Presentation on theme: "Mark Brooke Samar Shefta"— Presentation transcript:
1 Mark Brooke Samar Shefta Musculoskeletal HDRMark BrookeSamar Shefta
2 Why Is MSK So Important?1 in 5 patients consulting their GP is for a MSK conditionMSK conditions are often one of the main reasons for repeat consultations FRUSTRATION!
3 The only treatment for bunions is surgery Question 1The only treatment for bunions is surgeryTrue or False?
4 Plantar fasciitis is best treated by Question 2Plantar fasciitis is best treated bysteroid injectionTrue or False?
5 Mortons neuroma is more common Question 3Mortons neuroma is more commonwith a Mortons footTrue or False?
6 A sprained ankle should be better Question 4A sprained ankle should be betterby two weeksTrue or False?
7 Suspected Osgood-Schlatters disease should be x-rayed for confirmation Question 5Suspected Osgood-Schlatters disease should be x-rayed for confirmationTrue or False?
8 Question 6Arthroscopy and washout is a good treatment for osteoarthritis of the kneeTrue or False?
9 Question 7 McMurrays test is the best way to diagnose meniscal tears True or False?
10 Ultrasound guidance is needed for trochanteric bursitis injections Question 8Ultrasound guidance is needed for trochanteric bursitis injectionsTrue or False?
11 Question 960% of patients presenting with whiplash injuries suffer long lasting symptomsTrue or False?
12 The lifetime prevalence of acute low back pain is 58% Question 10The lifetime prevalence of acute low back pain is 58%True or False?
13 Hallux Valgus The only treatment for bunions is surgery FALSE~150 different operationsCorrective action in some casesEg: flat feet, hyperpronation, small shoes(!)PhysiotherapyInjections
14 Plantar FasciitisPlantar fasciitis is best treated by steroid injectionFALSEInflammatory conditionHeel pain worst in morning / after restExamination = tender spot on stretchingXray NOT neededAddress the risk factors!
15 Mortons Neuroma Mortons neuroma is more common with a Mortons foot FALSEInterdigital neuroma between metatarsalsShooting pain + numbness in affected toeFoot squeeze “Mulders click”<5mm steroid injection>5mm surgery
16 Ankle Sprain A sprained ankle should be better by 2 weeks FALSENot worth investigating until >6wksComplications often missedTalar dome #Peroneal tendon dislocationAlways examine on standing!
18 Ankle Sprain A = Calcaneus, B = Lateral malleolus, C = Fibula Ottawa rules:Bony tenderness at posterior tip of lateral malleolusBony tenderness at posterior tip of medial malleolusUnable to weight bear at the time of injury and when examined
19 Osgood-Schlatters Disease Suspected Osgood-Schlatters disease should be xrayed for confirmationFALSEOsteochondritis of antr tibial tubercleMore common in active childrenDiagnosis is clinical!Treat with activity modification
20 Knee OsteoarthritisArthroscopy and washout is a good treatment for OA of the kneeFALSEUnless a loose body is presentMany conservative treatmentsARC website, NICE guidelines
21 Meniscal TearsMcMurrays test is the best way to diagnose meniscal tearsFALSEHistory! (NB: degenerative tears)Weight-bearing rotational injury swelling ?ongoing lockingJoint line tenderness
22 Trochanteric Bursitis US guidance is needed for trochanteric bursitis injectionsFALSEInflammation / degenerative changes over greater trochanterPain on lateral hip after exertionWeakness in hip abductionPhysiotherapy! Ice + injections
23 ‘Whiplash’60% of patients presenting with whiplash injuries suffer long lasting symptomsFALSEStretching / tearing of cervical muscles + ligaments due to sudden extension Pain and decreased neck mobilityAnalgesia + early mobilisation40% suffer long lasting symptoms
24 Back Pain The lifetime prevalence of acute low back pain is 58% TRUEAcute low back pain = <6wk durationChronic low back pain = >3monthsPrevention!‘Red flag’ signs
25 Back Pain ‘Red Flag’ Signs <20 yrs>55 yrsNon-mechanical painThoracic painPMH of carcinomaHIVSteroid useUnwellWeight lossWidespread neurologyStructural deformity