MSK Medial Overview

Question 1

What are the two types of arthritis in D2?

Answer 1

There are two types of arthritis in D2,

1. Osteoarthritis (wear and tear)
2. Inflammatory arthritis (swelling of the synovium)

Question 2

Describe the examination findings of osteoarthritis

Answer 2

Inspection: pain on gait. Deformity and osteophytes. Mild swelling
Palpation: Tender and swollen
Movement: Limited by effusion and pain.
Special tests: Strength test ad function test = reduced

Question 3

Describe the examination findings of Inflammatory arthritis

Answer 3

Inspection: Undernourished looking. Pain on gait. Swelling, erythema
Palpation: Warm, swollen, tender
Movement: Limited by effusions and pain.
Special tests: Strength test ad function test = reduced

Question 4

What is tendinopathy?

Answer 4

Tendinopathy is essentially the disrupted healing of a tendon. Passive movement will not be painful as the muscle is not doing ‘work’

Question 5

Describe the examination findings of tendinopathy

Answer 5

Inspection: Painful gait. Swelling of tendon and surrounding area. No erythema
Palpation: Tenderness over tendon. Maybe swelling
Movement: Pain on active and resisted movement.
Special tests: Resisted movement of the muscle is the special test

Question 6

What are the 3 grades of tendon tears?

Answer 6

Grade 1: stretching of fibres
Grade 2: tearing of some but not all fibres
Grade 3: complete tear

Question 7

Describe the examination findings of tendon tears

Answer 7

Inspection: Pain/ limp
Palpation: Swelling, erythema
Movement: Tenderness over tendon
Special tests: Active, passive and resisted movements

Question 8

What are the three grades of ligament tears?

Answer 8

Grade 1: normal endpoint. however there is pain and stress
Grade 2: soft endpoint, little laxity
Grade 3: no endpoint, laxity

Question 9

Describe the examination findings of ligament tears?

Answer 9

Inspection: Pain, limp, bruising swelling and possible deformity
Palpation: maximally tender ligament
Movement: movement may be limited due to pain
Special tests: positive test should be paid for and movement is increased there is a lack of endpoint of the ligament.

Question 10

What are muscle strains?

Answer 10

Muscles strains arise with sudden contraction they feel like a localised cramp. Inflammation usually occurs.

Question 11

What are the grades of muscle strains?

Answer 11

Grade 1: stretching of fibres
Grade 2: some tearing of fibres
Grade 3: complete tearing of fibres

Question 12

Describe the examination findings of muscle strains

Answer 12

Inspection: pain and limping. Swelling bruising and may occur
Palpation: Maximal tenderness over muscle.
Movement: Active movement will be painful. Passive movement will only be painful when the muscle is stretched.
Special tests: Active passive and resisted movements are special tests for muscle strains

Question 13

Describe the examination findings of fractures

Answer 13

Inspection: pain. Patient may feel unwell. Swelling and deformity
Palpation: Very tendon over fractures site
Movement: may be able to move but painful
Special tests: Axial compression will produce pain.

Question 14

Describe nerve root compression

Answer 14

Nerves it’s exit the spinal-cord through the intervertebral foramen. They are susceptible to compression in osteoarthritis because of the intervertebral disk losing water. Several sensory issues such as pins and needles and hypoalgesia.

Question 15

Describe the examination findings of nerve root compression

Answer 15

Inspection: Pain in walk + limp. Significant atrophy
Tone: Reduced tone
Strength: Reduced power
Reflexes: Reduced/absent reflexes
Sensation: there is reduced sensation in the corresponding dermatome

Question 16

Describe the examination findings of dislocation

Answer 16

Inspection: Patient will be distressed and pale. Deformity + bruising
Palpation: very tender
Movement: no movement
Special tests: nil

Question 17

Describe tenosynovitis

Answer 17

Tenosynovitis is inflammation of the tendon sheath surrounding the tendons.

Question 18

Describe the examination findings of tenosynovitis

Answer 18

Inspection: pain on gait. Swelling of tendon and surrounding tendon.
Palpation: Maximum tenderness over tendon. Swelling
Movement: Pain with movement of the relative muscle there is maximal pain on resisted movement and then active movement. In tenosynovitis, that is pain on passive movement in the opposite direction because the tendon is stretched.
Special tests: n/a