Musculoskeletal HDR Mark Brooke Samar Shefta Why Is MSK So Important? 1 in 5 patients consulting...
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Transcript of Musculoskeletal HDR Mark Brooke Samar Shefta Why Is MSK So Important? 1 in 5 patients consulting...
![Page 1: Musculoskeletal HDR Mark Brooke Samar Shefta Why Is MSK So Important? 1 in 5 patients consulting their GP is for a MSK condition MSK conditions are often.](https://reader035.fdocuments.us/reader035/viewer/2022062404/551612ed55034694308b53cf/html5/thumbnails/1.jpg)
Musculoskeletal HDR
Mark Brooke
Samar Shefta
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Why Is MSK So Important?
1 in 5 patients consulting their GP is for a MSK condition
MSK conditions are often one of the main reasons for repeat consultations
FRUSTRATION!
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Question 1
The only treatment for bunions is surgery
True or False?
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Question 2
Plantar fasciitis is best treated by
steroid injection
True or False?
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Question 3
Mortons neuroma is more common
with a Mortons foot
True or False?
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Question 4
A sprained ankle should be better
by two weeks
True or False?
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Question 5
Suspected Osgood-Schlatters disease should be x-rayed for confirmation
True or False?
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Question 6
Arthroscopy and washout is a good treatment for osteoarthritis of the knee
True or False?
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Question 7
McMurrays test is the best way to
diagnose meniscal tears
True or False?
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Question 8
Ultrasound guidance is needed for trochanteric bursitis injections
True or False?
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Question 9
60% of patients presenting with whiplash injuries suffer long lasting symptoms
True or False?
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Question 10
The lifetime prevalence of acute low back pain is 58%
True or False?
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Hallux Valgus
The only treatment for bunions is surgery FALSE
~150 different operations Corrective action in some cases
Eg: flat feet, hyperpronation, small shoes(!) Physiotherapy Injections
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Plantar Fasciitis
Plantar fasciitis is best treated by steroid injection FALSE
Inflammatory condition Heel pain worst in morning / after rest Examination = tender spot on stretching Xray NOT needed Address the risk factors!
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Mortons Neuroma
Mortons neuroma is more common with a Mortons foot FALSE
Interdigital neuroma between metatarsals Shooting pain + numbness in affected toe Foot squeeze “Mulders click” <5mm steroid injection >5mm surgery
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Ankle Sprain
A sprained ankle should be better by 2 weeks FALSE
Not worth investigating until >6wks Complications often missed
Talar dome # Peroneal tendon dislocation
Always examine on standing!
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Ankle Sprain
A = Calcaneus, B = Lateral malleolus, C = Fibula
Ottawa rules: Bony tenderness at posterior tip of lateral
malleolus Bony tenderness at posterior tip of medial
malleolus Unable to weight bear at the time of injury and
when examined
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Osgood-Schlatters Disease
Suspected Osgood-Schlatters disease should be xrayed for confirmation FALSE
Osteochondritis of antr tibial tubercle More common in active children Diagnosis is clinical! Treat with activity modification
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Knee Osteoarthritis
Arthroscopy and washout is a good treatment for OA of the knee FALSE
Unless a loose body is present Many conservative treatments
ARC website, NICE guidelines
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Meniscal Tears
McMurrays test is the best way to diagnose meniscal tears FALSE
History! (NB: degenerative tears) Weight-bearing rotational injury
swelling ?ongoing locking Joint line tenderness
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Trochanteric Bursitis
US guidance is needed for trochanteric bursitis injections FALSE
Inflammation / degenerative changes over greater trochanter
Pain on lateral hip after exertion Weakness in hip abduction Physiotherapy! Ice + injections
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‘Whiplash’
60% of patients presenting with whiplash injuries suffer long lasting symptoms FALSE
Stretching / tearing of cervical muscles + ligaments due to sudden extension Pain and decreased neck mobility
Analgesia + early mobilisation 40% suffer long lasting symptoms
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Back Pain
The lifetime prevalence of acute low back pain is 58% TRUE
Acute low back pain = <6wk duration Chronic low back pain = >3months Prevention! ‘Red flag’ signs
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Back Pain ‘Red Flag’ Signs
<20 yrs >55 yrs Non-mechanical
pain Thoracic pain PMH of carcinoma HIV
Steroid use Unwell Weight loss Widespread
neurology Structural
deformity
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Questions?
Total points: 24
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References
www.getwelluk.com www.wayodd.com www.foot-ankle.co.uk www.eorthopod.com www.runnersweb.com www.e-radiography.net Biomed.brown.edu www.healthallrefer.com www.orthogate.org