Flashcards in Musculoskeletal Deck (60)
How often does lower back pain resolve?
90% in 6-12 weeks
DD for lower back pain?
Lumbar strain, disc buldge, Degenerative disc disease, spinal stenosis, spondyloarthropathy, spondylosis, sacroiliac dysfunction
What do you do to test for spondylosis?
When do you do radiographic tests?
Hx trauma, 55 years with persistent pain, noted spinal deformity, S&S of spondyloarthropathy, suspicion for tumor or infection, failure of conservative treatment after 6 weeks.
When is lower back pain an emergency?
Cauda Equina syndrome
Treatment for lower back pain?
NSAIDs, steroids, non-narcotics, muscle relaxers, narcotics rarely indicated, Physcial terapy, surgery
What is herniated disc?
Nucleus pulpus is forced through a weakened part of the disc;
Symptoms of herniated disc
Low back pain with associated leg symptoms
How successful is conservative treatment with herniated disc?
90% symptom management with non operative management
What is a tendon?
Attach muscle to bone
Common sites of tendonitis?
Rotator cuff, insertion of wrist extensors and flexors at elbow, tibial tenon at leg, patellar and poplital, illiotibial, achilles tendons
Symptoms of Tendonitis?
Pain under pressure, restricted movement, burning sensation, swollen, red, warm
Treatment of tendonitis?
Radiology is rarely indicated, PRICE, brace area, anti-inflammatory agents
Treatment for DeQuervian's Tendonitis?
Base of thumb, occurs over snuff box, point for 3-6 weeks, NSAIDS for two weeks
What is bursitis?
Painful inflammation of bursa
Risk factors for bursitis?
Over use, not stretching, rheumatoid disease, staphylococcal or other bacterial infections
Symptoms of bursitis
Pain that increases with movement of joint, joint tenderness, with swelling and redness in affected area
Treatment of bursitis?
Anti-inflammatory drugs, injection of corticosteroids, may need surgical intervention
Three types of femoral neck fractures?
Femoral neck (high risk for avascular necrosis), intertrochanteric, and subtrocanteric
Diagnosis and S&S of hip fracture?
Pain, inability to bear weight, shortened leg, externally rotated, tenderness over groin, hip motion painful, XR of hip. If negative, do MRI
What is carpel tunnel syndrome?
repetitive stress injury due to inflammation of the tissues around the median nerve
S&S of Carpal tunnel?
Pain in wrist and hand, nubness, pain that wakes you up at night, all but pinky and side of ring fever
DD of carpel tunnel syndrome?
Arthritis, cervical radiculopahty, (C6 thumb and index finger only), DM with neuropathy, cubism, wrist arthritis
Exam for carpel tunnel?
Tunnel's sign, phalen's sign, hypothenar atrophy
Diagnostic test for carpel tunnel?
Electromyography, XR to r/o fractured bones
Conservative tx for carpel tunnel?
RICE, NSAIDs, srugery, B6, acupuncture, electromagnetic fields
When do you refer for carpel tunnel?
Thenar atrophy or failure of conventional treatment
What is plantar fasciitis?
Inflammation of plantar fascial tissue, adjacent to its insertion into heel.
Etiology of plantar fasciitis?
strucutral abnormlaitis, flat foot, high arch, runners