musculoskeletal

Question 1

4 main imaging techniques:

Answer 1

• xray
• CT scan
• MRI
• DXA

Question 2

imaging technique: photons produced by electromagnetic energy are absorbed by large calcium atoms but not absorbed by smaller atoms in soft tissue

useful in the detection of pathology of the skeletal system

Answer 2

X-ray

Question 3

The ABCDs of reading X-rays:

Answer 3

A - alignment

B - bone (is it intact, fractured, has spurs?)

C - cartilage (joint spaces between bones)

D - density (osteoporosis cannot be Dxed by a X-ray)

Question 4

Imaging technique:

combines a series of X-ray views taken from many different angles and computer programming to produce cross-sectional images of the bones and soft tissues

Answer 4

CT Scan

Computerized Tomography

Question 5

3 main CT scan indications:

Answer 5

• when xray results are normal, but physical exam findings suggest pathology is present
• determining pathology in the transverse plane
• small lesions

Question 6

imaging technique:

uses a magnetic field and radio waves to create detailed images of the organs and tissues within 3 dimensional images

Can’t be used if metal is present

Answer 6

MRI, Magnetic Resonance Imaging

Question 7

imaging technique:

preferred technique for measuring bone density

non-invasive, 10-20 minutes, mostly hip and spine.

Answer 7

DEXA

Dual Energy X-ray Absortiometry

Question 8

_______:

• Loose joints
• short stature
• h/o multiple fractures (BUE and BLE)
• mild scoliosis
• wears B AFOs
  DME: rear-wheeled walker, manual wc
  Meds: bisphosphonate (since 3yo)

Answer 8

osteogenesis imperfecta

Question 9

_____ is second only to heart disease as a cause of work disability

Answer 9

arthritis

Question 10

A type of arthritis marked by progressive cartilage deterioration in synovial joints, particularly hands, spine, knees and hips.

Answer 10

Osteoarthritis, OA

Question 11

an autoimmune disorder causing chronic systemic inflammatory disease of unknown etiology. Presence of serum rheumatoid factor

Answer 11

Rheumatoid Arthritis, RA

Question 12

pain in cartilage, bone, swelling is ____ pain

Answer 12

peripheral pain (local)

Question 13

pain causing diffuse hyperalgesia, multifocal, fatigue, insomnia, memory impairment, mood disorders

Answer 13

central pain

Question 14

• an alteration in pain processing
• loss of descending anti-nociceptive mechanisms
• “wind up”
• sensitivity of central neurons to peripheral inputs

Answer 14

central sensitization

Question 15

perceived increase in pain intensity over time when a given painful stimulus is delivered repeatedly above a critical rate. Caused by repeated stimulation of group C peripheral nerve fibers, leading to progressively increasing electrical response in the corresponding spinal cord neurons.

Answer 15

wind-up

Question 16

perceived pain from non-painful input

Answer 16

allodynia

Question 17

heightened painful sensation from a painful input (out of proportion to the stimulus)

Answer 17

hyperalgesia

Question 18

______ SandS:

• resting and night pain
• morning stiffness lasting > 1 hour
• muscle weakness
• lethargy, weight loss
• swelling; inflammatory signs
• joint deformities
• muscle wasting

Answer 18

Rheumatoid Arthritis

Question 19

treatments for RA:

Answer 19

• surgery: joint replacements, joint fusions

- PT: exercise, aquatic therapy, modalities

Question 20

deposits of uric acid crystals in tissue and fluid. Episodic rather than chronic. Risk factors include:

• diuretic use
• diet rich in purines (seafood, red meat)
• beer and spirits intake

Answer 20

gout

Question 21

formerly known as “Marie Strumpell disease

• S and S include:
• fibrosis
• calcification
• fusion of joints
• very painful

Answer 21

Ankylosing Spondylitis

Question 22

asymptomatic, loss of ROM, swelling, warmth, tenderness, progressive loss of motion when inflammation should be resolving.

• bone formation in soft tissue
• idiopathic, prolonged immobility

Answer 22

Heterotopic Ossification

Question 23

inflammation of a bursa. This small sac acts as a cushion between moving structures

• most common in hip, elbow, knee, and heel

Answer 23

bursitis

Question 24

inflammation of a tendon usually due to repetitive motion. Very tender to the touch

Answer 24

tendinitis

Question 25

inflammation of the lining of the synovial sheath that surrounds a tendon. Most common is DeQuervains in wrist

Answer 25

tenosynovitis

Question 26

deceased bone mass and microdamage. SandS: - loss of weight - postural changes - back pain - weakness

Answer 26

Osteoporosis

Question 27

softening of the bones. Metabolic disorder involving mineral loss in bone. SandS: - pain - pathological fractures - muscle weakness - changes on radiographs - changes in blood work - legs bowing - children below average height

Answer 27

osteomalacia

Question 28

``` a bone infection usually caused by bacteria or fungi. SandS: - signs of infection - blood count abnormalities - swelling - radiographic changes - muscle spasms - abscesses - may be asymptomatic - pain - tenderness to touch - fever ```

Answer 28

osteomyelitis

Question 29

- progressive bone disease that occurs in adults older than 40 years - metabolic disorder affecting how bone breaks down and remodels - the rate at which old bone is broken down and new bone is formed is distorted, bones appear thick and are brittle

Answer 29

Paget's Disease

Question 30

abnormal growth of cells within the bone that may be benign or malignant.

Answer 30

bone tumors

Question 31

pain and stiffness in multiple proximal muscles due to joint inflammation - gradual onset - idiopathic - responds well to prednisone

Answer 31

polymyalgia rheumatica

Question 32

overuse/muscle stress syndrome with trigger points. Caused by overload, trauma, postural faults, stress

Answer 32

myofascial pain syndrome