NEET PG Orthopaedics Flashcards

24 sample cards from the Orthopaedics deck

Sampled from the end of the deck, so these are different cards from the ones shown on the syllabus page.

1. What is the typical clinical appearance of a displaced extracapsular hip fracture?

   The affected limb is shortened and externally rotated, with pain and inability to weight-bear; external rotation is more marked than in intracapsular fractures.

2. What is the unhappy triad (O'Donoghue triad) of the knee?

   A combined injury of the anterior cruciate ligament (ACL), the medial collateral ligament (MCL), and the medial meniscus (classically described; lateral meniscus is now considered more commonly involved), typically from a lateral blow to a planted, flexed knee.

3. Which clinical tests assess anterior cruciate ligament integrity, and which is most sensitive?

   The anterior drawer test, the Lachman test (most sensitive), and the pivot-shift test (most specific) assess ACL integrity; a soft or absent endpoint indicates a tear.

4. What is the McMurray test used to detect?

   Meniscal tears; the examiner flexes the knee and rotates the tibia while extending — a palpable or audible click with pain suggests a meniscal tear (external rotation for medial meniscus, internal rotation for lateral).

5. What is the most common ankle sprain and which ligament is involved?

   An inversion (lateral) sprain involving the anterior talofibular ligament (ATFL), the weakest and most commonly injured lateral ankle ligament.

6. What are the Ottawa ankle rules used for?

   They are clinical decision rules to determine when ankle/foot X-rays are needed: X-ray if there is bony tenderness at the posterior edge/tip of either malleolus, the navicular, or the base of the 5th metatarsal, or inability to bear weight for four steps both immediately and in the ED.

7. What is the difference between hallux valgus and hallux rigidus?

   Hallux valgus is lateral deviation of the great toe at the first MTP joint (bunion formation); hallux rigidus is degenerative arthritis of the first MTP joint causing stiffness, pain, and loss of dorsiflexion.

8. What is developmental dysplasia of the hip (DDH) and which clinical tests screen for it in neonates?

   A spectrum of abnormal hip development from dysplasia to frank dislocation. Neonatal screening uses the Ortolani test (relocates a dislocated hip with a 'clunk') and the Barlow test (dislocates a dislocatable hip); ultrasound is the imaging of choice under 6 months.

9. What are the risk factors for DDH (the classic associations)?

   Female sex, first-born child, breech presentation, oligohydramnios, family history, and being on the left side; mnemonic considerations include the 'packaging' problems that limit fetal hip movement.

10. What are the four components of the deformity in congenital talipes equinovarus (clubfoot)?

    CAVE: Cavus (high medial arch), Adductus (of the forefoot), Varus (heel/hindfoot inversion), and Equinus (ankle plantarflexion). First-line treatment is the Ponseti method of serial casting.

11. What is the difference between scoliosis, kyphosis, and lordosis?

    Scoliosis is a lateral curvature of the spine with rotation (Cobb angle >10°); kyphosis is excessive posterior (outward) convex curvature of the thoracic spine; lordosis is excessive anterior (inward) concave curvature, usually lumbar.

12. What is the Cobb angle and why is it important in scoliosis?

    The Cobb angle measures the magnitude of spinal curvature between the most tilted end vertebrae on a standing radiograph; it guides management — bracing typically considered around 25–40° in a skeletally immature patient and surgery often considered above ~45–50°.

13. What is the most common primary malignant bone tumour, in whom does it occur, and where?

    Osteosarcoma; it most commonly affects adolescents/young adults, arises around the knee (distal femur/proximal tibia, the metaphysis), and shows a 'sunburst' periosteal reaction and Codman's triangle on X-ray.

14. What is the classic radiographic and clinical feature of Ewing's sarcoma?

    Ewing's sarcoma typically affects children/adolescents in the diaphysis of long bones or pelvis, shows an 'onion-skin' (lamellated) periosteal reaction, and is associated with the t(11;22) translocation (EWS-FLI1 fusion).

15. What is a giant cell tumour of bone (osteoclastoma) and its characteristic location?

    A locally aggressive, usually benign tumour of young adults (20–40 years) arising at the epiphysis/metaphysis of long bones, classically the distal femur or proximal tibia, with a 'soap-bubble' lytic appearance and a lytic eccentric pattern.

16. Which cancers most commonly metastasise to bone, and is the spread usually lytic or blastic?

    Breast, prostate, lung, kidney (renal), and thyroid (mnemonic: BLT with a Kosher Pickle). Most are osteolytic; prostate cancer characteristically produces osteoblastic (sclerotic) lesions, and breast can be mixed.

17. What is the most common benign soft tissue tumour, and what is the most common adult soft-tissue sarcoma?

    The most common benign soft-tissue tumour is the lipoma; among adult soft-tissue sarcomas, undifferentiated pleomorphic sarcoma (formerly malignant fibrous histiocytoma) and liposarcoma are the most common.

18. What is the RICE protocol for acute soft-tissue sports injuries?

    Rest, Ice, Compression, and Elevation — used in the acute phase (first 24–72 hours) to limit swelling, pain, and bleeding; often expanded to PRICE (Protection) or POLICE (Protection, Optimal Loading, Ice, Compression, Elevation).

19. What is the difference between an acute traumatic injury and an overuse injury, with an example of the latter?

    Acute injuries result from a single identifiable high-force event (e.g., ankle sprain, ACL rupture); overuse injuries result from repetitive microtrauma exceeding tissue repair capacity (e.g., stress fracture, tendinopathy, shin splints).

20. What general criteria must be met before an athlete is cleared for return to play after injury?

    Full pain-free range of motion, restoration of strength (typically ≥90% of the uninjured side), normal proprioception/balance, completion of sport-specific functional testing, and psychological readiness, progressing through a graded rehabilitation programme.

21. In orthopaedic physiotherapy, what is the difference between cryotherapy and thermotherapy and when is each used?

    Cryotherapy (cold) causes vasoconstriction and reduces acute swelling, pain, and inflammation (used in acute injury). Thermotherapy (heat) causes vasodilation, increases blood flow and tissue extensibility, and relieves stiffness/spasm (used in subacute/chronic phases).

22. What is the difference between isometric, isotonic, and isokinetic muscle exercises in rehabilitation?

    Isometric: muscle contracts without joint movement or change in muscle length (static). Isotonic: muscle changes length against a constant load with joint movement (concentric/eccentric). Isokinetic: movement at a constant (fixed) angular velocity with accommodating resistance, requiring special equipment.

23. What is the difference between arthroscopy and arthroplasty?

    Arthroscopy is minimally invasive joint surgery using a fibre-optic camera and small portals to diagnose and treat intra-articular pathology (e.g., meniscal repair, ACL reconstruction). Arthroplasty is surgical reconstruction or replacement of a joint (e.g., total hip/knee replacement).

24. What is the most common indication for total joint replacement, and what is the principle of evidence-based orthopaedics that guides such decisions?

    Osteoarthritis is the most common indication for total hip and knee replacement. Evidence-based orthopaedics integrates the best available research evidence (ideally randomised controlled trials and meta-analyses, the top of the hierarchy of evidence), clinical expertise, and patient values to guide treatment.

What this deck covers

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