Chapter 22, module 6; LE Limb Pain Flashcards Preview

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Flashcards in Chapter 22, module 6; LE Limb Pain Deck (126)
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1
Q

Repetitive trauma activities;pain with movement

A

Tenosynovitis (tendinitis)

2
Q

Swelling over tendon, crepitus

A

Tenosynovitis (tendinitis)

3
Q

DIAGNOSTIC STUDIES FOR Tenosynovitis (tendinitis)?

A

None

4
Q

History of overuse; aching pain over affected bursae that radiates along limb

A

Bursitis

5
Q

Local tenderness, swelling; limited joint motion; muscle weakness

A

Bursitis

6
Q

DIAGNOSTIC STUDIES FOR Bursitis?

A

None

7
Q

Presentation depends on age, location of infection; history of infection, trauma, penetration, invasive procedure; refusal to bear weight (hip); constant pain

A

Osteomyelitis

8
Q

Fever, chills, vomiting; pain localized over affected area but progressively worsens; soft tissue injury or abscess

A

Osteomyelitis

9
Q

DIAGNOSTIC STUDIES FOR Osteomyelitis?

A

Increased WBCs, ESR, C-reactive protein; radiographs

10
Q

Older adults; asymmetrical joint pain and stiffness that improves throughout day; history of repetitive joint trauma; obesity

A

Osteoarthritis

11
Q

DIP, PIP joints enlarged; Heberden nodes; limited cervical spine ROM

A

Osteoarthritis

12
Q

DIAGNOSTIC STUDIES FOR Osteoarthritis?

A

ESR; radiograph may reveal osteophytes, loss of joint space

13
Q

Morning stiffness of small joints; symmetrical involvement; anorexia, weight loss

A

Rheumatoid arthritis

14
Q

Fever, rheumatoid nodules, ulnar deviation of wrists

A

Rheumatoid arthritis

15
Q

DIAGNOSTIC STUDIES FOR Rheumatoid arthritis?

A

Increased ESR, positive rheumatoid factor, anemia on CBC; radiograph shows bony erosion

16
Q

Fatigue, weight loss, failure to thrive, refusal to walk, joint pain and stiffness

A

Juvenile rheumatoid arthritis

17
Q

Fever, rash, guarding of joints, limited ROM; joint swelling, nodules

A

Juvenile rheumatoid arthritis

18
Q

DIAGNOSTIC STUDIES FOR Juvenile rheumatoid arthritis?

A

Elevated WBCs, ESR; positive rheumatoid factor and antinuclear antibody

19
Q

History of systemic infection, malaise, diaphoresis, refusal to bear weight (hip), acute joint pain

A

Septic arthritis

20
Q

Fever; red, swollen joint; limited range of motion

A

Septic arthritis

21
Q

DIAGNOSTIC STUDIES FOR Septic arthritis?

A

WBCs, culture of joint aspirate, ESR, C-reactive protein, ultrasound of joint

22
Q

Acute pain of large joint, asymmetrical; males over 30 yr, history of gout

A

Gout

23
Q

Inflamed, swollen joint; tophi; sodium urate crystals

A

Gout

24
Q

DIAGNOSTIC STUDIES FOR Gout?

A

Increased serum uric acid level, ESR, WBCs

25
Q

Older adults; asymmetrical joint pain and stiffness that improves throughout day; history of repetitive joint trauma; obesity

A

Osteoarthritis

26
Q

DIP, PIP joints enlarged; Heberden nodes; limited cervical spine ROM

A

Osteoarthritis

27
Q

DIAGNOSTIC STUDIES FOR Osteoarthritis?

A

ESR; radiograph may reveal osteophytes, loss of joint space

28
Q

Morning stiffness of small joints; symmetrical involvement; anorexia, weight loss

A

Rheumatoid arthritis

29
Q

Fever, rheumatoid nodules, ulnar deviation of wrists

A

Rheumatoid arthritis

30
Q

DIAGNOSTIC STUDIES FOR Rheumatoid arthritis?

A

Increased ESR, positive rheumatoid factor, anemia on CBC; radiograph shows bony erosion

31
Q

Fatigue, weight loss, failure to thrive, refusal to walk, joint pain and stiffness

A

Juvenile rheumatoid arthritis

32
Q

Fever, rash, guarding of joints, limited ROM; joint swelling, nodules

A

Juvenile rheumatoid arthritis

33
Q

DIAGNOSTIC STUDIES FOR Juvenile rheumatoid arthritis?

A

Elevated WBCs, ESR; positive rheumatoid factor and antinuclear antibody

34
Q

History of systemic infection, malaise, diaphoresis, refusal to bear weight (hip), acute joint pain

A

Septic arthritis

35
Q

Fever; red, swollen joint; limited range of motion

A

Septic arthritis

36
Q

DIAGNOSTIC STUDIES FOR Septic arthritis?

A

WBCs, culture of joint aspirate, ESR, C-reactive protein, ultrasound of joint

37
Q

Acute pain of large joint, asymmetrical; males over 30 yr, history of gout

A

Gout

38
Q

Inflamed, swollen joint; tophi; sodium urate crystals

A

Gout

39
Q

DIAGNOSTIC STUDIES FOR Gout?

A

Increased serum uric acid level, ESR, WBCs

40
Q

Children: During rapid growth spurts; knee pain worse with activity

A

Slipped capital femoral epiphysis

41
Q

Limitation of medial hip rotation, limp

A

Slipped capital femoral epiphysis

42
Q

DIAGNOSTIC STUDIES FOR Slipped capital femoral epiphysis?

A

Radiograph of epiphyseal plate

43
Q

Children less than 10 yr; history of upper respiratory tract infection; limp, pain in anteromedial thigh and knee

A

Transient synovitis of hip

44
Q

Tenderness on palpation over anterior hip; hip movement increases pain and is limited; low-grade fever

A

Transient synovitis of hip

45
Q

DIAGNOSTIC STUDIES FOR Transient synovitis of hip?

A

Ultrasound, ESR

46
Q

Boys age 3-11 yr; groin or medial thigh pain, limp

A

Legg-Calve-Perthes disease (LCPD)

47
Q

Decreased hip ROM

A

Legg-Calve-Perthes disease (LCPD)

48
Q

DIAGNOSTIC STUDIES FOR Legg-Calve-Perthes disease (LCPD)

A

AP and frog lateral radiographs of hip; LCPD may show increased density of femoral head

49
Q

History of repetitive flexion of hip; pain worse with movement

A

Iliopsoas tendinitis

50
Q

With patient sitting, place heel of affected leg on knee of other; test is positive if pain is elicited

A

Iliopsoas tendinitis

51
Q

DIAGNOSTIC STUDIES FOR Iliopsoas tendinitis?

A

None

52
Q

History of direct trauma to the fibula or ankle

A

Proximal fibular fracture

53
Q

Pain on weight bearing, edema and tenderness to palpation over fracture

A

Proximal fibular fracture

54
Q

DIAGNOSTIC STUDIES FOR Proximal fibular fracture?

A

Radiography, CT if soft tissue injury is suspected

55
Q

Younger age, history of overuse of lower extremities

A

Stress fracture

56
Q

Pain with activity

A

Stress fracture

57
Q

DIAGNOSTIC STUDIES FOR Stress fracture?

A

Radiography, MRI

58
Q

Adolescent females; history of knee trauma or misalignment, knee pain worse with activity

A

Chondromalacia patellae

59
Q

Tenderness to palpation over knee

A

Chondromalacia patellae

60
Q

DIAGNOSTIC STUDIES FOR Chondromalacia patellae?

A

Four-view radiographs of knees to rule out arthritis

61
Q

History of overuse, especially running or jumping; dull, achy knee pain; click

A

Patellar tendinitis

62
Q

Q angle >10 degrees in males, 15 degrees in females; clicking or popping with knee movement

A

Patellar tendinitis

63
Q

DIAGNOSTIC STUDIES FOR Patellar tendinitis?

A

None

64
Q

History of valgus stress to knee; limp; pain

A

Medial collateral liga¬ ment sprain

65
Q

Effusion and point tenderness over knee; valgus and varus pressure to assess instability

A

Medial collateral liga¬ ment sprain

66
Q

DIAGNOSTIC STUDIES FOR Medial collateral ligament sprain?

A

AP and lateral radiographs may reveal a ligament avulsion of femoral origin

67
Q

History of twisting injury to the knee, pain, difficulty flexing, bearing weight, clicking or catching of knee with movement

A

Medial meniscus tear

68
Q

Positive McMurray test, click¬ ing or locking during joint movement

A

Medial meniscus tear

69
Q

DIAGNOSTIC STUDIES FOR Medial meniscus tear?

A

Four-knee view radio¬ graphs to rule out bony abnormality; MRI

70
Q

History of twisting or extension knee injury; audible “pop”

A

Anterior cruciate ligament tear

71
Q

Swelling; positive Lachman test

A

Anterior cruciate ligament tear

72
Q

DIAGNOSTIC STUDIES FOR

Anterior cruciate ligament tear?

A

Radiograph to rule out fracture; MRI

73
Q

Adolescent males; knee pain and swelling aggravated by activity, limp

A

Osgood-Schlatter disease

74
Q

Tenderness, warmth, swelling over anterior tibial tubercle

A

Osgood-Schlatter disease

75
Q

DIAGNOSTIC STUDIES FOR Osgood-Schlatter disease?

A

Radiograph with knee rotated inward may show soft tissue swelling

76
Q

Fullness or swelling of posterior knee, aggravated by walking

A

Bakercyst

77
Q

Negative Foucher sign; normal joint examination; positive Homans sign in ruptured cyst

A

Bakercyst

78
Q

DIAGNOSTIC STUDIES FOR Bakercyst?

A

none

79
Q

History of inversion stress with audible “pop,” immediate swelling

A

Ankle sprain

80
Q

Swelling, soft tissue trauma, able to perform active ROM with ligament sprain

A

Ankle sprain

81
Q

DIAGNOSTIC STUDIES FOR Ankle sprain?

A

Radiograph needed only with tenderness over the lateral malleolus to rule out fracture

82
Q

Ache or pain over medial tibia that is worse with exercise, history of running

A

Shinsplints

83
Q

Tenderness over medial tibia

A

Shinsplints

84
Q

DIAGNOSTIC STUDIES FOR Shin splints?

A

AP and lateral radiographs may show a stress fracture; a bone scan will be positive with increased uptake along the medial tibia

85
Q

Pain and tightness over Achilles tendon, especially with walking or running

A

Achilles tendinitis

86
Q

Tenderness over Achilles tendon; pain worse with dorsiflexion ankle; calf weakness

A

Achilles tendinitis

87
Q

DIAGNOSTIC STUDIES FOR Achilles tendinitis?

A

Lateral ankle radiograph reveals enlarged posterosuperior tuberosity of the calcaneus

88
Q

History of chronic weight bearing; aching feet, muscle spasms, obesity

A

Plantar fasciitis

89
Q

Misalignment of foot structures, especially talus, calcaneus, and plantar ligaments

A

Plantar fasciitis

90
Q

DIAGNOSTIC STUDIES FOR Plantar fasciitis?

A

None

91
Q

History of upper respiratory tract infection; malaise, chills, cold symptoms, general muscle aches

A

Viral infections

92
Q

Fever, ill-appearing adult or child

A

Viral infections

93
Q

DIAGNOSTIC STUDIES FOR Viral infections?

A

Viral serumtiter

94
Q

Pain is diffuse; varies in pattern of activity, setting; history of depression or anxiety

A

Psychogenic

95
Q

Normal examination or patient response to examination maneuvers disproportionate to physical findings or subjective complaints

A

Psychogenic

96
Q

DIAGNOSTIC STUDIES FOR Psychogenic?

A

none

97
Q

Female 20-50 yr; history of depression, sleep disturbance, chronic fatigue, general muscle and joint aches

A

Fibromyalgia

98
Q

Palpation of trigger points will produce pain; normal physical examination

A

Fibromyalgia

99
Q

DIAGNOSTIC STUDIES FOR Fibromyalgia?

A

none

100
Q

Hip pain in children, refusal to walk

A

Acute leukemia

101
Q

Fever, hepatosplenomegaly, bruising

A

Acute leukemia

102
Q

DIAGNOSTIC STUDIES FOR Acute leukemia?

A

CBC

103
Q

African American, family history; appears after 6 mo of age; acute pain with swelling of hands and feet, abdominal pain, decreased appetite, malaise

A

Sickle cell disease

104
Q

Normal examination

A

Sickle cell disease

105
Q

DIAGNOSTIC STUDIES FOR Sickle cell disease?

A

Hemoglobin S genotype

106
Q

Female; transient arthritis of small joints, malar rash

A

Systemic lupus erythmatosus

107
Q

Normal examination may have joint tenderness on palpation

A

Systemic lupus erythematosus

108
Q

DIAGNOSTIC STUDIES FOR Systemic lupus erythematosus?

A

Kidney function tests, antinuclear antibody, CBC

109
Q

History of exposure to endemic areas of deer tick; chills, diffuse joint pain and swelling; often knee is affected

A

Lyme arthritis

110
Q

Asymmetrical swelling, warmth of joint; erythema migrans; may have myocardial involvement

A

Lyme arthritis

111
Q

DIAGNOSTIC STUDIES FOR Lyme arthritis?

A

Serum IgM and IgG antibodies, ESR

112
Q

Under age 5 yr; pain in bones

A

Neuroblastoma

113
Q

Unexplained fever

A

Neuroblastoma

114
Q

DIAGNOSTIC STUDIES FOR Neuroblastoma?

A

Urine for vanillylmandelic or homovanillic acid; CT scan

115
Q

Age 10-25 yr; intermittent pain of lower femur, upper tibia; limp

A

Osteogenic sarcoma

116
Q

Tenderness over affected area

A

Osteogenic sarcoma

117
Q

DIAGNOSTIC STUDIES FOR Osteogenic sarcoma?

A

Radiograph, serum alkaline phosphatase

118
Q

History of pressure to knee from a cast, sports injury, or trauma; pain over head of fibula; clumsy gait

A

Peroneal compression

119
Q

Unilateral footdrop

A

Peroneal compression

120
Q

DIAGNOSTIC STUDIES FOR Peroneal compression?

A

none

121
Q

Pain in ankle and proximal foot; weakness of toe flexors; ill-fitting shoes

A

Tarsal tunnel syndrome

122
Q

Tapping posterior tibial nerve elicits pain

A

Tarsal tunnel syndrome

123
Q

DIAGNOSTIC STUDIES FOR Tarsal tunnel syndrome?

A

none

124
Q

Pain and sensory loss, usually of lower extremities; history of alcohol ingestion, diabetes mellitus

A

Neuritis

125
Q

Decreased sensory and pain sensation

A

Neuritis

126
Q

DIAGNOSTIC STUDIES FOR Neuritis?

A

Liver function tests, hemoglobin A1C to rule out diabetes mellitus