acetabular impingement Ilioinguinal nerve entrapment Quadriceps contusion

. . . . . . . . . . . . Hip bursitis

3.4: Flip card for diagnosis description (MOI/risk factors, signs, OE tests/intervention), choose from diagnosis selection below. scroll down for correct answer: Internal snapping hip Adductor strain Hip OA Hip fracture External snapping hip Hermia Septic arthritis Legg-Calve-Perthes disease Myositis ossificans

. . . . . . . . . . . . Hip fracture (90% femoral neck or intertrochanteric)

3.2: Flip card for diagnosis description (MOI/risk factors, signs, OE tests/intervention), choose from diagnosis selection below. scroll down for correct answer: Gluteus minimus and/or medius injury Insufficiency stress fracture Hip avascular necrosis Developmental dysplasia Hip labral tear Osteitis pubis Althetic pubalgia

. . . . . . . . . . . . Hip labral tear

3.4: Flip card for diagnosis description (MOI/risk factors, signs, OE tests/intervention), choose from diagnosis selection below. scroll down for correct answer: Hamstring strain Ilioinguinal nerve entrapment (T12-L1) Femoral nerve entrapment (L2-4) Developmental dysplasia Obturator nerve entrapment (L2-4) Hip avascular necrosis

. . . . . . . . . . . . Ilioinguinal nerve entrapment (T12-L1)

. . . . . . . . . . . . Insufficiency stress fracture (hip - commonly femoral neck)

3.3: Flip card for diagnosis description (MOI/risk factors, signs, OE tests/intervention), choose from diagnosis selection below. scroll down for correct answer: Legg-Calve-Perthes disease Myositis ossificans Internal snapping hip Adductor strain Hip OA Hip fracture

. . . . . . . . . . . . Internal snapping hip (more common than external)

2.5: Flip card for diagnosis description (MOI/risk factors, signs, OE tests/intervention), choose from diagnosis selection below. scroll down for correct answer: Bipartite patella Interosseous bruise Knee osteoarthritis Subperiosteal contusion / hemotoma Anterior knee pain (patellofemoral pain syndrome) Knee prepatellar bursitis ACL injury Osgood-Schlatter lesion (tibial apophysitis) MCL injury

. . . . . . . . . . . . Interosseous bruise

2.2: Flip card for diagnosis description (risk factors/MOI, signs, OE tests/intervention), choose from diagnosis selection below. scroll down for correct answer: Bipartite patella Segond fracture Knee osteoarthritis Tibial plateau fracture Patellofemoral instability Sinding-Larsen-Johansson lesion (patellar apophysitis) Patellar tendon rupture Knee prepatellar bursitis

. . . . . . . . . . . . Knee osteoarthritis

2.4: Flip card for diagnosis description (MOI/risk factors, signs, OE tests/intervention), choose from diagnosis selection below. scroll down for correct answer: Patellofemoral instability Meniscus tear (can be medial or lateral) Knee prepatellar bursitis Osgood-Schlatter lesion (tibial apophysitis) Subperiosteal contusion / hemotoma PCL injury Bipartite patella ACL injury Quadriceps tendon rupture

. . . . . . . . . . . . Knee prepatellar bursitis

. . . . . . . . . . . . LCL injury

3.5: Flip card for diagnosis description (MOI/risk factors, signs, OE tests/intervention), choose from diagnosis selection below. scroll down for correct answer: Legg-Calve-Perthes disease (pediatric avascular necrosis of hip) Quadriceps contusion Femoral nerve entrapment (L2-4) Septic arthritis Internal snapping hip Fatigue stress fracture Acute transient synovitis

. . . . . . . . . . . . Legg-Calve_Perthes disease (avascular necrosis of the hip)

. . . . . . . . . . . . MCL injury

2.2: Flip card for diagnosis description (risk factors/MOI, signs, OE tests/intervention), choose from diagnosis selection below. scroll down for correct answer: Meniscus tear (can be medial or lateral) Interosseous bruise Patellar fracture Subchondral bruise/fracture Subperiosteal contusion / hemotoma Tibiofemoral dislocation Quadriceps tendon rupture Osgood-Schlatter lesion (tibial apophysitis) Baker's cyst

. . . . . . . . . . . . Meniscus tear (can be medial or lateral)

3.4: Flip card for diagnosis description (MOI/risk factors, signs, OE tests/intervention), choose from diagnosis selection below. scroll down for correct answer: Athletic pubalgia Septic arthritis Legg-Calve-Perthes disease Myositis ossificans Internal snapping hip Adductor strain Hip OA

. . . . . . . . . . . . Myositis ossificans

3.4: Flip card for diagnosis description (MOI/risk factors, signs, OE tests/intervention), choose from diagnosis selection below. scroll down for correct answer: Septic arthritis Slipped capital femoral epiphysis (SCFE) Femoral acetabular impingement Femoral nerve entrapment (L2-4) Quadriceps contusion Obturator nerve entrapment (L2-4)

. . . . . . . . . . . . Obturator nerve entrapment (L2-4)

2.5: Flip card for diagnosis description (MOI/risk factors, signs, OE tests/intervention), choose from diagnosis selection below. scroll down for correct answer: Knee prepatellar bursitis ACL injury Osgood-Schlatter lesion (tibial apophysitis) MCL injury PCL injury Patellar tendon rupture Quadriceps tendon rupture Tibiofemoral dislocation LCL injury

. . . . . . . . . . . . Osgood-Schlatter lesion (tibial apophysitis)

. . . . . . . . . . . . Osteitis pubis

2.2: Flip card for diagnosis description (risk factors/MOI, signs, OE tests/intervention), choose from diagnosis selection below. scroll down for correct answer: LCL injury Anterior knee pain (fat pad/plica) MCL injury PCL injury Osteochondral lesion / defect Bipartite patella Segond fracture Knee osteoarthritis Tibial plateau fracture

. . . . . . . . . . . . Osteochondral lesion/defect

2.2: Flip card for diagnosis description (risk factors/MOI, signs, OE tests/intervention), choose from diagnosis selection below. scroll down for correct answer: Osgood-Schlatter lesion (tibial apophysitis) Baker's cyst Anterior knee pain (patellofemoral pain syndrome) ACL injury Osteochondritis dessicans LCL injury Anterior knee pain (fat pad/plica) MCL injury PCL injury

. . . . . . . . . . . . Osteochondritis dessicans

. . . . . . . . . . . . PCL injury

2.5: Flip card for diagnosis description (MOI/risk factors, signs, OE tests/intervention), choose from diagnosis selection below. scroll down for correct answer: Patellofemoral instability Subchondral bruise/fracture Patellar fracture Anterior knee pain (fat pad/plica) Bipartite patella Interosseous bruise Knee osteoarthritis Subperiosteal contusion / hemotoma Anterior knee pain (patellofemoral pain syndrome) Knee prepatellar bursitis

. . . . . . . . . . . . Patellar fracture

2.4: Flip card for diagnosis description (MOI/risk factors, signs, OE tests/intervention), choose from diagnosis selection below. scroll down for correct answer: Sinding-Larsen-Johansson lesion (patellar apophysitis) Patellar tendon rupture Tibial plateau fracture Segond fracture LCL injury MCL injury Patellofemoral instability Meniscus tear (can be medial or lateral) Knee prepatellar bursitis

. . . . . . . . . . . . Patellar tendon rupture

. . . . . . . . . . . . Patellofemoral instability

3.4: Flip card for diagnosis description (MOI/risk factors, signs, OE tests/intervention), choose from diagnosis selection below. scroll down for correct answer: Femoral acetabular impingement Ilioinguinal nerve entrapment (T12-L1) Quadriceps contusion Slipped capital femoral epiphysis (SCFE) Hamstring strain Fatigue stress fracture

. . . . . . . . . . . . Quadriceps contusion

2.4: Flip card for diagnosis description (MOI/risk factors, signs, OE tests/intervention), choose from diagnosis selection below. scroll down for correct answer: PCL injury Bipartite patella ACL injury Quadriceps tendon rupture Interosseous bruise Osteochondral lesion / defect Patellar fracture Knee osteoarthritis Subchondral bruise/fracture Anterior knee pain (fat pad/plica)

. . . . . . . . . . . . Quadriceps tendon rupture

2.5: Flip card for diagnosis description (MOI/risk factors, signs, OE tests/intervention), choose from diagnosis selection below. scroll down for correct answer: Osgood-Schlatter lesion (tibial apophysitis) MCL injury PCL injury Patellar tendon rupture Quadriceps tendon rupture Tibiofemoral dislocation LCL injury Sinding-Larsen-Johansson lesion (patellar apophysitis) Osteochondral lesion / defect Segond fracture Baker's cyst

. . . . . . . . . . . . Segond fracture

. . . . . . . . . . . . Septic arthritis

2.5: Flip card for diagnosis description (MOI/risk factors, signs, OE tests/intervention), choose from diagnosis selection below. scroll down for correct answer: MCL injury PCL injury Patellar tendon rupture Quadriceps tendon rupture Tibiofemoral dislocation LCL injury Sinding-Larsen-Johansson lesion (patellar apophysitis) Osteochondral lesion / defect Segond fracture Baker's cyst

. . . . . . . . . . . . Sinding-Larsen-Johansson lesion (patellar apophysitis)

. . . . . . . . . . . . Slipped capital femoral epiphysis (SCFE)

2.5: Flip card for diagnosis description (MOI/risk factors, signs, OE tests/intervention), choose from diagnosis selection below. scroll down for correct answer: Tibial plateau fracture Patellofemoral instability Subchondral bruise/fracture Patellar fracture Anterior knee pain (fat pad/plica) Bipartite patella Interosseous bruise Knee osteoarthritis

. . . . . . . . . . . . Subchondral bruise/fracture compare with subperiosteal bruise fracture: Direct impact to bone w/ minimal soft tissue protection (tibia) Bruising Swelling Tender to palpation MRI: bone w/ periosteum lesion (over)

2.5: Flip card for diagnosis description (MOI/risk factors, signs, OE tests/intervention), choose from diagnosis selection below. scroll down for correct answer: Subperiosteal contusion / hemotoma Anterior knee pain (patellofemoral pain syndrome) Knee prepatellar bursitis ACL injury Osgood-Schlatter lesion (tibial apophysitis) MCL injury PCL injury Patellar tendon rupture

. . . . . . . . . . . . Subperiosteal contusion / hematoma

2.5: Flip card for diagnosis description (MOI/risk factors, signs, OE tests/intervention), choose from diagnosis selection below. scroll down for correct answer: Osteochondritis dessicans Tibial plateau fracture Patellofemoral instability Subchondral bruise/fracture Patellar fracture Anterior knee pain (fat pad/plica) Bipartite patella Interosseous bruise Knee osteoarthritis Subperiosteal contusion / hemotoma Anterior knee pain (patellofemoral pain syndrome)

. . . . . . . . . . . . Tibial plateau fracture

2.5: Flip card for diagnosis description (MOI/risk factors, signs, OE tests/intervention), choose from diagnosis selection below. scroll down for correct answer: LCL injury MCL injury Knee prepatellar bursitis Tibiofemoral dislocation Baker's cyst ACL injury Segond fracture Osgood-Schlatter lesion (tibial apophysitis) Interosseous bruise Knee osteoarthritis Sinding-Larsen-Johansson lesion (patellar apophysitis)

. . . . . . . . . . . . Tibiofemoral dislocation

5.2: Flip card for diagnosis description (MOI/risk factors, signs, OE tests/intervention), choose from diagnosis selection below. scroll down for correct answer: Discoid meniscus Bankart lesion Patellar instability Growth plate fracture (physeal, salter harris) Hill sachs lesion GH instability Apophyseal avulsion fracture / stress reactions ALPSA lesion Spondylolisthesis Osteosarcoma

. . . . . . . . . . . . discoid meniscus

. . . . . . . . . . . . femoral nerve entrapment (L2-4)

5.2: Flip card for diagnosis description (MOI/risk factors, signs, confirmation /OE tests), choose from diagnosis selection below. scroll down for correct answer: Little league shoulder Plica syndrome Hill sachs lesion Discoid meniscus Little leagues elbow Growth plate fracture (physeal, salter harris) ALPSA lesion Spondylolisthesis Osteosarcoma Patellar instability Apophyseal avulsion fracture / stress reactions GH instability

. . . . . . . . . . . . hill sachs lesion

3.4: Flip card for diagnosis description (MOI/risk factors, signs, OE tests/intervention), choose from diagnosis selection below. scroll down for correct answer: Gluteus minimus and/or medius injury Obturator nerve entrapment (L2-4) Lateral femoral cutaneous nerve entrapment (meralgia paresthetica) Hip fracture Hip OA Hip avascular necrosis Ilioinguinal nerve entrapment (T12-L1)

. . . . . . . . . . . . lateral femoral cutaneous nerve entrapment (meralgia paresthetica)

5.2: Flip card for diagnosis description (MOI/risk factors, signs, confirmation /OE tests), choose from diagnosis selection below. scroll down for correct answer: Plica syndrome Patellar instability Spondylolisthesis Discoid meniscus Little leagues elbow Osteosarcoma Apophyseal avulsion fracture / stress reactions Bankart lesion Greenstick fracture Growth plate fracture (physeal, salter harris) GH instability

. . . . . . . . . . . . little league elbow

5.2: Flip card for diagnosis description (MOI/risk factors, signs, confirmation /OE tests), choose from diagnosis selection below. scroll down for correct answer: Hill sachs lesion Growth plate fracture (physeal, salter harris) ALPSA lesion Plica syndrome Little leagues elbow Apophyseal avulsion fracture / stress reactions Greenstick fracture Spondylolisthesis Osteosarcoma Little league shoulder Patellar instability

. . . . . . . . . . . . little league shoulder

5.2: Flip card for diagnosis description (MOI/risk factors, signs, OE tests/intervention), choose from diagnosis selection below. scroll down for correct answer: Hill sachs lesion GH instability Greenstick fracture Apophyseal avulsion fracture / stress reactions Little league shoulder Patellar instability Bankart lesion Osteosarcoma Discoid meniscus Plica syndrome ALPSA lesion

. . . . . . . . . . . . osteosarcoma

5.2: Flip card for diagnosis description (MOI/risk factors, signs, OE tests/intervention), choose from diagnosis selection below. scroll down for correct answer: Hill sachs lesion Apophyseal avulsion fracture / stress reactions Spondylolisthesis Bankart lesion GH instability Patellar instability Osteosarcoma Plica syndrome Discoid meniscus Greenstick fracture Little leagues elbow

. . . . . . . . . . . . patellar instability

3.4: Flip card for diagnosis description (MOI/risk factors, signs, OE tests/intervention), choose from diagnosis selection below. scroll down for correct answer: Piriformis syndrome Insufficiency stress fracture Hip bursitis External snapping hip Hip labral tear Hamstring strain

. . . . . . . . . . . . piriformis syndrome

5.2: Flip card for diagnosis description (MOI/risk factors, signs, OE tests/intervention), choose from diagnosis selection below. scroll down for correct answer: Greenstick fracture Plica syndrome Patellar instability Discoid meniscus Apophyseal avulsion fracture / stress reactions Growth plate fracture (physeal, salter harris) Hill sachs lesion GH instability Little league shoulder Little leagues elbow Bankart lesion

. . . . . . . . . . . . plica syndrome

5.2: Flip card for diagnosis description (MOI/risk factors, signs, confirmation /OE tests), choose from diagnosis selection below. scroll down for correct answer: Apophyseal avulsion fracture / stress reactions Plica syndrome Patellar instability Hill sachs lesion Spondylolisthesis GH instability Greenstick fracture Little league shoulder ALPSA lesion Discoid meniscus Growth plate fracture (physeal, salter harris)

. . . . . . . . . . . . spondylolisthesis

4.2: categorize the following groups of activities what are 1. recommended/allowed, 2, allowed with experience, 3. not recommended and 4. not conclusive post THA (as classified by the 1999 hip society survey). -speed walking, downhill skiing, weight machines, ice skating -canoeing, hiking, cross country skiing -swimming, walking -high impact aerobics, jogging

1. -swimming, walking 2. -canoeing, hiking, cross country skiing 3. -high impact aerobics, jogging 4. -speed walking, downhill skiing, weight machines, ice skating

What are the three injuries that are often concomitant with glenohumeral instability and what are the differences between the 3?

1. Bankhart lesion: labrum injury without bony involvement 2. ALPSA lesion: labrum injury with bony involvement 3. hill sachs lesion: injury to the humeral head as it rests on the labrum

4LS: Patient is a 12-year-old moderately obese black male who is an avid baseball fan and plays league ball. He has had complaints of R knee pain for most of the last year that was always worse with activity. Following his slide into home plate during his game last week he noticed that his knee pain has become constant and he also experiences groin pain and thigh pain. The doctor covering the games said it was probably a muscle pull and gave him a referral to see you after the game. Other Specifics Pain is constant NPRS= Worst 10/10, best 5/10 Agg= standing, moving hip in any direction but especially IR Ease= holding leg like I have it now (slightly flexed, ER) 1. What is your hypothesis for this case? indicate at least two risk factors supporting it. 2. What explains the knee pain? 3. What is the best physical therapist response to these findings and why?

1. SCFE: desire for open pac position of hip, age 2. having a slipped femoral disc would cause referral pain to the knee --> unstable hips lead to more stress on the knee 3. education about condition, unloading with crutches for the time being, consider surgery

4LS: Patient is a 50-year-old male office worker who noticed an onset of left hip pain that was first noticed about 6 months ago. The pain began as some aching at the end of the day, but now has become more pronounced and is accompanied by morning stiffness. In addition, other symptoms include stiffness after prolonged sitting and at the beginning of tennis matches (plays 3x per week). Past medical history includes prostate cancer 3yrs ago, surgically removed. Has noticed a loss of ~15#s in the last month. Other Specifics Pain is intermittent, worse at end of day and stiff in AM NPRS= worst 4/10, best 0-1/10 Agg= as described above, initial movements of getting out of sedan cause some pain. Ease=frequent changes of position, hot showers at night. 1. What are two primary hypotheses for this patient based on the information given? 2. Which of these hypotheses is more likely?

1. What are two primary hypotheses for this patient based on the information given? Hip OA: morning stiffness + stiffness after prolonged sitting, increase in pain with activity; eases with changes of position Bone Cancer: weight loss, history of cancer 2. Which of these hypotheses is more likely? Hip OA (aggravating and alleviating factors consistent with OA, no other symptoms of cancer); non-constant/intermittent pain; cancer removed 3 years ago

5.2: What are the 5 components of the Beighton hypermobility score? How is it scored?

1. elbows hyperextended <0 2. Knees hyperextended <0 3. thumbs touch forearms 4. Ankles DF >45° 5. Fingers hyperextend to be parallel to forearm 9 point scale (one point for each side/measure) - higher score = more hypermobile

4.2: categorize the following groups of activities what are 1. suitable, 2. suitable but more risky, 3. avoid (as classified by the knee society survey). -downhill skiing, ice skating, speed walking, hunting, low impact aerobics, volleyball -baseball, basketball, football, hockey, soccer, high impact aerobics, jogging, parachuting, power lifting -cycling, swimming, low-resistance rowing, walking, hiking, low-resistance weight lifting, ballroom dancing, square dancing

1. suitable: cycling, swimming, low-resistance rowing, walking, hiking, low-resistance weight lifting, ballroom dancing, square dancing 2. downhill skiing, ice skating, speed walking, hunting, low impact aerobics, volleyball 3. baseball, basketball, football, hockey, soccer, high impact aerobics, jogging, parachuting, power lifting

2.2A: Which injury to the articular cartilage has the best prognosis for healing on its own? A small, superficial tear to the articular cartilage. An injury that extends to the subchondral bone.

A small, superficial tear to the articular cartilage. An injury that extends to the subchondral bone.

2.2A: Which meniscus injury likely has the best prognosis for healing? A tear in the inner one-third of the medial meniscus A tear in the outer one-third of the lateral meniscus A tear in the middle one-third of the lateral meniscus A tear in the middle one-third of the medial meniscus

A tear in the inner one-third of the medial meniscus A tear in the outer one-third of the lateral meniscus A tear in the middle one-third of the lateral meniscus A tear in the middle one-third of the medial meniscus

3LS: A 5-year-old male child presents with complaints of inability to walk. The parents report that the child was walking fine yesterday and woke up today, limped a little and now will not walk. The child is afebrile (not feverish), reports no trauma or falls. What is the most likely condition?

Acute transient synovitis (refuses to walk, age matches the demographic)

4.3A: Which ligament is not often spared during a total knee replacement? ACL PCL MCL LCL

ACL

4LS: What three structures are commonly injured in the knee with valgus and internal rotation injury mechanisms. What about these structures causes them to commonly be injured together?

ACL, MCL, medial meniscus ACL resists internal rotation - if internal rotation force goes too far it will cause an ACL rupture. Medial knee structures that are attached / within the joint capsule (MCL and medial meniscus share attachment) are also stressed by internal rotation, and are ruptured with too much internal rotation as well.

1.6A: A 34-year-old patient presents with posterior ankle pain that has persisted for 5 months. The ankle pain began after a long run while training for a marathon. Pain is 3/10 on a numeric pain rating scale (NPRS) and is eased with rest. The patient reports a failed course of ibuprofen. The physical therapist noticed reduced passive ankle dorsiflexion range of motion and a palpable thickening on the posterior aspect of the ankle. What is the most likely diagnosis? Achilles tendonosis Achilles tendonitis Sever's disease

Achilles tendonosis Achilles tendonitis Sever's disease "The long duration and low intensity of this patient's pain signify that this is more of a chronic condition. The fact that anti-inflammatory medication did not help also helps rule out tendonitis."

6.3A: Dysfunction in the structure of the vertebral disc can be referred to as: Herniated disc Prolapses disc All of the other responses Schmorl's nodes Bulging disc

All of the other responses

1.7A: Which of the following is/are risk factor(s) for development of plantar heel pain? Running Work-related weight bearing Increased BMI Decreased ankle dorsiflexion All of these answers are correct Only 3 1 3 and 4 2 and 3

All of these answers are correct Only 3 1 3 and 4 2 and 3

6.3A: The lumbar disc has a fibrous, outer portion called the: Lamina Nucleus pulpolsis Annuus fibrosis Vertebral end plate

Annuus fibrosis

4.2: Which THA approach has a much lower early dislocation risk and thus requires less hip precautions? How long are hip precautions usually in place?

Anterolateral approach 3 months, up to a year

2.2A: Hyaline cartilage receives its nutrition via which of the following methods? Arterial supply Transdermally Osmosis Diffusion

Arterial supply Transdermally Osmosis Diffusion

4LS: A 43-year-old professor has severe knee osteoarthritis. He is considering whether or not to follow a surgeon's recommendation for a TKA. Which of the following best describes an evidence-based strategy to make this decision? Get it as soon as possible to avoid co-morbidities. Wait as long as possible, since the arthroplasty components will not last beyond 20 years. Participate in aerobic exercise, management of comorbidities, and wait as long as possible to get the TKA. Balance overall health and function, cardiovascular risk factors, and age to determine the best timing for the surgery, taking into account patient preference, and estimated component duration.

Balance overall health and function, cardiovascular risk factors, and age to determine the best timing for the surgery, taking into account patient preference, and estimated component duration.

1.7A: A patient was backing their motorcycle into a parking spot when their leg became trapped between the bike and an unseen metal object. The result was that the weight of the motorcycle momentarily rested on the patient's anterior tibia. The patient, after spending the day at work with the leg in a dependent position, presented to urgent care with complaints of painful and weak dorsiflexion, swelling, bruising on the shin, and resting pain of 7/10 NPRS. What is the injury this patient is experiencing? Bone bruise compartment syndrome Soft tissue injury Tendinitis of anterior tibialis muscle

Bone bruise compartment syndrome Soft tissue injury Tendinitis of anterior tibialis muscle

1.4A: What is another name for hallux valgus? Bunion Haglung'd deformity Tarsal tunnel syndrome Fat pad syndrome

Bunion Haglung'd deformity Tarsal tunnel syndrome Fat pad syndrome

4.2: What is the name of the Dr that introduced total hip arthroplasty, in what decade>

Charnley, 1960s

4.5A: Which of the following motions should be protected after a reverse total shoulder arthroplasty? Internal rotation Flexion Abduction External rotation

Internal rotation

6.4: Name and describe the six laslett cluster tests as discussed in the 566 6.4 asynch material

Drop test: patient stands and drops on heel of affected side, would be painful in affected SIJ Sacral thrust: patient prone, PT thrusts SIJ downwards (bilateral test) Compression test: patient sidelying, PT compress downward on hip Distraction test: patient supine, PT use hypothenar eminences to distract SIJ bilaterally Thigh thrust test/posterior shear: patient supine with one leg in 90/90 position, PT appleis axial (downward) load through femur while stabilizing sacrum (goal = gap SIJ) Gaenslen's test: flexion one leg, extension other leg, looking for twisting/shearing pain in SIJ

4.2: What is the most common post THA complication? what is the % range of prevalence and what medication treatment is prescribed preop to decrease risk? Name a few of the other 7 mentioned complications in Otto, 2005

DVT is most common 8-70%, prophylactic anticoagulants are prescribed pre op to decrease risk

4.7A: Which of the following is the most common complication following joint arthroplasty? Joint dislocation Deep vein thrombosis

Deep vein thrombosis

6.5A: The first step in treatment-based classification is to Establish what factors you will utilize to categorize the patient into a treatment category. Fit the patient into the appropriate category based on examination findings and history. Establish that the patient is appropriate for physical therapy intervention.

Establish that the patient is appropriate for physical therapy intervention.

1.5A: For which of the following types of ankle sprains would weight bearing be problematic for several weeks? Eversion ankle sprain Inversion ankle sprain Syndesmotic sprain

Eversion ankle sprain Inversion ankle sprain Syndesmotic sprain "Since this type of sprain injures the ligamentous connections between the tibia and fibula along their syndesmotic attachment, weight bearing can cause the dome of the talus to cause separation between these two bones. Inversion or eversion sprains do not interfere with weight bearing aside from pain due to inflammation or swelling."

1.2A: The diagnostic approach that involves generating a leading list of probable hypotheses and subsequently testing them to rule out or rule in a condition is called Exhaustive Hypothetico-deductive Exhaustive Algorithmic

Exhaustive Hypothetico-deductive Exhaustive Algorithmic "Hypotheses are generated from experience, patterns, and knowledge and are subsequently systematically tested to arrive at the best diagnosis."

4.2: ________ __________ disruption was seem in 6 of 290 post TKA patients in a study mentioned in the lecture material

Extensor mechanism disruption

6LS: A patient experienced forceful eversion and external rotation of the foot and ankle upon stepping into a hole while running. A physical therapist conducting an examination determined a positive talar tilt test denoting laxity in the deltoid ligament. What other special test is likely to be positive? a. External rotation stress test b. Anterior drawer test c. Windlass test d. Thompson test

External rotation stress test this is a test for high ankle sprain which is likely with an eversion and ER MOI

1Q: TF A maisonneuve fracture is a frcture of the distal fibula associated with a sydesmosis sprain

False

2LS: TF: Distance running is a major risk factor for the development of knee OA

False

2LS: TF: The majority of ACL injuries are non traumatic

False

3LS: TF: The MCL is unrelated to the medial meniscus

False

4.7A: True or false: A reverse total hip arthroplasty follows the same biomechanical principles as a reverse total shoulder arthroplasty. Fasle True

False

4LS: A 28-year-old female endurance athlete presents to your clinic with a 3-week history of insidious onset of L hip pain. She reports increased pain with weight bearing and activity, decreased with rest. She has also recently increased her mileage and intensity of her runs prior to competition. What is the most likely differential diagnosis based on this limited history? Hip OA Acetabular Impingement Femoral Neck Stress Fracture Labral Tear

Femoral Neck Stress Fracture

4LS: Of the hip fracture sites listed below, which is the most common? Femoral neck Acetabulum Greater trochanter Femoral head

Femoral neck

4LS: Name several bones/locations that are common locations for stress fractures to occur.

Femoral neck, pubic rami, acetabulum, femoral head, sacrum, tibia, 5th metatarsal (base of 5th/Jones Stress fx/Zone 2 or shaft/Diaphyseal Stress Fx/Zone 3...Zone 1 is usually avulsion full fracture of tubercle), metatarsals 2-4?

3.2: Word used to describe articular cartilage rough surface associated with OA

Fibrillation

1.5A: Match the affected ligaments with the correct grade of ankle sprain Grade I Grade II Grade III ATFL ATFL and CFL PTFL and CFL and ATFL

Grade I: ATFL Grade II: ATFL and CFL Grade III: PTFL and CFL and ATFL

6.4A: Your patient is a 45-year-old health care recruiter who is being seen at your clinic for an ankle sprain. During your treatment today she reports a fall where she landed on her back. She has had back pain since the event, but today she has noted numbness and tingling between her legs and extending down the posterior thigh. Which of the following questions would be the most valuable as you try to determine whether or not your patient has an emergent condition? Have you had any change in your ability to urinate, specifically starting the flow of urine? Does your pain have a "pulsating" sensation? Have you had any unexplained loss of weight over the past 3 months? Do you or anyone in your family have a history of cancer?

Have you had any change in your ability to urinate, specifically starting the flow of urine?

1.3: Match the tissue healing phase with the primary characteristic Hemostasis Inflammation Proliferation Remodeling -Matrix is comprised of 30% Type III collagen -WBCs activate macrophages to eat bad things --> macrophages activate fibroblasts to repair good tissue -Platelet activation -Matrix is comprised of 80-90% Type I collagen

Hemostasis: Platelet activation Inflammation: WBCs activate macrophages to eat bad things --> macrophages activate fibroblasts to repair good tissue Proliferation: Matrix is comprised of 30% Type III collagen Remodeling: Matrix is comprised of 80-90% Type I collagen

4LS: What is a common complication that can develop following a biceps contusion? Heterotopic bone formation Chronic compartment syndrome Erythema Mild Edema

Heterotopic bone formation

3.2: ACR criteria for hip OA diagnosis: Hip pain for >___ of the past ___ days AND at least (one/two) of the following: 1. ________ sedimentation rate <20mm/first hour 2. _________s on xray exam 3. obliteration of _______ _______

Hip pain for >25 of the past 30 days AND at least (one/two) of the following: 1. erythrocyte sedimentation rate <20mm/first hour 2. osteophytes on xray exam 3. obliteration of joint space

4.5: What are the three components of a TSA?

Humeral stem Humeral head Glenoid cup

5LS: A 34-year-old female presents with complaints of centralized low back pain (6/10NPRS) that began two weeks prior. They have had a previous history of back pain, with episodes about once per year for 5 years. Examination reveals the following key findings: SLR 85, hypomobile lumbar spine with PA springing, pain worse with extension (8/10 NPRS), +PIT test, reversed lumbopelvic rhythm. What is the best diagnosis for this patient? LBP with mobility impairments Facet dysfunction Non-specific LBP likely to respond to exercise Disc derangement

LBP with mobility impairments

3.2A: Which of the following is NOT an extra-articular cause of hip pain? Labral tears Greater trochanteric bursitis Piriformis syndrome Snapping hip

Labral tears Greater trochanteric bursitis Piriformis syndrome Snapping hip Why? The hip labrum is part of the synovial joint

2.3A: Which of the following structures is the primary restraint to valgus forces applied to the knee? Lateral collateral ligament Posterior cruciate ligament Medial collateral ligament Anterior cruciate ligament

Lateral collateral ligament Posterior cruciate ligament Medial collateral ligament Anterior cruciate ligament

4LS: Describe the differences between the medial and lateral meniscus. How does this translate to likelihood of injury?

Lateral meniscus has more freedom to move and the medial meniscus is more stationary which makes it more prone to injury (it cannot move and adapt to the stresses)

3.4A: The hip is most commonly dislocated in which direction? Laterally Posteriorly Inferiorly Anteriorly

Laterally Posteriorly Inferiorly Anteriorly "Posterior dislocations account for about 90% of hip dislocations. The remainder are anterior dislocations."

2.5A: A patient who had just completed a marathon presents to a physical therapist who is working the athletic event complaining of severe pain in the foot and leg. The therapist observes discoloration of the foot and toes, weak dorsiflexion, and a diminished dorsal pedal pulse. Which is the most appropriate action? Leave a message with the physician. Tell the patient to elevate the leg and wait to see if symptoms improve. Immediately send the patient in an ambulance to the hospital and phone the physician. Take no action; this is a normal response in a fatigued individual after a long run.

Leave a message with the physician. Tell the patient to elevate the leg and wait to see if symptoms improve. Immediately send the patient in an ambulance to the hospital and phone the physician. Take no action; this is a normal response in a fatigued individual after a long run.

1.6A: A 34-year-old patient presents with posterior ankle pain that has persisted for 5 months. The ankle pain began after a long run while training for a marathon. Pain is 3/10 on a numeric pain rating scale (NPRS) and is eased with rest. The patient reports a failed course of ibuprofen. The physical therapist noticed reduced passive ankle dorsiflexion range of motion and a palpable thickening on the posterior aspect of the ankle. Which of the following would be an expected finding? Limited ankle plantarflexion AROM Weak ankle dorsiflexion strength Weak ankle plantarflexion strength The presence of platelets in the achilles tendon

Limited ankle plantarflexion AROM Weak ankle dorsiflexion strength Weak ankle plantarflexion strength The presence of platelets in the achilles tendon "weak ankle plantarflexors would be present along with the observed limited ankle dorsiflexion range of motion."

6.4: is lumbar or SIJ manipulation more effective when treating SIJ dysfunction

Lumbar - Tullberg (scientist) found that there was no change in pre-post SIJ manipulation

5LS: A 34-year-old female presents with complaints of centralized low back pain (6/10NPRS) that began two weeks prior. They have had a previous history of back pain, with episodes about once per year for 5 years. Examination reveals the following key findings: SLR 85, hypomobile lumbar spine with PA springing, pain worse with extension (8/10 NPRS), +PIT test, reversed lumbopelvic rhythm. What is the intervention that would result in the most likely treatment success? Lumbar traction Transverse abdominis activation Lumbar HVLA technique Facet joint mobilization

Lumbar HVLA technique

5LS: What method of testing could theoretically be used to examine the irritability of the lumbar facet joints? Lumbar rotation range of motion Lumbar flexion range of motion Lumbar extension range of motion Lumbar flexion range of motion with overpressure

Lumbar extension range of motion lumbar extension would be the most irritable to the facet joints (loading the posterior elements of the spine)

6.4: What special test is a test for true lumbar instability (which is very rare)? What special test that is more common is used for "general" lumbar instability, which is a broader category of patients with movement coordination deficits?

Lumbar shear test Prone instability test

6.5A: What is the best intervention to choose for a patient who presents with pain distal to the buttock, signs of nerve root compression (+ SLR < 45 degrees, diminished L4 reflex), and a (+)crossed-straight leg raise and peripheralization with movement? Repeated motions Lumbar traction Spinal manipulation Motor control exercises

Lumbar traction

2LS: What is the difference between swelling with an ACL or MCL rupture?

MCL blends into capsule --> swelling more diffuse through knee ACL is more contained in capsule --> swelling is more contained in the joint (localized)

1.5A: What is the most important factor from a patient's history that can help you identify their particular type of ankle sprain?

MOI: find out of their "rolled" or "twisted" their ankle, if they did so what direction the "roll" or "twist" happened in

4LS: Which of the following are hallmark examination findings associated with knee meniscal injury? Mild edema, joint line tenderness, inability to bear weight, positive valgus test. Moderate edema, joint line tenderness, clicking, positive entrapment tests, hamstring weakness Mild-moderate edema, positive McMurray and Apley Grind tests, quad inhibition, positive Thessaly test Mild-moderate edema, joint line tenderness, positive McMurray and Apley Grind tests, quad inhibition.

Mild-moderate edema, joint line tenderness, positive McMurray and Apley Grind tests, quad inhibition OE (hallmark signs of meniscus tear): 1.Joint line tenderness 2.Effusion 3. (+) entrapment test (McMurray's, Thessaly's) 4. Quad inhibition

3.2A: Your patient is a 52 yo male with a history that leads you to a primary hypothesis of L hip OA. However, during your exam you note that his L hip IR and flexion ROM are 25 and 120, respectively, and that hip IR is painful. Which of the following clinical findings, if also present, would support your primary hypothesis of hip OA? Morning stiffness < 60 min Positive Thomas test for tight psoas Weak gluteus maximus Positive Trendelenburg sign

Morning stiffness < 60 min Positive Thomas test for tight psoas Weak gluteus maximus Positive Trendelenburg sign

6LS: A 27-year-old female complains of pain between her third and fourth toes on the left foot. Which of the following is the MOST likely medical diagnosis? a. Achilles tendonopathy b. Morton's neuroma c. Tibialis anterior tendonitis d. Tibial stress fracture

Morton's neuroma

3.2: Hip arthroscopy precautions: Muscle activity to promote: prime movers and stabilizers: -hip extensor: ________ ________ -hip abductor: _______ _________ -trunk stabilizer: _________ __________ -knee extend group: ______ -knee flex group: ___________ Muscles activity to demote: "hypertonic" compensators -hip ______ group -hip abductor: ___ -hip _________ group

Muscle activity to promote: prime movers and stabilizers: -hip extensor: glut max -hip abductor: glut med -trunk stabilizer: transverse abdominis -knee extend group: quads -knee flex group: hams Muscles activity to demote: "hypertonic" compensators -hip flexor group -hip abductor: TFL -hip adductor group

3LS: David, a 74-year-old male was golfing yesterday with his friends when he fell on a ramp to the clubhouse. He was found by EMS to have a shortened and externally rotated left lower extremity. A physical therapist arrives the next day to see David in an acute care setting. He's unable to orient to time and place, and seems exceedingly anxious. He refuses PT, and sends the PT out of the room. The physical therapist decides to try to see David later that day when perhaps he has relaxed some. Did the physical therapist make the correct decision, why or why not?

No he didn't: Disorientation = red flag; should have alerted care team immediately for risk of infection, DVT, PE (high risk after hip fracture)

4LS: Explain in your own words, the difference between nociception and pain?

Nocioception: afferent-receptors that are triggered with chemical/mechanical/thermal changes in tissues and send signals to the brain Pain: efferent interpretation of the afferent receptor message (nociception)

6LS: Which of the following clinical findings is consistent with a diagnosis of gluteus medius muscle strain? a. Negative Ober test b. Anterior groin pain c. Pain with resisted abduction testing d.Tenderness to palpation over the origin of the Tensor Fascia Lata

Pain with resisted abduction testing

2.2A: Which of the following is NOT a clinical sign associated with knee OA? Palpable bony enlargement Morning stiffness < 30 minutes Palpable warmth Palpable tenderness

Palpable bony enlargement Morning stiffness < 30 minutes Palpable warmth Palpable tenderness

6.4A: In which patient do you suspect ankylosing spondylitis (AS)? Patient A: A 19-year-old male who reports sacral pain, but has otherwise normal radiographs. The patient reports running improves symptoms. Patient B: A 67-year-old female with dramatic reduction in intervertebral joint space and increased thoracic kyphosis. Lung capacity is reduced due to her forward flexed posture. Patient A Patient B

Patient B

5LS: A patient presents with a diagnosis of herniated lumbar disc with nerve root involvement at L4-L5. What is NOT an expected finding for this patient? Positive straight leg raise test Positive femoral nerve stretch test Weakness in ankle dorsiflexion Limited lumbar extension range of motion

Positive femoral nerve stretch test L4 comes out between L4 and 5, but a hernia at a junction actually affects the NEXT ONE DOWN (so in this case it would be the L5 nerve root) if we're thinking about L5, femoral nerve stretch wouldnt be a problem SO femoral nerve stretch is the only NOT finding in this case

4LS: Write scripts to instruct a patient for their post-surgical precautions following a THA for both a posterior-lateral and an anterio-lateral approach.

Posterior approach: Do you know your precautions? No? Let me fill you in. Don't bring you leg up in front of you past your hip, that means you can sit up in a chair but don't lift your leg past that. Don't cross your legs Don't sleep on your side without a pillow between your legs Don't turn your toes in Don't kick your leg waaaaay back (a little is okay) Anterior Approach: Don't rotate your leg out Don't extend your hip past neutral/midline Don't abduct/lift your leg out to the side very much

3.5A: A 13 y/o slightly overweight male patient c/o left knee and hip pain. He recalls no injury. Examination reveals weak hip musculature, a leg-leg length difference of 3 cm, and decreased ROM in hip IR and abduction. He has palpable pain anterolaterally at the hip joint. At rest, he prefers the open packed position for comfort. What is the most likely pathology? Posterior hip dislocation Femoral neck fracture Midshaft femur fracture Slipped capital femoral epiphysis

Posterior hip dislocation Femoral neck fracture Midshaft femur fracture Slipped capital femoral epiphysis

6LS: Considering internal snapping hip, which tendon most commonly causes the snap? a. Adductor magnus b. Tensor fasciae latae c. Rectus femoris d. Psoas

Psoas

2.5A: A patient presents to physical therapy with painful and weak knee extension after completing a soccer match in which they felt sudden pain in the thigh and had to stop playing. A physical therapist examines the patient and finds no positive special tests, but that there is some mild edema around the distal thigh, and knee extension muscle strength is 3+/5 and painful. What is the most likely diagnosis? Quad contusion Peripheral edema Patellar tendon rupture Quadriceps strain

Quad contusion Peripheral edema Patellar tendon rupture Quadriceps strain

4.3A: What muscle should be a high priority for careful assessment and intervention following total knee arthroplasty? Glut med Glut max Quadriceps Hamstrings

Quadriceps

3.3A: With internal snapping hip, which tendon most commonly causes the snap? Rectus femoris Psoas Tensor fascia latae Adductor magnus

Rectus femoris Psoas Tensor fascia latae Adductor magnus

5LS: A 60-year-old patient has been receiving physical therapy for 3 weeks for her low back pain. The patient presents with signs/symptoms of spinal stenosis and the physical therapist has been using a regional manual therapy approaching including spinal manipulation and exercise, and body-weight supported treadmill training. The patient reports minimal gains on a PSFS, and her symptoms have remained relatively unchanged. She asks you about acupuncture for her pain? What is the most appropriate action? Refer to physician Alter treatment plan to include specific core exercise Alter treatment plan to include lumbar traction Refer to acupuncture

Refer to physician

4.7A: What activity would be problematic 2 months postop from a THA completed with a posterior approach? Seated hamstring stretch Getting up from a chair Using the toilet Getting a sock off the floor

Seated hamstring stretch

3.5A: The parents of a 2-year-old girl report their daughter has been noticeably fussy and uncomfortable for the past 2 days. The baby becomes especially irritable during diaper changes when her left hip is moved and the area appears to be excessively warm. They state that she hasn't eaten much lately and developed a high fever last night that has been persistent. Given the findings in the case above, which of the following diagnoses is most probable? Septic arthritis Legg-Calve-Perthes Transient synovitis Slipped capital femoral epiphysis

Septic arthritis Legg-Calve-Perthes Transient synovitis Slipped capital femoral epiphysis

2.3: What is the name of ligament-bone insertion fibers? (HSM)

Sharpey's fibers

4LS: A physical therapist is working with a patient for gait training following an auto-pedestrian injury which resulted in two fractured metatarsals and a non-weight bearing restriction. During the examination, the therapist observes pallor of the foot and toes. The patient complains of severe pain that is worse than during the initial injury following placement of a hard cast. Which is the most appropriate action? Leave a note in the chart for the physician about the change in pain status Tell the nursing desk about the change in pain status Speak directly to the physician about the change in pain status. No action is required at this time, this is a normal progression of inflammation.

Speak directly to the physician about the change in pain status.

6LS: A 17-year-old ballet dancer presents with low back pain x 6-months that is worse with lumbar extension, during ballet practice, and improves at night while sleeping. The pain is centralized and can be classified as intermittent. What is the most likely diagnosis? a. Schmorl's nodes b. Lumbar disc herniation c. Facet joint pathology d.Spondylolisthesis

Spondylolisthesis

6.4: What four structures make up the "lumbar box" ?

Superior: diaphragm Inferior: pelvic floor Posterior: deep multitfidus fibers Anterior: transverse abdominis

1.6: Match the condition with the definition Tendinitis Tendinosis -short duration + high intensity, inflammation of tendon due to acute overload -long duration + low intensity, degeneration of tendon collagen due to chronic overuse

Tendinitis: short duration + high intensity, inflammation of tendon due to acute overload Tendinosis: long duration + low intensity, degeneration of tendon collagen due to chronic overuse

6LS: Which type of femoral neck stress fracture would require ORIF? a. Tension side b. Compression side c. Lateral side d.Inferior side

Tension side

3.4A: Which of the following types of stress fractures of the femoral neck is considered unstable and may require surgical stabilization? Tension side stress fractures of the femoral neck Compression side stress fractures of the femoral neck Compression side stress fractures of the subtrochanter Tension side stress fractures of the subtrochanter

Tension side stress fractures of the femoral neck Compression side stress fractures of the femoral neck Compression side stress fractures of the subtrochanter Tension side stress fractures of the subtrochanter

3.2: Hip OA diagnosis test clusters Test cluster 1: -hip pain and -hip IR <___° -hip flex <____° OR if hip IR is >___°, use Test cluster 2: -painful hip IR and ->___ YO -AM hip stiffness <___ minutes

Test cluster 1: -hip pain and -hip IR <15° -hip flex <115° OR if hip IR is >15°, use Test cluster 2: -painful hip IR and ->50 YO -AM hip stiffness <60 minutes

2.3: The (ACL/PCL) attaches at the anterior-(lateral/medial) horn of the meniscus, which is why (ACL/PCL) and (lateral/medial) meniscus injures are often concurrent

The (ACL/PCL) attaches at the anterior-(lateral/medial) horn of the meniscus, which is why (ACL/PCL) and (lateral/medial) meniscus injures are often concurrent

2.3 The (MCL/LCL) has deep layer fibers that blend with the (medial/lateral) meniscus, which makes concurrent (MCL/LCL) and meniscus injuries more common.

The (MCL/LCL) has deep layer fibers that blend with the (medial/lateral) meniscus, which makes concurrent (MCL/LCL) and meniscus injuries more common.

2.3: The (MCL/LCL) is taught at 0-30° of flexion, while the (MCL/LCL) is taught at differing ranges of flexion

The (MCL/LCL) is taught at 0-30° of flexion, while the (MCL/LCL) is taught at differing ranges of flexion

2.3: The anterior-medial bundles of the ACL/PCL are most taught in (flexion/extension), while the posterior-lateral bundle of the ACL/PCL is most taught in (flexion/extension)

The anterior-medial bundles of the ACL/PCL are most taught in (flexion/extension), while the posterior-lateral bundle of the ACL/PCL is most taught in (flexion/extension)

4.7A: Which of the following is true concerning a reverse total shoulder arthroplasty? The concave surface is on the scapula. The concave surface is on the humerus.

The concave surface is on the humerus.

4LS: Which of the following is a primary source of pain that results from a normal inflammatory response after an MCL sprain, for example? (think about stages of tissue healing) Swelling stretches and tears the tissues and activates nociceptors. The presence of red blood cells in the interstitial space activates nociceptors. The presence of prostaglandins and other chemical mediators activates nociceptors. Capillary permeability into the interstitial space activates nociceptors.

The presence of prostaglandins and other chemical mediators activates nociceptors.

4LS: A patient has internal snapping hip that is painful and limits motion. Which of the following tests would most likely be positive? Ober's test Thomas test Ely's test Wright's test

Thomas test

5LS: Joe was diagnosed with spinal stenosis 3 years ago. He's 55-years-old and is a physical therapist. Yesterday, following an annual examination with radiographs, he began to feel parethesia's in his testicals. Joe's colleague conducted a neuro exam and discovered some reduced sensation in the saddle region and posterior calf, and weakness in plantar flexion. What other finding would confirm the likely hypothesis? a. Urinary retention b. Urinary tract infection c. S2 nerve root impairments d. Positive straight leg raise test

Urinary retention

6Q: Which of the following findings is correlated with cauda equine syndrome? Select one: a. Urinary retention b. Urinary tract infection c. S2 nerve root impairments d. Difficulty standing on toes

Urinary retention I GOT TIS WRONG its not S2 nerve root impairments because you cant confirm that in an SE/OE

4LS: A patient experienced forceful eversion and external rotation of the foot and ankle upon stepping into a hole while running. A physical therapist conducting an examination determined a positive talar tilt test denoting laxity in the deltoid ligament. What functional motion is likely to be most painful? Weight-bearing dorsiflexion Weight bearing heel raises Inversion to end-range Anterior Drawer test

Weight-bearing dorsiflexion widening of the mortise would hurt = eversion ankle sprain

What action should be taken next? apply ottowa ankle rules: tenderness at lat or med malleolus, base of 5th of or navicular AND/OR can't walk four steps

6.4: What are the two combined motion types at the SI joint? Do these two motion occur on multiple axes simultaneously or indidivually? What is the degree and mm ROM at the SI joint? In mm, how much can the PSIS change with any given body position?

What are the two combined motion types at the SI joint? rotation and translation Do these two motion occur on multiple axes simultaneously or indidivually? simultaneously What is the degree and mm ROM at the SI joint? 2-3°, <1-2mm In mm, how much can the PSIS change with any given body position? 0.4mm

1LS: Millicent Carter, a 72-year-old female presents with plantar heel pain. The pain has been ongoing for several months and is worse when weight-bearing. What are typical causes of plantar heel pain? How can you differentiate between them? Is Millicent likely presenting with an achilles tendinopathy? Why/why not?

What are typical causes of plantar heel pain? plantar fasciitis, fat pad syndrome How can you differentiate between them? 24 hour behavior: PF worse after prolonged inactivity (morning), FPD worse after prolonged standing (night) windlass testing: PF = (+) stretching plantar fascia, FPD = (-) plantar fascia not the problem occupation: if her job requires lots of standing / walking it is likely PF (repetitive fascia strain) Is Millicent likely presenting with an achilles tendinopathy? Why/why not? not really, pain would be more posterior / achilles would be thickening. ask if she is taking fluoroquinolone.

2LS: Big Toe is a 57-year-old tow truck driver. He presents to physical therapy with complaints of weakness in his right knee. Pain is worse in the morning and he reports a large amount of popping when he bends and straightens his knee. Getting on and off of the tow truck has been difficult. His past medical history is significant for smoking 1PPD, hyperlipidemia, and obesity. -What condition does Big Toe likely have? -What factors led you to this decision? -Does his smoking history play a role in your decision? -What special tests might be significant?

What condition does Big Toe likely have? OA What factors led you to this decision? Age, pain in morning Does his smoking history play a role in your decision? Yes What special tests might be significant? joint distraction to see if pain is alleviated

2LS: Devon is a 38-year-old patient presenting with complaints of knee pain and instability. They complain of injuring their knee while getting off of their motorcycle after a long ride across the Nevada desert on Rt 6. They present with mild edema, 4/5 knee extension MMT, and reports some popping sounds in the joint. What condition is Devon likely experiencing? Name a special test that might be positive? What factors impact prognosis?

What condition is Devon likely experiencing? Meniscus tear Name a special test that might be positive? Thessalys What factors impact prognosis? Age, deepness of tear (vascularity)

4.5: When is a reverse TSA performed? What is biomechanically significant about this procedure? What muscle becomes the primary mover after a reverse TSA?

When there is poor or no rotator cuff musculature or tendon The convex / concave components are reversed - convex portion is now glenoid Anterior deltoid

3Q: Of the hip fracture sites listed below, which is the most common? Select one: a. Greater trochanter b. Acetabulum c. Femoral neck d. Femoral shaft

a. Greater trochanter b. Acetabulum c. Femoral neck d. Femoral shaft

1LS: Pat, a 24-year-old triathlete, fell when they landed in a hole while trail running earlier in the day and rolled their ankle. They were able to limp out of the trail and got a ride to your direct access clinic to get crutches to assist with walking. Upon examination, tenderness was noted at the base of the 5th metatarsal. Six months later, Pat has healed from the severe lateral ankle sprain and they are training hard to be able to compete in an upcoming triathlon. They are behind in their training. Pat returns to the clinic complaining of recurrent tenderness at the base of the 5th metatarsal. What information do you need to know to make a pre-test hypothesis? What is the most likely diagnosis for this person?

What information do you need to know to make a pre-test hypothesis? -agg / easing factors -potential stress fracture: palpate / potential injury -when did recurrent tenderness start coming on? -family / medical history of patient -ask if they know what ligaments were injured in the initial injury -training plan/intensity What is the most likely diagnosis for this person? stress fracture

What is the most common area of the hip involved in his likely injury?Posterior hip dislocation - acetabulum, femoral head, surrounding ligaments (requires highly acute trauma) Possible fracture -- femoral neck or intertrochanteric region (more likely due to age, bone integrity, MOI) What are some options for interventions?Emergency room first to reduce dislocation

6.4: What is the sacrum shaped like? What is the SI joint shape? Label the convex and concave portions of the SI joint. How many ligaments support the SI joint?

What is the sacrum shaped like? wedge What is the SI joint shape? sinuous joint shape Label the convex and concave portions of the SI joint. sacrum concave, ilium convex How many ligaments support the SI joint? seven ligaments

6.4: What is the test cluster called for SIJ dysfunction? What is the finding surrounding positive likelihood ratio and the "ideal" amount of cluster tests performed? Is this likelihood ratio strong or weak? What does this mean surrounding the efficacy of SIJ dysfunction tests?

What is the test cluster called for SIJ dysfunction? laslett cluster What is the finding surrounding positive likehood ratio and the "ideal" amount of cluster tests performed? when 3+ tests are performed the + likelihood ratio is the highest at 4.3. Is this likelihood ratio strong or weak? 4.3 is still pretty weak What does this mean surrounding the efficacy of SIJ dysfunction tests? that they are not very effective (even when the ideal number of 3 tests are performed)

3LS: Daniella is a 22-year-old track and field athlete, competing in javelin. She reports intermittent right hip pain, occasionally sharp, and range of motion assessment reveals limited internal rotation and flexion of the right hip. Symptoms have been present for several months and seem to be worsened during stretching or running. What is your differential diagnosis? What is the preferred treatment for the most likely diagnosis?

What is your differential diagnosis? FAI - limited IR and flexion, symptoms worsen with running/stretching; labral tear (dull pain and be sharp, worse with activity) What is the preferred treatment for the most likely diagnosis? Hip arthroscopy, followed by conservative treatment to increase ROM, strength, neuromuscular control

3LS: Rahsmi, a 17-year-old female presents to physical therapy with complaints of bilateral knee pain x 2 weeks, and the inability to participate in her track and field practices, where she runs hurdles. She reports no trauma or giving way, no instability or clicking and popping. Range of motion assessment reveals full knee range of motion. What should be evaluated next? What is your differential diagnosis? What motion patterns could help you differentiate between items on your list of hypotheses?

What should be evaluated next? Evaluate the hip next as it can refer pain to the knee Neuro screen Gait analysis - trendelenburg, femoral add, IR, limp ROM: hip IR and ABduction What is your differential diagnosis? SCFE (referred pain from the hip, common bilaterally) What motion patterns could help you differentiate between items on your list of hypotheses? Out-toeing during standing (ER more comfortable for open packed position), limited IR and abduction/extension, hip drop

1LS: Jane, a kicker for a Division 1 Football team, was tackled roughly during a blocked extra point attempt. She presents to the team physical therapist following the game with complaints of 8/10 pain and swelling in her left calf. The limb is painful to palpation and the dorsal pedal pulse is diminished. What should be evaluated next? What actions should be taken? Discuss the various forms of this condition.

What should be evaluated next? measure edema, potential paralysis --> neuro screen What actions should be taken? emergency situation Discuss the various forms of this condition. compartment syndrome: acute compartment syndrome: -intense pain, pretty quick diagnosis -anterior pain (between bones) -emergency situation chronic compartment syndrome -long standing pain before diagnosis -pain all over / non specific -RICE treatment

2LS: Lindsey is a 33-year-old professional downhill skier. She experienced a valgus knee collapse in a knee flexed position What was likely injured? What tests could rule this in? How does this injury relate to knee OA, if at all?

What was likely injured? MCL, maybe ACL and meniscus (unhappy triad) What tests could rule this in? anterior drawer/lachman's test for ACL, thessalys/mcmurrays for meniscus, valgus stress test for MCL How does this injury relate to knee OA, if at all? Yes, an ACL injury increases risk for OA lateral in life (even if reconstructed)

4.2: When 12 patients with unilateral TKAs were compared to patients with bilateral TKAs, short term and long term outcomes were _______ by ______ weeks minus _______ strength, and all outcomes were ______ by _____ weeks

When 12 patients with unilateral TKAs were compared to patients with bilateral TKAs, short term and long term outcomes were equal by 12 weeks minus quad strength, and all outcomes were equal by 52 weeks

3.4: With a (compression/tension) stress fracture of the hip, the superior side of the femoral neck is involved and surgical pinning is involved due to unstable nature With a (compression/tension) stress fracture of the hip, the inferior side of the femoral neck is involved and no surgery is involved (just limited WB for 6-8 wks) due to stable nature

With a (compression/tension) stress fracture of the hip, the superior side of the femoral neck is involved and surgical pinning is involved due to unstable nature With a (compression/tension) stress fracture of the hip, the inferior side of the femoral neck is involved and no surgery is involved (just limited WB for 6-8 wks) due to stable nature

1Q: A 27-year-old female complains of pain between her third and fourth toes on the left foot. Which of the following is the MOST likely medical diagnosis? Select one: a. Achilles tendonopathy b. Morton's neuroma c. Tibialis anterior tendonitis d. Tibial stress fracture

a. Achilles tendonopathy b. Morton's neuroma c. Tibialis anterior tendonitis d. Tibial stress fracture

3Q: With internal snapping hip, which tendon most commonly causes the snap? Select one: a. Adductor magnus b. Tensor fasciae latae c. Rectus femoris d. Psoas

a. Adductor magnus b. Tensor fasciae latae c. Rectus femoris d. Psoas

6Q: Which of the following scenarios is consistent with observing a centralization phenomenon? Select one: a. After intervention, the patient reports less calf pain and more back pain. b. After intervention, the patient reports increased numbness in the calf. c. After intervention, the patient reports more calf pain and less back pain. d. After intervention, the patient reports the pain moved from the back to the buttocks.

a. After intervention, the patient reports less calf pain and more back pain.

1Q: Examination findings that include a negative talocrural anterior drawer and positive talar tilt test suggest injury to the following structure(s). a. Anterior talofibular ligament and calcaneofibular ligament b. Isolated anterior talofibular ligament c. Isolated calcaneofibular ligament

a. Anterior talofibular ligament and calcaneofibular ligament b. Isolated anterior talofibular ligament c. Isolated calcaneofibular ligament

3Q: The hip is most commonly dislocated in which direction? Select one: a. Anteriorly b. Posteriorly c. Laterally d. Inferiorly

a. Anteriorly b. Posteriorly c. Laterally d. Inferiorly

6LS: Frank, a retired airport maintenance worker, finds he needs to lean on shopping carts to go grocery shopping and has pain and tingling in both lower extremities in the buttock region and posterior lower leg segments when walking upright. It's been getting worse for about a year. When he sits, the pain goes away. a. Central stenosis b. Anterior longitudinal ligament tear c. Lateral stenosis d.Lumbar disc herniation

a. Central stenosis central vs lateral: central = neurogenic claudication (both leg pain, weakness) lateral = radiculopathy like symptoms

6LS: Your patient is a 17-year-old student with complaints of pain over the lateral aspect of the foot on the plantar surface, which is aggravated by walking and running. They state the pain began approximately 3 weeks ago following a trail run when they "turned their ankle". Based upon this information, which of the following is the MOST LIKELY diagnosis? a. Cuboid syndrome b. Iselin's disease (apophysitis of base 5th metatarsal) c. Tarsal coalition d.Tarsal tunnel syndrome

a. Cuboid syndrome anatomical connection between cuboid syndrome and lateral ankle sprains: peroneus longus wraps around the cuboid laterally (doesnt attach there) but would pull on cuboid with lateral sprain I was wrong I put b. Iselin's disease (apophysitis of base 5th metatarsal)

1Q: A patient experienced forceful eversion and external rotation of the foot and ankle upon stepping into a hole while running. A physical therapist conducting an examination determined a positive talar tilt test denoting laxity in the deltoid ligament. What other special test is likely to be positive? a. External rotation stress test b. Anterior drawer test c. Windlass test d. Thompson test

a. External rotation stress test b. Anterior drawer test c. Windlass test d. Thompson test

3Q: Ober's test is used to help identify the presence of the following condition. Select one: a. ITB tightness b. Plica syndrome c. Prepatellar bursitis d. Patellar femoral dysfunction

a. ITB tightness b. Plica syndrome c. Prepatellar bursitis d. Patellar femoral dysfunction

1Q: A patient who had just completed a marathon presents to a physical therapist who is working the athletic event, complaining of severe pain in the foot and leg. The therapist observes discoloration of the foot and toes, weak dorsiflexion, and a diminished dorsal pedal pulse. Which is the most appropriate action? a. Immediately send the patient in an ambulance to the hospital and phone the physician. b. Leave a message with the physician. c. Tell the patient to elevate the leg and wait to see if symptoms improve. d. Take no action; this is a normal response in a fatigued individual after a long run.

a. Immediately send the patient in an ambulance to the hospital and phone the physician. b. Leave a message with the physician. c. Tell the patient to elevate the leg and wait to see if symptoms improve. d. Take no action; this is a normal response in a fatigued individual after a long run.

3Q: Your patient is a 52 yo male with a history that leads you to a primary hypothesis of L hip OA. However, during your exam you note that his L hip IR and flexion ROM are 25 and 120, respectively, and that hip IR is painful. Which of the following clinical findings, if also present, would support your primary hypothesis of hip OA? Select one: a. Morning stiffness <60 min b. + Trendelenburg sign c. Weak gluteus maximus (3+) d. + Thomas test for tight psoas

a. Morning stiffness <60 min b. + Trendelenburg sign c. Weak gluteus maximus (3+) d. + Thomas test for tight psoas

2Q: Which of the following injuries can occur concomitantly with a ligamentous tear of the knee? Select one: a. Osteochondral lesion b. Tibial plateau fracture c. Meniscus injury d. Both a and b e. All of the above

a. Osteochondral lesion b. Tibial plateau fracture c. Meniscus injury d. Both a and b e. All of the above

2Q: Injury to the knee meniscus will have the greatest potential for healing if located in this region of the meniscus. Select one: a. Outer third b. Middle third c. Inner third

a. Outer third b. Middle third c. Inner third

6LS: Which of the following is a hallmark sign of a meniscal injury? a. Quad inhibition b. Positive Lachman test c. Hamstring weakness d.Pain with compression

a. Quad inhibition

2Q: Hallmark examination findings associated with knee meniscal injury include all of the following EXCEPT Select one: a. Quadriceps inhibition b. Joint line tenderness c. Mild effusion d. Clicking with active knee extension

a. Quadriceps inhibition b. Joint line tenderness c. Mild effusion d. Clicking with active knee extension the fourth sign is a positive entrapment test (thessaly's, mcmurray's)

6Q: Radicular pain is described as Select one: a. Radiating paresthesia, numbness in a dermatome, or weakness b. Sharp, shooting, superficial, or deep pain into the leg c. Poorly localized, aching pain

a. Radiating paresthesia, numbness in a dermatome, or weakness

6LS: Which of the following terms indicates an injury of the spinal nerve root? a. Radiculopathy b. Neuritis c. Adverse neural tension d. Neurotemesis

a. Radiculopathy

6Q: Which of the following terms indicates an injury of the spinal nerve root? Select one: a. Radiculopathy b. Neuritis c. Adverse neural tension d. Neurotemesis

a. Radiculopathy

2Q: What is a common complication that can develop following a quad contusion? Select one: a. Stress fracture b. Myositis ossificans c. Chronic compartment syndrome d. Ecchymosis

a. Stress fracture b. Myositis ossificans c. Chronic compartment syndrome d. Ecchymosis

2Q: The absence of an intact PCL can result in a false-positive anterior drawer test. Select one: a. True b. False

a. True b. False "This has a little bit of an implication if you're trying to test for a PCL versus an ACL injury. If you were to do an anterior drawer test on a patient who you suspect has an ACL injury, but they really were presenting with a posterior sag sign, or a sagittal sign, you could have a false-positive ACL injury test."

6LS: Which of the following findings is correlated with cauda equine syndrome? a. Urinary retention b. Urinary tract infection c. S2 nerve root impairments d. Difficulty standing on toes

a. Urinary retention

4.4: What are the five components of a THA and the corresponding materials that each component is made out of

acetabular shell - titanium alloy acetabular cup/liner - "cross linked" polyethylenes (plastic), metal, ceramic femoral stem - titanium alloy femoral head - ceramic or cobalt chrome cement - methyl methacrylate

6LS: A physical therapist is treating a 25-year-old female with complaints of episodes of sharp low back pain when she makes quick movements. Lumbopelvic rhythm is reversed and PA testing reveals hypermobility throughout the lumbar spine. Which of the following diagnoses would you consider to be most likely? a. Ankylosing spondylitis b. Low back pain with motor coordination deficits c. Lumbar stenosis d.Low back pain with mobility deficits

b. Low back pain with motor coordination deficits

4.2: Why is cementless THA the preferred method?

because it allows the bone to fuse with the implant more effectively over time, providing a longer lasting acetabular component of the surgery (15 year mark measured)

6LS: Which is the most common type of fracture following a lateral ankle sprain? a. Burst b. Compound c. Avulsion d. Jones

c. Avulsion (zone 1)

6LS: Which of the following conditions should be screened for in all patients low back pain since it is a common associated finding? a. Osteoarthritis b. Osteoporosis c. Depression d.Diabetes

c. Depression

6LS: A physical therapist is treating a patient with spinal stenosis. They present with increased pain in the low back and legs with extension movements. A flexed position relieves their pain. According to treatment-based classification, what is the best intervention for this patient? a. Lumbar HVLA technique b. Prone press ups c. Double knee to chest d.Repeated motions

c. Double knee to chest because this would be relieving and inducing of a flexed position I was wrong this would be a test d.Repeated motions

6LS: A 3-year-old child of a friend has experienced a recent change in his gait with inability to bear weight on his left leg. The mother explains her son has had no recent falls or trauma but had a fever for the past day. Based upon these findings what pathology, requiring immediate orthopaedic referral, may the patient be experiencing? a. Avascular necrosis b. Legg-Calve-Perthes disease c. Septic arthritis d.Transient synovitis

c. Septic arthritis indicators: child has a fever, not a sole determinant that the child is older than 2 (as the slide said) I was wrong I put b. Legg-Calve-Perthes disease

6.3: compression fractures occur from _______ or _______ flexion, cause failure+diminished height of the ______ column, ______ column remains intact and acts as a hinge, increased stress on ________ column. Common surgical treatment is ________.

compression fractures occur from anterior or lateral flexion, cause failure+diminished height of the anterior column, middle column remains intact and acts as a hinge, increased tension stress on posterior column. Common surgical treatment is kyphoplasty

4.2A: True/false: It's best to wait as long as one can endure to obtain a joint arthroplasty, since they don't last forever. True False

false "While implants do not last forever, waiting too long for joint arthroplasty can be problematic. People with severe OA may not be mobile and suffer additional comorbidities on account of the lack of mobility. Furthermore, the reduced functional status can reduce prognosis after surgery and complicate the recovery period. Exactly when to get an arthroplasty is still a bit of an art rather than a science."

4.4: A common consequence of a resurfacing hip replacement (ie just replacing the femoral head) vs a THA is risk of

femoral neck fracture

6.3: what is the difference between lateral and central stenosis? what are two causes of each?

lateral: impingement of nerve roots in nerve root canal, lateral recess or intervertebral foramen causes= hypertrophic facets or osteophytes/disc disease central: impingement of spinal cord in central canal causes= degenerative or hypertrophic facets

6.3: What is the inside of the intervertebral disc called? What about the outside? Is the outside thicker: anteriorly/medially, anteriorly/laterally, posteriorly/medially or posterior/laterally?

nucleus pulposus annulus fibrosis anterior, lateral

6.3: What load sharing are the facet joints responsible for? anterior posterior medial lateral

posterior

6.3: What is neurogenic claudication?

proximal to distal thigh pain with walking with relief from lumbar flexion

6.3: What is the difference between low back pain with radicular symptoms (9) vs referred symptoms (5)?

radicular symptoms: -unilateral leg pain that is worse than back pain -pain can radiate to foot/toes -common sensory symptoms -associated with nerve root irritation -restricted lumbar ROM -restricted segmental mob -(+) neurodynamic tests (SLR, slump test) -decreased DTR -dermatomal pattern sensory changes referred symptoms: -back pain concurrent with pain in butt, thigh or leg -referral to foot is rare -associated with spinal structural problem -restricted AND painful lumbar ROM that is increased with overpressure -pain with stress on involved tissue

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