Mnemonic: NISA 10-50-90-100 Type I – Non-displaced Neck fracture (upto 10% risk of AVN) 1 blood vessel damaged (entering talar neck) Management: 8 weeks in cast and 4 weeks in CAM cast Type II – Type I + Inferior (subtalar) subluxation/dislocation (upto 50% risk of AVN) 2 blood vessels damaged…
Tag: Musculoskeletal system
Clinical Skills and Approaches 
Mortarmen’s knee
Synonym: Adult onset tibial tubercle exostoses History: Pain over anterior surface of upper tibia Pain during running, jumping, squatting, kneeling and descending stairs Usually no history of trauma, anterior knee pain or Osgood-Schlatter disease Physical examination: Tenderness over hypertrophic tibial tubercle Quadriceps tightness (Ely’s test) X-rays: AP, lateral and tangential…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Osteoid Osteoma : Mnemonic
Epidemiology and Clinical features Mnemonic: LMNOP Lower extremity predilection (proximal femur > tibial diaphysis) Male predilection (2:1 to 3:1) Night pain relieved by NSAIDs (absent in osteoblastoma) Osteogenic benign tumor Prostaglandins (PGE2) and Cyclooxygenase (COX1 and 2) release by nidus (explains night pain and response to NSAIDs) 3 Concentric layers…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Fibromyalgia : Mnemonic Approach
Clinical Features Mnemonic: FIBRO 1. Fatigue: 80-90% Feeling “overwhelming tiredness” or “completely washed out” Less prominent than in Chronic Fatigue Syndrome 2. Fibrofog: Dyscognition or Cognitive impairment e.g. trouble concentrating, forgetfulness, and disorganized or slow thinking 3. Insomnia: 90% Non-restorative sleep rather than insomnia 4. Blues: Depression and anxiety 5….
Clinical Skills and Approaches 
Ely’s test
Rectus femoris is the only Quadriceps muscle that cross the hip joint and act as a hip flexor and knee extensor. When the rectus femoris is shortened/tightened, it tends to pull the pelvis forward into anterior pelvic tilt and also forces the knee into hyperextension. Ely’s test: Patient is positioned…
Clinical Skills and Approaches 
Ober’s Test
Tensor fascial latae (TFL) originates from the anterior superior iliac spine (ASIS) outer surface, outer lip of anterior iliac crest and deep surface of fascia latae, continues down in thigh as Iliotibial band (ITB) and inserts to the ipsilateral Gerdy’s tubercle. TFL plays role in flexion, medial rotation and abduction…
Clinical Skills and Approaches 
Thomas Test and Staheli Test
Thomas test Synonym: Hip flexion contracture test, Iliacus test, Iliopsoas test Fixed flexion deformity of the hip and anterior pelvic tilt leads to a compensatory hyperlordosis of the lumbar spine to restore the body’s center of gravity. Compensatory hyperlordosis can mask the fixed flexion deformity of hip. Thomas test: With…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Boutonniere and Swan neck Deformity – Pathophysiology
Understanding of the Boutonniere and Swan neck deformity requires clear concept of the finger extensor apparatus, which has been discussed here. The extrinsic extensor tendons trifurcate giving a central slip which attaches to the middle phalanx base and two lateral slips which join with lateral band (formed by intrinsic muscles…