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Have your say during the 12MD summing up  lecture tomorrow.  Audience response system will be used to see what you all think as a class. 

Also time for your individual personal responses and opinions.

Would an on-going, constantly growing, regularly updated DundeeBones be of any  use later in the year?/ next year? / when you are on  4th year orthopaedic placements? / if you are lonely?

Come along to  tell us what Mr DundeeBones mean to you tomorrow.

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EMI on the back (part2)

Another 3 problems to  go with the Pathology / diagnosis theme EMI in the previous post.

I’m hoping it will be possible  to get all this self-assessment material into the Test Yersel page soon but at the moment there’s not a quick way in.

Enjoy the EMIs, answers at the end of the week, (the photo of the spine model has nothing to do with the questions, Ed)

Theme : pathology

A S1 nerve root entrapment

B  spondylolisthesis

C  central  cord compression

D T1 root entrapment

E  C5/6 root entrapment

F  L3 root compression on the  left

G  infection in the L4/5 disc

H  spinal  tumour

I  cauda equina lesion

J  L3 root compression  on the right side

Match the clinical presentations below to the most appropriate pathology listed above:

4.   Back pain without radiation in a 60 year-old woman associated with pyrexia, high white cell count and a “hot spot”    on bone scan.

5.  Bilateral  leg pain with back pain and urinary retention.

6.  Loss of ankle jerk on examination.

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Here’s an example of a EMI question for spinal problems which goes with last week’s core clinical focus

Theme : pathology

A S1 nerve root entrapment

B  spondylolisthesis

C  central  cord compression

D T1 root entrapment

E  C5/6 root entrapment

F  L3 root compression on the  left

G  infection in the L4/5 disc

H  spinal  tumour

I  cauda equina lesion

J  L3 root compression  on the right side

Match the clinical presentations below to the most appropriate pathology listed above:

1  Neck pain and wasting of the interossei muscles in the hand

2  Depressed right knee jerk and weakness on knee extension

3  Pain shooting from the back down the side of the leg to the lateral  side of the foot

More later but that’s all for now (don’t let me forget to post the answers by Friday, Ed)

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Self Assessment

More sample questions to test yourself

Carpal tunnel syndrome is due to which nerve being compressed?

A. Radial

B. Musculocutaneous

C. Ulnar

D. Median

Carpal tunnel syndrome is typically due to entrapment at the:

A. Flexor retinaculum

B. Spiral groove in the humerus

C. 1st cervical rib

D. Ligament of Struthers

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More Mnemonics

There was a request for more mnemonics. Here’s some for Paediatric orthopaedics:

When to be concerned in Paediatric Orthopaedics
– when a child presents with the 5 S‘s

Symptoms
Stiffness
aSymmetry
Syndrome
Systemic Disorders

Common causes of a limp in children (by age)

The limping child DIPS

Age Condition
Birth DDH
0-5 Infection
5-10 Perthe’s disease
10-15 SUFE

Please note that there is some overlap between ages at which paediatric conditions occur.

Risk Factors for DDH

All the Fs

Female
First born
LeFt side mainly
Fluid defect (oligohydramnios)
Faulty position (breech)
Female hormones (relaxin)

Clinical tests for DDH

dislocataBle and Out to in

Barlow’s test – Is the hip dislocataBle?
Ortolani’s test – Is the hip reducible? (from Out to in)

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Mnemonics In Orthopaedics

Do you find mnemonics a useful way of remembering essential facts? Here are a few related to Orthopaedics:

X-ray features of Osteoarthritis (LOSS)

Loss of joint space
Osteophytes
Subchondral sclerosis
Subchondral cysts

Radiological Features of Rheumatoid Arthritis (LESS)

Loss of joint space
Erosions
Soft tissue Swelling
Soft bones (osteopenia)

Compartment Syndrome (all the Ps)

Early
Pain out of proportion to the injury
Pain with passive movement

Later
Paraylsis
Pulselessness
Paraesthesia
Pallor
Poikilothermia (or Perishing cold)

If you find these mnemonics helpful, let us know – we can post some more!

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Take a break!

Well done on making it to the end of week 2 of  the MSS!

This is the time to re-cap on your learning so far in relation to the shoulder and hand.  Take a look again at the bone of the week and  case of the  week especially for shoulder and hand stuff.

Week 3 will be focusing on back and neck pain, especially nerve root compression and mechanical   back pain but with something about  other back problems as well – enjoy!

Dundeebones

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