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INI CET Orthopaedics Syllabus

The Orthopaedics syllabus for INI CET in full: 10 chapters, 30 topics and 107 sub-topics, every one listed below, plus 50 Orthopaedics flashcards with answers.

10Chapters

30Topics

107Sub-topics

50Flashcards

Orthopaedics syllabus: all 10 chapters

Expand any chapter to see its topics and sub-topics.

General Orthopaedics
3 topics
- Introduction to Orthopaedics
  - History, scope, and importance in medical practice
- Basic Principles of Orthopaedic Examination
  - History taking
  - Physical examination
  - Assessment of musculoskeletal function
- Imaging Modalities in Orthopaedics
  - X-ray
  - CT scan
  - MRI
  - Ultrasound
  - Nuclear medicine imaging
Trauma and Fractures
4 topics
- Classification of fractures
  - Open vs. closed fractures
  - Displaced vs. nondisplaced fractures
  - Complete vs. incomplete fractures
- Principles of fracture management
  - Closed reduction
  - Open reduction
  - Internal fixation
  - External fixation
  - Plaster immobilization
- Complications of fractures
  - Delayed union
  - Nonunion
  - Malunion
  - Compartment syndrome
  - Infection
- Fracture healing
  - Phases of fracture healing
  - Factors influencing healing
  - Principles of fracture fixation
Orthopaedic Disorders of the Upper Limb
3 topics
- Shoulder disorders
  - Rotator cuff injuries
  - Shoulder dislocation
  - Adhesive capsulitis
  - Shoulder impingement syndrome
- Elbow disorders
  - Tennis elbow
  - Golfer's elbow
  - Elbow instability
- Hand and wrist disorders
  - Carpal tunnel syndrome
  - Trigger finger
  - Dupuytren's contracture
  - De Quervain's tenosynovitis
Orthopaedic Disorders of the Lower Limb
3 topics
- Hip disorders
  - Osteoarthritis
  - avascular necrosis of the hip
  - hip fractures
  - hip dysplasia
- Knee disorders
  - Osteoarthritis
  - meniscal injuries
  - ligamentous injuries (ACL, PCL)
  - patellofemoral syndrome
- Ankle and foot disorders
  - Ankle sprain
  - Achilles tendon rupture
  - plantar fasciitis
  - hallux valgus (bunion)
Pediatric Orthopaedics
3 topics
- Developmental dysplasia of the hip (DDH)
  - Screening
  - Diagnosis
  - Management of DDH in infants and children
- Congenital talipes equinovarus (clubfoot)
  - Classification
  - Ponseti method
  - Surgical correction
- Developmental disorders of the spine
  - Scoliosis
  - Kyphosis
  - Congenital vertebral anomalies
Orthopaedic Oncology
3 topics
- Primary Bone Tumors
  - Osteosarcoma
  - Chondrosarcoma
  - Ewing's Sarcoma
  - Giant Cell Tumor
- Metastatic Bone Disease
  - Pathophysiology
  - Clinical Presentation
  - Management of Bone Metastases
- Soft Tissue Tumors
  - Lipoma
  - Fibroma
  - Synovial Sarcoma
  - Malignant Fibrous Histiocytoma
Sports Medicine
3 topics
- Sports-related injuries
  - Muscle strains
  - Ligament sprains
  - Tendonitis
  - Stress fractures
- Overuse injuries
  - Runner's knee
  - Shin splints
  - Tennis elbow
  - Stress fractures
- Rehabilitation and return to play
  - Physiotherapy
  - Strengthening exercises
  - Gradual progression of activities
Orthopaedic Rehabilitation and Physiotherapy
3 topics
- Principles of orthopaedic rehabilitation
  - Range of motion exercises
  - Strengthening exercises
  - Proprioceptive training
- Modalities in orthopaedic physiotherapy
  - Heat therapy
  - Cold therapy
  - Ultrasound therapy
  - Electrical stimulation
  - Traction
- Postoperative rehabilitation
  - Rehabilitation protocols following orthopaedic surgeries
  - Joint replacement
  - Ligament reconstruction
  - Fracture fixation
Orthopaedic Surgery Techniques
3 topics
- Arthroscopic Surgery
  - Indications
  - Techniques
  - Complications of arthroscopic procedures in various joints
- Joint Replacement Surgery
  - Total Hip Arthroplasty (THA)
  - Total Knee Arthroplasty (TKA)
  - Total Shoulder Arthroplasty (TSA)
- Spinal Surgery
  - Decompression Procedures
  - Spinal Fusion
  - Instrumentation Techniques in the Management of Spinal Disorders
Orthopaedic Research and Evidence-Based Practice
2 topics
- Basics of orthopaedic research
  - Study design
  - Data collection
  - Statistical analysis
  - Interpretation of research findings
- Evidence-based orthopaedics
  - Critical appraisal of research literature
  - Application of evidence-based guidelines
  - Practice-based learning

INI CET Orthopaedics flashcards — 50 questions with answers

What does orthopaedics deal with, and what is the origin of the term?
Orthopaedics is the branch of surgery concerned with the diagnosis and treatment of disorders of the musculoskeletal system (bones, joints, ligaments, tendons, muscles, nerves). The term derives from Greek 'orthos' (straight) and 'paidion' (child), originally referring to correction of childhood deformities.
What does the 'look, feel, move' sequence describe in orthopaedic examination?
It is the standard order of musculoskeletal examination: Look (inspection for swelling, deformity, scars, muscle wasting), Feel (palpation for tenderness, warmth, crepitus), and Move (active, passive, and resisted range of motion). It is often followed by special tests and a neurovascular assessment.
What does a positive Trendelenburg test indicate?
When the patient stands on one leg, the pelvis on the unsupported (opposite) side drops instead of rising. A positive test indicates weakness or insufficiency of the hip abductors (gluteus medius/minimus) or instability of the supporting hip joint on the standing side.
Which imaging modality is the first-line investigation for suspected fractures, and what is the minimum rule for views?
Plain X-ray (radiograph) is first-line. The 'rule of twos' applies: at least two views (typically anteroposterior and lateral), including the two joints proximal and distal to the injury, and where relevant two limbs (comparison) and two occasions (repeat imaging).
When is MRI the preferred imaging modality in orthopaedics?
MRI is preferred for soft-tissue and marrow pathology: ligament and meniscal tears, tendon injuries, cartilage assessment, occult/stress fractures, avascular necrosis, infection (osteomyelitis), spinal cord/disc disease, and soft-tissue or marrow tumours. It gives excellent soft-tissue contrast without ionising radiation.
What is the main advantage of CT over plain X-ray in fracture assessment?
CT provides detailed cross-sectional and 3D bony anatomy, making it superior for complex/intra-articular fractures (e.g., tibial plateau, calcaneus, pelvis/acetabulum), surgical planning, and detecting occult fractures not seen on plain films.
Describe the Salter-Harris classification of physeal (growth plate) fractures.
Type I: through the physis only (Slipped). Type II: through physis and metaphysis (Above). Type III: through physis and epiphysis (Lower/below). Type IV: through metaphysis, physis, and epiphysis (Through). Type V: crush injury of the physis. Mnemonic 'SALTR'. Higher types carry greater risk of growth disturbance.
Differentiate a simple (closed) fracture from a compound (open) fracture.
A closed fracture has intact overlying skin with no communication between the fracture and the external environment. An open (compound) fracture has a wound connecting the fracture site to the outside, raising the risk of contamination and infection.
What does the Gustilo-Anderson classification grade, and what distinguishes the types?
It classifies open fractures by soft-tissue injury. Type I: clean wound <1 cm. Type II: wound 1-10 cm without extensive soft-tissue damage. Type III: wound >10 cm or high-energy/contaminated, subdivided into IIIA (adequate soft-tissue coverage), IIIB (extensive soft-tissue loss needing flap coverage), and IIIC (associated arterial injury requiring repair).
What are the four general principles ('Rs') of fracture management?
Resuscitation (treat the patient first, ATLS), Reduction (restore alignment - closed or open), Retention/Restriction (hold reduction with cast, traction, or fixation), and Rehabilitation (restore function). Reduce, hold, and rehabilitate are the core surgical aims.
What is the difference between absolute and relative stability in fracture fixation?
Absolute stability eliminates motion at the fracture (e.g., lag screw/compression plate) and heals by primary (direct) bone healing with no callus. Relative stability permits controlled micromotion (e.g., intramedullary nail, bridging plate, external fixator) and heals by secondary healing with callus.
Define malunion, delayed union, and nonunion.
Malunion: fracture heals in an unacceptable position (angulation, rotation, shortening). Delayed union: healing takes longer than expected for that bone/site but is still progressing. Nonunion: healing has stopped and the fracture will not unite without intervention (subtypes: hypertrophic vs atrophic).
What is compartment syndrome, and what is the classic clinical hallmark?
A surgical emergency in which raised pressure within a closed osteofascial compartment compromises perfusion, causing tissue ischaemia. The classic hallmark is pain out of proportion to the injury, worsened by passive stretch of the muscles. The definitive treatment is urgent fasciotomy.
Which fracture is most associated with avascular necrosis, and why?
Femoral neck (intracapsular) fracture, because the femoral head's blood supply (mainly the medial femoral circumflex artery via the retinacular vessels) is disrupted. Other classic sites are the scaphoid (proximal pole) and talus (body).
List the stages of secondary (indirect) fracture healing.
1) Haematoma/inflammation (clot and inflammatory cells). 2) Soft (fibrocartilaginous) callus formation. 3) Hard (bony) callus formation by endochondral and intramembranous ossification. 4) Remodelling (Wolff's law reshapes bone to mechanical demands).
What is primary (direct) bone healing and when does it occur?
Direct cortical healing without callus, occurring under absolute stability with anatomic reduction and rigid fixation. It proceeds via cutting cones (osteoclasts followed by osteoblasts forming new Haversian systems) across the fracture; called contact healing when gap is minimal and gap healing for small gaps.
List patient and local factors that impair fracture healing.
Patient factors: smoking, diabetes, malnutrition, old age, NSAID/steroid use, vitamin D deficiency. Local factors: inadequate immobilisation/excessive motion, poor blood supply, infection, soft-tissue interposition, large fracture gap/bone loss, and intra-articular location.
What is the most common direction of shoulder (glenohumeral) dislocation, and which nerve is at risk?
Anterior dislocation is by far the most common (~95%). The axillary nerve is most at risk, tested by sensation over the 'regimental badge' area of the lateral shoulder and deltoid function.
Describe the typical pain pattern of subacromial impingement / rotator cuff disease.
Pain over the lateral shoulder, worse with overhead activity and at night, with a painful arc of abduction typically between 60 and 120 degrees. Caused by impingement of the supraspinatus tendon/subacromial bursa under the coracoacromial arch.
What is adhesive capsulitis (frozen shoulder) and its hallmark examination finding?
A condition of progressive shoulder stiffness and pain from inflammation and fibrosis of the glenohumeral capsule. The hallmark is global loss of both active AND passive range of motion, especially external rotation. It is associated with diabetes and typically passes through freezing, frozen, and thawing phases.

Show the other 30 Orthopaedics flashcards

Differentiate lateral epicondylitis from medial epicondylitis.
Lateral epicondylitis ('tennis elbow') is tendinopathy of the common wrist extensor origin (ECRB), with pain on resisted wrist extension. Medial epicondylitis ('golfer's elbow') affects the common flexor-pronator origin, with pain on resisted wrist flexion/pronation.
What is carpal tunnel syndrome and which nerve and digits are affected?
Compression of the median nerve beneath the flexor retinaculum at the wrist, causing pain and paraesthesia in the thumb, index, middle, and radial half of the ring finger, often worse at night, with thenar wasting in chronic cases. Tinel's and Phalen's tests are positive.
Which carpal bone is most commonly fractured, and what is the key complication?
The scaphoid. It is prone to avascular necrosis and nonunion of the proximal pole because its blood supply enters distally and runs retrograde. Tenderness in the anatomical snuffbox suggests a scaphoid fracture even with a normal initial X-ray.
Why is shortening and external rotation of the leg a classic sign of a femoral neck fracture?
The fracture allows the unopposed pull of muscles: the limb shortens because fragments override, and it externally rotates due to the iliopsoas and short external rotators acting on the proximal fragment, with the gravity of the foot. The leg appears shortened, abducted, and externally rotated.
What is the difference in management between intracapsular and extracapsular hip fractures?
Intracapsular (subcapital/transcervical) displaced fractures in elderly are usually treated with arthroplasty (hemi- or total hip replacement) due to high avascular necrosis risk. Extracapsular (intertrochanteric/subtrochanteric) fractures preserve blood supply and are treated with internal fixation (dynamic hip screw or intramedullary nail).
What are the unhappy/terrible triad injuries of the knee?
Injury to the anterior cruciate ligament (ACL), the medial collateral ligament (MCL), and the medial meniscus, classically from a lateral blow to a planted, flexed knee (valgus + rotation force).
Which special tests assess anterior cruciate ligament integrity?
The Lachman test (most sensitive - tibia drawn forward at ~30 degrees flexion), the anterior drawer test (at 90 degrees flexion), and the pivot-shift test (assesses rotational instability). Increased anterior tibial translation with a soft endpoint indicates ACL deficiency.
What is the McMurray test used for?
It assesses meniscal tears: the knee is flexed and the tibia rotated while extending the knee; a painful click/clunk suggests a meniscal tear (external rotation tests the medial meniscus, internal rotation the lateral meniscus).
Differentiate the most common ankle ligament injured in an inversion sprain.
The anterior talofibular ligament (ATFL) of the lateral ligament complex is the most commonly injured in an inversion (supination) ankle sprain. The Ottawa ankle rules help decide the need for radiographs.
What is developmental dysplasia of the hip (DDH)?
A spectrum of abnormal development of the hip joint in which the femoral head and acetabulum are improperly aligned, ranging from acetabular dysplasia to subluxation and frank dislocation. It is more common in firstborn girls, breech presentation, and with a positive family history.
Which two clinical tests screen newborns for DDH, and what does each detect?
The Ortolani test reduces a dislocated hip (a palpable 'clunk' as the femoral head relocates into the acetabulum on abduction). The Barlow test dislocates a dislocatable hip (posterior pressure with adduction). Ultrasound is the imaging of choice under 6 months.
What is the first-line treatment for DDH in an infant under 6 months of age?
A Pavlik harness, which holds the hips in flexion and abduction to maintain reduction and promote normal acetabular development. Older or failed cases may need closed/open reduction and a hip spica cast.
Describe the components of the deformity in congenital talipes equinovarus (clubfoot) using CAVE.
CAVE: Cavus (high medial arch), Adductus (forefoot adduction), Varus (hindfoot inversion), and Equinus (plantarflexion of the ankle). The foot is turned inward and downward and cannot be passively corrected to neutral.
What is the standard first-line treatment for clubfoot?
The Ponseti method: serial manipulation and casting (correcting in the CAVE order), usually with a percutaneous Achilles tenotomy to correct residual equinus, followed by a foot-abduction (boots-and-bar) bracing programme to prevent relapse.
Differentiate scoliosis, kyphosis, and lordosis.
Scoliosis is an abnormal lateral curvature of the spine (with rotation), measured by the Cobb angle. Kyphosis is excessive posterior (outward) curvature of the thoracic spine. Lordosis is excessive anterior (inward) curvature, typically lumbar. Adolescent idiopathic scoliosis is the most common type of scoliosis.
What are the most common primary malignant and benign bone tumours, and the typical age groups?
Osteosarcoma is the most common primary malignant bone tumour, typically in adolescents/young adults around the knee (distal femur/proximal tibia). Osteochondroma is the most common benign bone tumour. Ewing sarcoma and chondrosarcoma are other important malignancies.
Which radiographic signs suggest an aggressive/malignant bone lesion?
A wide zone of transition (ill-defined margins), permeative/moth-eaten bone destruction, aggressive periosteal reaction (Codman triangle, 'sunburst'/'onion-skin' patterns), cortical breach, and an associated soft-tissue mass. Sunburst suggests osteosarcoma; onion-skin suggests Ewing sarcoma.
Which primary cancers most commonly metastasise to bone, and what is the typical lesion type?
Breast, prostate, lung, kidney (renal), and thyroid (mnemonic 'BLT with Kosher Pickle'). Most are osteolytic; prostate metastases are characteristically osteoblastic (sclerotic). The axial skeleton (spine, pelvis) is most commonly involved, and metastases are far more common than primary bone tumours.
What is the most common soft-tissue sarcoma in adults, and a key clinical warning sign of a soft-tissue mass?
Undifferentiated pleomorphic sarcoma (formerly malignant fibrous histiocytoma) and liposarcoma are among the most common adult soft-tissue sarcomas. Warning ('red flag') features of a soft-tissue mass: size >5 cm, deep to fascia, rapidly enlarging, and painful - these warrant urgent MRI and referral before biopsy.
What is the immediate management of an acute soft-tissue sports injury?
The RICE protocol: Rest, Ice, Compression, Elevation (often expanded to PRICE with Protection, or POLICE with Optimal Loading). The aim is to limit swelling and bleeding in the first 48-72 hours; NSAIDs may aid analgesia.
What distinguishes an overuse injury from an acute injury, and give common examples.
An overuse injury results from repetitive submaximal loading without adequate recovery (microtrauma exceeding repair), rather than a single traumatic event. Examples: stress fractures, tendinopathies (Achilles, patellar 'jumper's knee'), shin splints (medial tibial stress syndrome), and apophysitis (e.g., Osgood-Schlatter disease).
What general criteria must be met before an athlete is cleared for return to play after injury?
Full pain-free range of motion, restored strength (typically >=90% of the contralateral side), normal sport-specific function and proprioception/neuromuscular control, psychological readiness, and being symptom-free under sport-specific loading. Return is graded and progressive to minimise re-injury.
State the core principles of orthopaedic rehabilitation.
Control pain and inflammation, protect healing tissue while avoiding harmful loading, restore range of motion, then progressively rebuild strength, endurance, proprioception, and finally sport/activity-specific function. Rehabilitation should be early, graded, patient-specific, and respect tissue-healing timelines.
Name common physical modalities used in orthopaedic physiotherapy and a key indication for each.
Cryotherapy (acute injury - reduces swelling/pain), heat/thermotherapy (chronic stiffness - increases blood flow), ultrasound (deep tissue heating/healing), TENS (pain relief via gate control), electrical muscle stimulation (muscle re-education/atrophy prevention), and therapeutic exercise/hydrotherapy (mobility and strengthening).
What are the general goals of postoperative orthopaedic rehabilitation?
Protect the surgical repair, control pain and swelling, prevent complications (DVT, stiffness, muscle atrophy), restore range of motion and strength progressively within surgeon-specified weight-bearing and motion restrictions, and return the patient to functional independence following protocol-driven phased progression.
What is arthroscopy and what are its main advantages?
Arthroscopy is minimally invasive joint surgery using a fibre-optic camera (arthroscope) and instruments through small portals. Advantages: smaller incisions, less soft-tissue damage, reduced pain, faster recovery, and the ability to both diagnose and treat (e.g., meniscectomy, ACL reconstruction, rotator cuff repair). The knee and shoulder are the most commonly scoped joints.
What are the leading indications for total joint replacement (arthroplasty)?
Severe symptomatic osteoarthritis (most common), rheumatoid arthritis, avascular necrosis, and selected fractures. The aim is to relieve pain and restore function. The hip and knee are the most commonly replaced joints; aseptic loosening and periprosthetic infection are major long-term complications.
Differentiate spinal decompression from spinal fusion surgery.
Decompression (e.g., discectomy, laminectomy) removes tissue (disc/bone) compressing neural structures to relieve nerve-root or cord symptoms. Fusion permanently joins vertebrae (with grafts/instrumentation) to eliminate motion at an unstable or painful segment. The two are often combined for instability with stenosis.
What is the hierarchy (levels) of evidence in evidence-based orthopaedics?
Level I: high-quality randomised controlled trials/systematic reviews of RCTs. Level II: lesser-quality RCTs and prospective cohort studies. Level III: case-control and retrospective comparative studies. Level IV: case series. Level V: expert opinion. Higher levels carry stronger evidence and lower bias.
What is a Patient-Reported Outcome Measure (PROM) and give an orthopaedic example?
A PROM is a validated questionnaire capturing the patient's own assessment of health/function and quality of life, used to evaluate treatment effectiveness in research and practice. Examples: Oxford Hip/Knee Scores, WOMAC (osteoarthritis), DASH (upper limb), and the Harris Hip Score.

Same Orthopaedics syllabus in other exams

The Orthopaedics outline above is identical in these 3 exams:

INI CET Orthopaedics FAQ

What is in the INI CET Orthopaedics syllabus?

INI CET Orthopaedics is split into 10 chapters: General Orthopaedics, Trauma and Fractures, Orthopaedic Disorders of the Upper Limb, Orthopaedic Disorders of the Lower Limb, Pediatric Orthopaedics, Orthopaedic Oncology, Sports Medicine, Orthopaedic Rehabilitation and Physiotherapy, Orthopaedic Surgery Techniques and Orthopaedic Research and Evidence-Based Practice. Together they contain 30 topics and 107 sub-topics.

How many chapters are in INI CET Orthopaedics?

10 chapters, containing 30 topics and 107 sub-topics. The largest chapter is Trauma and Fractures, with 4 topics.

Are there flashcards for INI CET Orthopaedics?

Yes — a 50-card Orthopaedics deck, printed in full in the flashcards section of this page and available in the Examius app with spaced repetition. The free plan covers one exam of your choice, including its flashcards; Examius Pro, a one-time purchase, unlocks every other exam and deck.