AMD Flashcards

Question

Achilles Tendon Rupture

Answer 1

Achilles: connect to heel (largest tendon) Etiology: Sudden pivoting or rapid acceleration More common in tennis, basketball, softball Pathogenesis: Recurrent microtrauma causes degeneration  damaged tendon becomes calcified, thickened, inelastic, fibrotic  shear stress (stop & go)  tear/rupture Fluroquinolones  typically w/in 1 week of start of ABX Clinical Manifestations: “pop”, pain, feel struck violently in back of ankle Diagnosis: Clinical exam, U/S, MRI (U/S best imaging) Treatment: Ice, NSAIDS, APAP, Rest (non-weightbearing w/crutches), immobilization, Surgical Repair

Answer 2

``` Occur at end of bone Causes Lack of blood supply Direct trauma to joint Repetitive use Clinical manifestations Pain with weight bearing Swelling Tenderness Limited mobility; occasional “locking” of knee Treatment NSAIDs & use of growth hormone; Weight loss; Rest; Ice ; Use of assistive devices to walk; Physical therapy; Nutritional supplements; Arthroscopic surgery ```

Answer 3

Tendon supporting muscle(s) rips / tears from bone Causes Fall on shoulder; Attempt to break fall with outstretched hand; Repeated overhead motions Clinical manifestations Dull ache in joint from microscopic tears Weakness when raising arm Inability to reach behind back Diagnosis Shoulder ROM assessment; X-ray; CT scan or MRI; Ultrasound or arthrogram Treatment Rest, application of cold or heat to area, NSAIDs, electrical stimulation of muscles; Cortisone injections; Surgery

Answer 4

Acute inflammation of ligaments in shoulder joint capsule Shoulder bones unable to move freely in joint Etiology: Primary (idiopathic) Thyroid disease, dyslipidemia, prolonged immobilization, stroke, autoimmune disease Rare: Parkinson disease, HIV antiretroviral therapy (protease inhibitors) Pathogenesis: Not completely understood  Inflammation of capsule Clinical manifestations Self-imposed immobility of shoulder because of pain Stiffness, more pain, continued loss of motion Unable to move arm above head or behind back Diagnosis Shoulder ROM assessment; X-ray to rule out other disease processes; MRI Treatment NSAIDs & steroid injections; Physical therapy ; Arthroscopic surgery Can resolve within 2 years with minimal loss of shoulder function without treatment

Answer 5

AKA Swimmer’s Shoulder Etiology: Acute shoulder injury Repeated movement Swimmers & throwing in baseball, football, javelin & tennis serves Pathogenesis: Rotator cuff tendon trapped under acromion Compression between humeral head & undersurface of acromion, acromioclavicular joint, or coracoacromial arch Clinical Manifestations: Pain when raising arm above head or behind back Diagnosis Pain relief with anesthetic X-rays to rule out other processes Treatment Ice, NSAIDs, physical therapy, Steroid injections, Arthroscopic surgery

Answer 6

Etiology: Bacteria, fungi, parasites, viruses; Infection carried to bone Pathogenesis: Bone infection Penetrating wound, from blood infection, skin breakdown Joint replacement & internal fixation surgeries Clinical manifestations Local indications: bone pain; drainage & ulceration; swelling, redness, warmth, tenderness Systemic indications: Lymph node swelling; Fever with chills, general malaise; Tachycardia; Nausea, vomiting; Anorexia Diagnosis Abscess / bone changes/bone destruction (X-ray, bone scan, MRI); WBC count & sed rate; blood cultures; bone biopsy/tissue samples Treatment Antibiotics (systemic), Surgery (for severe ischemia); Drainage tubes inserted in bone; Procedure to fill dead tissue space with muscle

Answer 7

Avascular necrosis, aseptic necrosis, ischemic necrosis Etiology & Pathogenesis Reduced blood flow to joint Bone breakdown occurs faster than replacement Causes: bone fracture, thrombosis/embolism, vessel injury, compartment syndrome, steroid therapy Risk factors Long-term use of steroids; Heavy alcohol intake; Direct injury to bone / joint ; Chemotherapy / radiation; Organ; transplantation; Diseases Clinical manifestations Insidious; no symptoms; Pain when pressure / weight applied to joint; Inability to use limb Diagnosis X-rays, MRI, CT scan; Bone scan; Bone biopsy; Measurement of bone pressure Treatment NSAIDs; Non-weight bearing status; ROM exercises; Electrical stimulation; Surgery

Answer 8

``` Abnormal growth of normal tissue Do not metastasize/interfere with body organ function Affected by growth hormones Clinical manifestations Lump associated with ache or pain Treatment Tumor heals when fracture heals Stops growing when growth hormone slows Surgery ```

Answer 9

Come from cartilage, bone cells, collagen, bone marrow Etiology: Exact cause unknown Pathogenesis: Possibly related to High bone growth or bone overstimulation by disease Radiation, bone marrow transplantation Osteolysis Osteosarcoma is most common in adolescents (75%<20 y/o) Clinical manifestations Deep bone pain; Skin over mass warm, erythematous Diagnosis X-rays; CT scans; MRI; Bone biopsy; Alk phos & calcium levels Treatment Surgery; Chemotherapy; Radiation

Answer 10

Cancer from another body site that migrates to bone Most common in spine, pelvis, thigh Clinical manifestations Sometimes asymptomatic If symptomatic Bone pain; Fractures; Changes in urinary & bowel continence; Limb weakness Diagnosis X-rays; CT scans; MRI; Blood tests; Bone or positron emission tomography scan Treatment Radiation; Chemotherapy

AMD Flashcards

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