Musculoskeletal & CT Disorders (Week 4) Flashcards Preview

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Flashcards in Musculoskeletal & CT Disorders (Week 4) Deck (25)
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1

Monoarticular (list common causes of pain)

Affecting 1 joint. In young adults usu from injury/infection. In older adults usu osteoarthritis & crystal-induced injuries. Less common causes include hemarthrosis, avascular necrosis, and tumors.

2

Oligoarticular (aka pauciarticular)

Affecting 4 or fewer joints

3

Polyarticular

Affecting many joints

4

Periarticular (give examples)

Affecting tissues around the joint (tendons, ligaments, bursa). Specific inflammations... Synovitis = synovial membrane. Tendonitis = tendon. Tenosynovitis = tendon and its enveloping sheath. Enthesitis = insertion points of ligaments or tendons. Bursitis = bursa.

5

Symmetric

Involving same joints bilaterally (common in autoimmune conditions)

6

Inflammatory

Due to infection, crystals, immune dysfunction

7

Noninflammatory

Due to traume or other mechanical derangements (osteoarthritis is usu classified as noninflammatory arthritis)

8

What do we ask about onset & chronology?

When, acute v insidious, trauma, progressive v static, periodicity or diurnal pattern, how long do episodes last?

9

What do we ask about location?

Which joints, symmetric or asymmetric, polyarticular or monoarticular?

10

What do we ask about Palliation/provocation?

Better use v rest, affect of therapeutics

11

What do we ask about Quality?

Aching (most myalgias & arthritis) v burning (neuropathies)

12

What do we ask about Severity?

Pain scale, impacted ADLs, Deformity

13

General sxs that can help with a dx

fever, wt loss, fatigue

14

Skin sxs that can help with a dx

Rash, Raynaud's, nodules, nail changes

15

Eye sxs that can help with a dx

irritation, pain, photosensitivity

16

Respiratory sxs that can help with a dx

cough, SOB

17

Cardiac sxs that can help with a dx

chest pain, palpitations

18

GI sxs that can help with a dx

oral ulcers, bowel changes, hx of GI dz

19

GU sxs that can help with a dx

vaginal ulcers, STI history

20

What is Osteoarthritis?

Degenerative disorder due to mechanical stress involving articular cartilage in synovial joints. Erosion of cartilage continues until underlying bone is exposed. The subchondral bone then thickens in areas of pressure, forming cysts and irregular outgrowths of new bone (osteophytes). It is classified as noninflammatory.

21

Etiology/Risk Factors for Osteoarthritis

Advancing age (most over 65 show arthritis on xray), Mechanical stress (repetitive use, obesity), Genetics, Joint trauma.

22

SSx Osteoarthritis

Gradual onset. Deep, aching pain worse with use & better with rest. Decreased ROM and crepitus. Morning stiffness of

23

Joints most often involved in Osteoarthritis

Hand: (mostly DIPs, some PIPs, base of thumb)
Cervical & Lumbar vertebrae: (can lead to spinal stenosis, which then leads to myelopathy or radiculopathy)
Foot: (First metatarsophlangeal joint)
Hip: (worse with wt bearing, may refer to knee)
Knee

24

Dx Osteoarthritis

Labs (not useful): Normal ESR & CRP, RF negative, Synovial fluid WBCs

25

Prognosis for Osteoarthritis

Depends on joints involved & severity. Joint replacement has good prognosis, prosthesis lasts only 10-15 years.