What is the anterior shoulder instability CPG?
Apprehension test, relocation and anterior drawer
What two tests of teh anterior shoulder instability CPG are the most specific and sensitive?
apprehension and relocation
what is the ankylosing spondylitis (Berlin criteria) CPG
morning stiffness over 30 min
improvement in back pain with exercise, not rest
awakening due to LBP during second half night only
alternating buttock pain
what is the ankylosing spondylitis (IBPcriteria) CPG
-age at onset <40
-insidious onset
-improvement with exercise
-no improvement with rest
-pain at night with improvement getting up
Need 4/5
Canadian c/s rules: high risk factors: what does it mean
-age over 65
-dangerous MOI (fall >1m, 5 steps, axial load, high speed MVA/recreational vehicle or bike)
-paresthesia in extremities
if 1 present: radiograph
CTS CPG:
-shaking hands for sxs relief
-wrist/ratio index >0.67
-sys severity score >1.9
-reduced median nerve sensory field of digit 1
-age >45
Canadian c/s rules: low risk factors to assess ROM: meanings?
simple rear end
normal sittin posture in ED
ambulatory since injury
delayed onset of neck pain and absence of midline tenderness
if 2 present and unable to rotate over 45 degrees to one direction, radiographs
when is the CTS CPG most sensitive and specific?
sensitive with 3 variables
specificity with 5 variables
what is the cervical myelopathy CPG? when specific?
- gait deviation
-positive hoffmans
-positive inverted supinator - positive babinski
-age >45
HIGHLY SPECIFIC IF 4 VARIABLES
c/s radiculopathy CPG? when most specific?
- positive ULTT A
-involved c/s rotation <60 deg - (+) distraction test
-(+) spurling test
very specific with 4
c/s closed fracture CPG
-age <55
- single marital status
-condition involved trauma
-acute condition
-condition involed ER visit
what are the characteristics of DVT (all 10) and how many factors mean what?
-acute cancer (within 6 months)
-paralysis, paresis, recent plaster immobilization
-bedridden 3+ days, surgery in last 12 weeks
-localized tenderness along deep veins
-entire leg swollen
-calf swelling at least 3 cm larger than asymptomatic side (10cm below tibial tuberosity)
-pitting edema confined to symptomtic leg
-previous DVT
-alternative dx at least as likely as DVT (-2)
> 3: high prob
1-2: mod prob
0: low prob
hip OA CPG
- squatting as agg factor
-(+) scour test for groin or lat hip pain - active hip flexion causing lateral hip pain
- passive IR <25 deg
- Active hip extension causing hip pain
lumbar stenosis CPG
-bilateral sxs
- leg pain >back pain
- pain during walking/standing
- pain relief with sitting
- >48 years old
MCL CPG
- trauma by external force to the knee
- rotational trauma
- pain with valgus stretss test at 30 deg
- laxity with valgus stress test at 30 deg
with MCL CPG, what is more specific (how many findings/what kind findings?)
2/2 on history with laxity being positive at 30 deg
meniscus CPG
- history of catching/locking
- JLT
- pain with forced hyperext
- pain with max PROM knee flexion
- pain or click with McMurray
is meniscus CPG more specific or sensitive?
specific
ottawa ankle rules: sensitive or specific?
pain in malleolar or midfoot area and either
- inability to WB immediately, and in ED (taking 4 steps)
OR
- bone tenderness at posterior edge tibia, or fibula, or tip of medial/lateral malleolus
- bone tenderness at navicular or prox base 5th metatarsal
SENSITIVE
Ottawa knee rules: sensitive or specific?
- age >55
- tenderness at head fibula
- isolated tenderness of patella with palpation
- inability to flex knee to 90 deg
- inability to WB immediately or in ED
SENSITIVE
Pittsburg knee rules: sensitive or specific?
blunt trauma or fall as MOI, plus either of the following:
- age over 50 years or younger than 12
- inability to walk 4 steps in ED
SENSITIVE
PE CPG
-age over 65 +1
- previous DVT or PE +3
- surgery or fx within 1 month +2
- active malignant condition +2
- unilateral lower limb pain +3
- haemoptysis +2
- HR 75-94 bpm +3
- HR 95 or more bpm +5
- pain on deep palpation of lower limb/unilateral edema +4
RTC CPG
age over 65
weakness in ER
night pain
SI joint pain
findings?
SI distraction
SI compression
thigh thrust
Gaenslens test
sacral thrust/patrick sign (FABER)
SENSITIVE with 3+
