20231013 Quiz Tendon disorders p3 Dr Rosalind

A 45-year-old gentleman sustained an injury to his left wrist while golfing. He felt a painful pop in his wrist after a swing when he contacted the ground. His wrist pain is ulnar-sided & is reproduced when the wrist is moved from pronation to supination with slight flexion, associated with snapping sensation. What is the most specific & sensitive test to diagnose the above condition?

• Fovea test

• Nakamura’s ulnar stress test

• ECU synergy test

• Grind test

• WHAT test

The extensor retinaculum inserts into the following structures EXCEPT

• Triquetrum

• Base of 5th metacarpal

• Volar soft tissues

• Hook of hamate

• Pisiform

Which of the following statements are TRUE?

• ECU subluxation in radial sided tears can be reduced back into subsheath with pronation of forearm

• ECU is the most vulnerable for injury with wrist in flexion, ulnar deviation & supination

• Periosteal stripping on ulnar wall will not cause ECU tendon instability

• ECU tendon exits the 6th dorsal compartment at an angle in pronation

• ECU synergy test is done with forearm in full pronation

A 30-year-old tennis player sustained ulnar-sided wrist pain after a game. ECU synergy test reproduces pain along ECU tendon. What is the next step of management?

• Ultrasound of the wrist

• MRI of the wrist

• Prescribe a Muenster splint

• Refer physiotherapy for range of motion exercises

• Counsel for surgery

The following are advantages of ultrasound imaging in ECU tendinitis EXCEPT

• Fast

• Dynamic assessment can be done in supination & pronation

• Comparison with contralateral upper limb

• Can assess inflammatory changes

• Can demonstrate anomalous tendon anatomy