NU665 Orthopedic
Patient presents with pain, loss of motion and stiffness in the shoulder, what is the diagnosis? - Answers
Frozen shoulder
Diagnostic tests for frozen shoulder? - Answers `x-ray and MRI
What is the Neer sign? - Answers Passively flexing the glenohumeral joint while simultaneously
preventing shoulder shrugging
What does a positive Neer sign mean? - Answers Shoulder impingement syndrome
How do you perform the Hawkins-Kennedy test? - Answers Stabilize the shoulder with one hand, and
with the patient's elbow flexed at 90 degrees, internally rotate the shoulder using the other hand
What does a positive Hawkins-Kennedy test mean? - Answers Positive indicates shoulder impingement
syndrome
Pain when the arm is internally rotated.
Diagnostics for impingement syndrome? - Answers MRI and X-ray
Patient presents with sunken area, limited active ROM, limited shrug, and inability to hold arm elevated.
What is the diagnosis? - Answers Rotator cuff tear
Diagnostics for rotator cuff tear? - Answers x-ray and MRI
Pediatric patient presents with arm pain, holding arm to body with forearm and thumb in pronation.
What is the dx? - Answers Nursemaids elbow
treatment of nursemaid's elbow - Answers A simple closed reduction using supination of the forearm
and flexion of the elbow.
, Patient presents with elbow swelling (fluid filled sac), pain, limited ROM. What is the DX? - Answers
Olecranon bursitis
How to perform Phalen test - Answers Ask the person to hold both hands back to back while flexing the
wrists 90 degrees. Acute flexion of the wrist for 60 seconds produces no symptoms in the normal hand.
(produces numbness and burning in a person with carpal tunnel).
Tinel's sign - Answers A distal tingling sensation on percussion of median nerve of the inner wrist;
characteristic of carpal tunnel syndrome
Sensory finding in carpal tunnel syndrome - Answers Unable to distinguish two-point discrimination
Loss of both active and passive motion in the shoulder indicates what? - Answers Frozen shoulder
Pain, loss of motion, stiffness into the shoulder indicates what? - Answers Frozen shoulder
Physical exam reveals 50% or more loss of motion, pain with motion; tenderness indicates what? -
Answers Frozen shoulder
Diagnostic test: X-ray to rule out fracture, osteophytes, loose bodies, tumors. MRI allows you to view the
capsule and rule out rotator cuff tear. What is the DX? - Answers Frozen shoulder
Treatment: Some appropriate and non-surgical treatments for this condition include NSAIDS, moist heat,
injections, and physical therapy. Surgical treatment involves a stretch or release the contracted joint
capsule with manipulation or arthroscopy. What is the diagnosis? - Answers Frozen shoulder
Patient presents with complaint of shoulder pain. Occupation requires repeated overhead activity. What
is the likely DX? - Answers Impingement syndrome
Persistent pain, especially when reaching up and behind the head or when reaching up to put on a shirt
or blouse. What is the likely DX? - Answers Impingement syndrome
Patient presents with pain, loss of motion and stiffness in the shoulder, what is the diagnosis? - Answers
Frozen shoulder
Diagnostic tests for frozen shoulder? - Answers `x-ray and MRI
What is the Neer sign? - Answers Passively flexing the glenohumeral joint while simultaneously
preventing shoulder shrugging
What does a positive Neer sign mean? - Answers Shoulder impingement syndrome
How do you perform the Hawkins-Kennedy test? - Answers Stabilize the shoulder with one hand, and
with the patient's elbow flexed at 90 degrees, internally rotate the shoulder using the other hand
What does a positive Hawkins-Kennedy test mean? - Answers Positive indicates shoulder impingement
syndrome
Pain when the arm is internally rotated.
Diagnostics for impingement syndrome? - Answers MRI and X-ray
Patient presents with sunken area, limited active ROM, limited shrug, and inability to hold arm elevated.
What is the diagnosis? - Answers Rotator cuff tear
Diagnostics for rotator cuff tear? - Answers x-ray and MRI
Pediatric patient presents with arm pain, holding arm to body with forearm and thumb in pronation.
What is the dx? - Answers Nursemaids elbow
treatment of nursemaid's elbow - Answers A simple closed reduction using supination of the forearm
and flexion of the elbow.
, Patient presents with elbow swelling (fluid filled sac), pain, limited ROM. What is the DX? - Answers
Olecranon bursitis
How to perform Phalen test - Answers Ask the person to hold both hands back to back while flexing the
wrists 90 degrees. Acute flexion of the wrist for 60 seconds produces no symptoms in the normal hand.
(produces numbness and burning in a person with carpal tunnel).
Tinel's sign - Answers A distal tingling sensation on percussion of median nerve of the inner wrist;
characteristic of carpal tunnel syndrome
Sensory finding in carpal tunnel syndrome - Answers Unable to distinguish two-point discrimination
Loss of both active and passive motion in the shoulder indicates what? - Answers Frozen shoulder
Pain, loss of motion, stiffness into the shoulder indicates what? - Answers Frozen shoulder
Physical exam reveals 50% or more loss of motion, pain with motion; tenderness indicates what? -
Answers Frozen shoulder
Diagnostic test: X-ray to rule out fracture, osteophytes, loose bodies, tumors. MRI allows you to view the
capsule and rule out rotator cuff tear. What is the DX? - Answers Frozen shoulder
Treatment: Some appropriate and non-surgical treatments for this condition include NSAIDS, moist heat,
injections, and physical therapy. Surgical treatment involves a stretch or release the contracted joint
capsule with manipulation or arthroscopy. What is the diagnosis? - Answers Frozen shoulder
Patient presents with complaint of shoulder pain. Occupation requires repeated overhead activity. What
is the likely DX? - Answers Impingement syndrome
Persistent pain, especially when reaching up and behind the head or when reaching up to put on a shirt
or blouse. What is the likely DX? - Answers Impingement syndrome
