Musculoskeletal disorders Flashcards

(66 cards)

1
Q

DJD Description

A

Degeneration of articular cartilage with hypertrophy of subchondral bone and joint capsule of WB joints
• Decreased joint space
• Decreased height of articular cartilage
• Presence of osteophytes

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2
Q

DJD Treatment

A

Corticosteriods
NSAIDS
Glucocorticoids (injected)

Common Intervention

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3
Q

DJD Dx

A
Plane images
Lab tests (rule out RA)
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4
Q

Ankylosing Spondylitis: Description

A

Progressive inflammatory disorder of unkown etiology that intially affects axial skeleton.
Initial onset (mid-LBP approx 3 months) before 40
• Mid and low back pain
• Morning stiffness
• Sacroiliitis
Results in kyphotic deformity or cervical and thoracic spine with flattening of lumbar
Affects men 3x >women

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5
Q

Ankylosing Spondylitis: Tx

A
NSAIDs
Corticosteroids
Cytotoxic drugs
Tumor Necrosis Inhibitors
Common intervention
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6
Q

Ankylosing Spondylitis: Dx

A

HLA-B27 antigen

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7
Q

Gout: Description

A

Genetic disorder of purine metabolism, characterized by elevated serum uric acis levels; which may form crystals and deposit into peripheral joints etc
Most frequently at the knee and great toe

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8
Q

Gout: Tx

A
NSAIDs 
Cox II inhibitors 
Colchicine
Corticosteriods
Adrenoacorticotropic hormone ACTH
Allopurinol
Probenecid
Sulfinpyrazone

Patient education
Early identification

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9
Q

Gout: Dx

A

Lab tests to identify monosodium urate cyrstals in synovial fluid and/or connective tissue samples

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10
Q

Psoariatic Arthritis: Description

A

Chronic erosive inflammatory disorder of unknown etiology associated with psoriasis
Erosive degeneration usually occurs in joints of digits and axial skeleton
Male = Female

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11
Q

Psoariatic Arthritis: Tx

A
Acetominophen
NSAIDs 
Anti rheumatics (DMARDs)
Biological response modifiers (BRMs)
(Enbrel)
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12
Q

Psoariatic Arthritis: Dx

A

Rule out RA

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13
Q

Rheumatoid Arthritis: Description

A

Chronic systemic disorder of unknown etiology involving a symmetrical pattern of dysfunction of synovial tissues and articular cartilage of joints in hands, wrists, elbows, shoulders, knees, ankles and feet
MCP = pannus, ulnar drift, volar sublux
PIP = swan neck, bouteniere, bouchards nodes
Women 2-3x > men
Juvenile RA onset before 16 with complete remission in 75% of children

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14
Q

Rheumatoid Arthritis: Tx

A
Gold compounds
Antirheumatics
NSAIDs
Immunosuppressive agents
Corticosteroids
Common Intervention
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15
Q

Rheumatoid Arthritis: Dx

A

Plain films (symetrical)
High white blood cell count and erythrocyte sedimentation rate
Elevated hemoglobin and hematocrit levels

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16
Q

Osteoporosis: Description

A

Metabolic disease that depletes bone mineral density/mass, predisposing individual to fracture.
Affects women 10x > than men
Common fracture sites include: lumbar, femoral neck, proximal humerus, proximal tibia, pelvis and distal radius
*primary or post-menopausal osteoporosis is directly related to decrease in estrogen production
*senile osteoporosis occurs from a decrease in bone activity

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17
Q

Osteoporosis: Tx

A
Calcium
Vitamin D
Estrogen
Calcitonin
Biophosphonates
Common intervention
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18
Q

Osteoporosis: Dx

A

CT scan

Single/Dual photon absorptiometry

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19
Q

Osteomalacia: Description

A
Characterized by decalcification of bones due to vitamin D deficiency
Symptoms:
	• Severe pain
	• Fractures
	• Weakness
	• Deformities
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20
Q

Osteomalacia: Tx

A

Calcium
Vitamin D
Calciferol (VD injections)
common intervention

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21
Q

Osteomalacia: Dx

A

Plain films
Lab tests
Bone scan
Bone biopsy

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22
Q

Osteomyelitis: Description

A

An inflammatory response within bone caused by an infection (usually staphylococcus aureus)
More common in children and immunosuppressed adults, males > females

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23
Q

Osteomyelitis: Tx

A

Antibiotics
Nutrition

Surgery (if needed)

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24
Q

Osteomyelitis: Dx

A

Lab tets

Bone biopsy

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25
Osteogenesis Imperfecta: Description
Inferited disorder transmitted by an autosomal dominant gene Characterized by abnormal collagen synthesis, leading to an imbalance between bone deposition and reabsorption. Cortical and cancellous bones become very thin, leading to fx/deformity of WB bones
26
Osteogenesis Imperfecta: Tx
``` Calcium Vitamin D Estrogen Calcitonin Biophosphonates Common Intervention ```
27
Osteogenesis Imperfecta: Dx
Bone scan Plain films Serological testing
28
Osteochondritis Dissecans: Description
A separation of articular cartilage from underlying bone (osteochondral fracture), usually involving *medial femoral condyle near intracondylar notch*
29
Osteochondritis Dissecans: Tx
Surgical intervention is req'd if fx is displaced | Common intervention - strength
30
Osteochondritis Dissecans: Dx
Plain film | CT scan
31
Myofascial Pain Syndrome: Description
Characterized by clinical entity known as a "trigger point" or palpable band of muscle Trigger points may be active or latent
32
Myofascial Pain Syndrome: Tx
Dry needling Injected analgesic Corticosteriod Flexibility Manual therapy Strength,
33
Myofascial Pain Syndrome: Dx
Clinical Assessment
34
Tendonosis or Tendonopathy: Description
``` Tendon dysfunction whose cause and pathogenesis is still not understood Includes: • Hypercellular • Hypervascularity • No indication of inflammation • Poor organization ``` Loosening of collagen fibrils
35
Tendonosis or Tendonopathy: Tx
``` Acetominophen NSAIDs Steriod injection Common Intervention Manual Therapy Thermal agents Patient education/training ```
36
Tendonosis or Tendonopathy: Dx
MRI
37
Bursitis: Description
Inflammation of bursa secondary to overuse, trauma, gout or infection Symptoms: • Pain with rest • PROM and AROM are limited due to pain but not in a capsular pattern
38
Bursitis: Tx
``` Acetominophen NSAIDs Steriod injection Common Intervention Manual Therapy Thermal agents Patient ed ```
39
Bursitis: Dx
Clinical Exam
40
Myositis Ossificans: Description
Painful condition of abnormal calcification within a muscle belly Usually precipitated by direct trauma that results in hematoma and calcification of the muscle Common locations include: quads, bicep and brachialis Can be induced by aggressive physical therapy following trauma
41
Myositis Ossificans: Tx
``` Acetominophen NSAIDs Surgical care is warranted only in patients with nonhereditary MO and only after maturation of the lesion(6-24 mo) Flexibility Manual therapy ``` Aerobic activity
42
Myositis Ossificans: Dx
Plain films CT scan MRI
43
Complex Regional Pain Syndrome: Description
Etiology largely unknown Results in dysfunction of sympathetic nervous system to include pain, circulation and vasomotor disturbances Type I: triggered by tissue injury Type II: clearly associated with nerve injury Long term changes include muscle wasting, trophic skin changes, decreased bone density, decreased proprioception, loss of strength from disuse and contractures
44
Complex Regional Pain Syndrome: Tx
``` Sympathetic nerve block Surgical sympathectomy SC stimulation Intrathecal drug pumps Topical analgesics Antiseizure drugs Anti-depressants Corticosteriods Opiods Patient education Desensitization activity Flexibility program TENs for p! relief ```
45
Complex Regional Pain Syndrome: Dx
none
46
Paget's Disease: Description
Etiology largely unknown Thought to be link to viral/environment Metabolic bone disease involving abnormal osteoclastic and osteoblastic activity Results in spinal stenosis, facet arthopathy and possible spinal fracture
47
Paget's Disease: Tx
Drug therapy for p! control Maybe calcitonin and etidronate disodium since they limit osteoclast activity Common Intervention
48
Paget's Disease: Dx
``` Plain imaging Lab tests (alkaline phosphatase and urinary hydroxyproline) ```
49
Idiopathic Scoliosis: Description
Structural: an irreversible lateral curvature of spine with rotational component Nonstructural: reversible lateral curvature of spine without rotation and straightening as individuals flex
50
Idiopathic Scoliosis: Tx
``` Bracing Possible surgery Placement of harrington rod For 45 spinal surgery Flexibility Strength E-stim ``` Patient education
51
Idiopathic Scoliosis: Dx
Cobb's Method | CT/MRI to rule out associated conditions
52
Torticollis: Description
Spasm or tightness of SCM with varied etiology | Dysfunction observed is side-bend toward and rotate away from affects SCM
53
Torticollis: Tx
``` Acetominophen Muscle relaxers NSAIDs Flexibility Manual Therapy ```
54
Torticollis: Dx
Clinical Assessment
55
Slipped Femoral Epiphysis: Description
``` Most common hip disorder in children and largely unknown etiology Males: 10-17 (13) Females: 8-15 (11) Males 2x > females AROM restricted in ABD, Flex, IR Vague knee, thigh, and hip pain Trendelenburg sign w/ chronic ```
56
Slipped Femoral Epiphysis: Tx
Acetominophen NSAIDs possible surgery
57
Slipped Femoral Epiphysis: Dx
Plain films
58
Legg-Calve-Perthes Dx: Description
Onset between 2-13 years avg = 6 Occurs 4x more in males Characteristics Psoatic limp due to weakness Affected LE moves in ER, flex, adduction Gradual onset of aching p! in hip, thigh and knee AROM limited in ABD and EXT
59
Legg-Calve-Perthes Dx: Tx
Acetominophen NSAIDs for p!/inflam Common intervention, possible surgery
60
Legg-Calve-Perthes Dx: Dx
MRI = (+) bony crescent sign (collapse of subchondral bone at femoral neck Common intervention, possible surgery
61
Arthrogryposis Multiplex Congentia: Description
Nonprogressive, non genetic Congential deformity of skeleton and soft tissues, characterized by limitation in joint motion and a "sausage like" appearance of limbs Normal development of intelligence
62
Arthrogryposis Multiplex Congentia: Tx
Ongoing communication required Common intervention AD/Orthosis Flexibility
63
Arthrogryposis Multiplex Congentia: Dx
Plain Films
64
Osgood-Schlatter Dx: Description
Mechanical dysfunction resulting in traction apophysitis of tibial tubercle at the patellar tendon insertion
65
Osgood-Schlatter Dx: Tx
Early flexibility Acetominophen NSAIDs Modify activities to prevent excess stress
66
Osgood-Schlatter Dx: Dx
Plan films indicate irregularities of epiphyseal line | Clinical exam