Revise Entire Ortho in Just 70 mins | NEET PG | INICET | FMGE | Dr. Apurv Mehra

Let's have a look at entire orthopedics

in

100 lines. Let's go.

Orthopedics means straight child.

Nicholas gave this word called as the

father of orthopedics.

The second father is Thomas who gave

Thomas splint and Thomas test for hip

flexion deformities.

Chanlays is called as the father of

arroplasty.

When you look at X-rays, it can show you

the bone. It can show you the soft

tissue planes. It can show you the

cortex in the bone. It can show you the

marrow. What it cannot show you is the

cartilage. When you look at the CT scan,

it can show you the calcifications. It

can show you the cortex. CT scan C,

cortex C, calcification C. But it's

rarely an investigation. In orthopedics,

if you want to choose an investigation,

go for MRI because it can show you the

marrow, it can show you the soft tissue,

it can show you the cartilage. Cartilage

is not seen on X-rays, is not picked up

on CT scan, it's picked up on MRI. When

I look at tumors and infection which are

usually the scenarios given to you for

diagnosis, biopsy or tissue is the gold

standard. Radiology is suggestive.

Tissue is diagnostic. When I look at

metastasis, when I look at metastasis,

PET scan is the investigation, the

radological investigation of choice. But

bone scan is preferred in osteoplastic

meds. And can you guess what causes

osteoplastic meds? Prostate. The

prostate is known for causing

osteoplastic metastasis. Perio reaction

came in neat PG 2024 paper 1 paper two

when they show you any perioile reaction

which is single layer solid perryio

reaction is benign bone tumor or acute

osteomalitis when wide zone of activity

31 they ask you number one sunray

appearance usually osteocaroma

codman's triangle usually osteocaroma

onion peel appearance usually evening

saroma but the location of the tumor is

more important than these radological

images. So think about e-wings in the

middle of a bone diaphasis and

osteocaromas

on the lower end or the upper end the

metaphysis. Remember in osteomalitis

you will get an X-ray done first

followed by MRI but MRI shows you

changes within 6 to 12 hours whereas

X-rays will show you loss of soft tissue

plane after 24 hours and perostal

reactions on day 7 to day 10. When we

look at the infections you know the king

of orthopedic is stefallocazorius

osteomalitis comes through blood

hematogenous is in the metaphysis and

when they ask you the organism remember

that staporius is the king exception

that you should remember is cle cell

anemia salmonella and foot is something

where you should think about an ivas you

should think about sudinas

osteomalitis when It's chronic which is

one of the most common invest the images

shown to you in orthopedics. Think about

sequestrum the dead bone which is

diagnostic and when you remove the

sequestrum the live bleeding bone comes

that's called as a paprika sign.

Remember multif focal oatis that is

osteolitis involving the multiple bones

right safo syndrome is number one safo

syndrome is a misnomer it is actual

osteitis but if they ask you which is

multif focal oitis choose safo syndrome.

Second common is cle cell anemia with

salmonella infections. Faber flexion

abideduction externation

of the lower limb is a position of

increased capacity of the hip joint

which is seen in sinovitis

infection anterior dislocation and when

there is ilotibial band contraurs. Faber

is usually associated with lengthening.

Opposite of it flexion, adduction,

interotation that is far is indicative

of arthritis or posterior dislocation.

So posterior dislocation more common

than arthritis. Trauma posterior

dislocations are much more common than

anterior dislocation. That is why faber

anterior dislocation is a cause later

but in firer posterior dislocation is

number one cause. And remember fer

shortening is there. Faber lengthening

is there. If you look at the infections

of the joints, they are surgical

emergencies called as septic arthritis.

Organism is staporious. Less than 5

years, toxic child. Compared to it,

transient sinoitis, temporary

proliferation of sinovium, age group is

6 to 12 years, nonoperative management.

Infections of the hand. The most common

infection of the hand is the infection

of the nail bed called as peronicia

organism staphorius. Infections in the

felon or vitlo is the infection of pulse

space of finger. The organism again the

king of orthopedic staff orius. When you

look at a chronic disease we live in

India. We talk about tuberculosis.

Tuberculosis of bone and joint is

usually secondary. Comes from the lungs

or the lymph nodes. Tuberculosis of bone

and joint is just like Shah Ruk Khan SRK

SHK spine then hip the knee. TB spine

also called as spot spine or cockpine

will never involve a single vertebrae.

It will involve two contiguous vertebrae

with the intervening disc called as

paradiscal involvement. The disease is

anterior to the neural tissue that is

the spinal cord as you can see in this

image and the disease rarely involve the

posterior elements that is the

involvement of the facet joints or the

spinus process is rarest in TB spine

remember tuberculosis spine is treated

by middle path regimen what means is

anti-tubacular therapy where ifin is the

most important drug plus rest to that

body part and surgery when indicated

what does that mean it means that you

will operate only when required But not

that you will never operate. Not that

you will always operate. Remember in TB

spine right because of the parispinal

muscle spasm the loss of curvature of

the spine is seen much earlier than the

reduced space. But the tuberculosis of

other parts of the body where the blood

supply becomes more because infections

get inflammation. Inflammation gets more

blood supply. There is osteopenia around

the joint called as per articular

osteopenia. Remember this when we look

at tuberculosis the knee joint right

there can be a triple deformity which is

posterior subluxation externation and

flexion whereas TB hip has got five

stages stage one remember faber fer

faber sinoitis lengthening good

prognosis stage two and three are stages

of arthritis there is flexion adduction

introduction in stage two less than 1 cm

shortening which is not clinically

appreciable

Stage three, late or advanced arthritis.

Whenever they mention shortening, it's

automatic. They're talking about more

than an inch. Forget about more than a

centimeter. So mark stage three. Stage

four, the acetablum is destroyed. The

femoral head is destroyed. The destroyed

femoral head migrates from one corner

estab to other called as wandering

establum. It should be better called as

wandering femoral head. But it's a

misnomer. And finally stage five is

fusion of the joint by fibrous tissue

called as fibrous ankylosis. Friends

arthrodesis

is surgical fusion of a joint the

surgeon fuses.

Ankyosis

is pathological fusion of a joint. The

disease fuses. The disease will not know

how much to fuse. If it fuses completely

is bony ankylosis painless. If it fuses

incomplete fibrous fibbrus as F pain

painful ankylosis TB spine bony

ankylosis everywhere else tuberculosis

will cause fibrokenyosis.

Bony fusion that is bony ankylosis is

solid.

Solid is painless.

S for solid. S for septic arthritis. So

bony ankylosis most common cause is

septic arthritis. S for spine. S for