Non-articular Rheumatism Flashcards Preview

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Flashcards in Non-articular Rheumatism Deck (97)
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1
Q
Diagnosis?
Pain with abduction 60-120 degrees
     -Pain increased when add resistance
    - Impingement sign positive 
less pain with passive than active motion
A

impingement/tendonitis

rotator cuff

2
Q

Diagnosis?

+ drop arm test = cannot hold arm abducted at 90 degrees for very long

A

rotator cuff tear

3
Q

what causes a rotator cuff tear?

A

trauma or gradual degradation

4
Q

shoulder injury more common in younger pts and more likely to be assc with a calcific deposit at the insertion of the supraspinatius tendon

A

impingement/tendonitis

rotator cuff

5
Q

Seen with prolonged immobilization of arm

Severe loss of active and passive ROM in ALL places

A

Adesive Capsulitis (Frozen shoulder)

6
Q

Adesive Capsulitis (Frozen shoulder) is assc with what condition

A

DM

7
Q

Diagnosis?
Yergason’s sign: supination against resistance elicits pain
Speed test: shoulder flexion against resitance elicits pain

A

Bicipical Tendonitis:

8
Q

What can prolonged bicipical tendoniti lead to?

A

rupture –> popeye sign

9
Q

What happens if you paplate the long head of the biceps tendon when a pt has bicipical tendonitis

A

it hurts

10
Q

Numbness and parathesis in dermatomal pattern

pain in a dermatomal pattern

A

numb: Nerve Entrapment Syndromes
pain: cervical radiculopathy

11
Q

median N entrapment syndrome name

A

carpel tunnel

12
Q

Nerve is compressed at suprascapualr notch by suprascapular ligament or the spinoglenoid notch by the transverse ligament

A

Suprascapular N entrapment syndrome

*due to overhead activities

13
Q

ulnar N entrapment syndrome name

A

cubital tunnel

14
Q

axillary N entrapment syndrome name

A

quadralateral space syndrome

15
Q

diagnosis
SWELLING, pain, increased vascularity and XR evidence of demineralization
–> atrophy of SKIN and muscles (skin my become cool and shiny)
–> irreversible flexion CONTRACTURES with pale, cool extremity

A

Reflex Sympathetic Dystrophy/Complex Regional Pain Syndrome

*follows minor trauma

16
Q

cervical radiculopathy, normal or abnormal EMG?

A

abnormal

17
Q

May be assc with viral infection, post viral syndrome, or vaccination

A

Brachial Neuritis:

18
Q

Long term hemodialysis pts with shoulder pain, weakness, loss of ROM, functional limitation

A

Dialysis Shoulder Arthropathy

19
Q

Diagnosis (2 diff)

  1. pain then atrophy of muscles
  2. swelling and pain then atrophy of skin and muscles –> flexion contractures
A
  1. brachial neuritis

2. Reflex Sympathetic Dystrophy/Complex Regional Pain Syndrome

20
Q

What muscles will atrophy in brachial neuritis

A

Deltoid, supraspinatus, infraspinatus, biceps, triceps, DIAPRAGM

BT SIDD

21
Q

Neoplasms that could cause shoulder pain in a younger pt? What part of the bone would they involve?

A
Chondroblastoma (epiphysis)
Osteogenic Sarcoma (metaphysis)
22
Q

Neoplasms that could cause shoulder pain in an older pt?

A

METASTASES
Multiple Myeloma
Pancoast
Apical Ling tumor

Mets MAP

23
Q

Fractured anatomical neck of Humerus can lead to…

A

osteonecrosis

24
Q

Long term steroid use, SLE, hemaglobinopathies, pancreitis, hyperbarism all pre-dispose a person to

A

osteonecrosis

25
Q

Numbness and parasthesia of the little finger and adj side of 4th digit

A

Ulnar N entrapment

medial side of elbow

26
Q

Ulnar N entrapment is diagnosed with…

A

EMG

27
Q
  1. Due to degeneration od the common EXTENSOR tendon (extensor carpi radialis brevis)
  2. Due to degeneration od the common FLEXOR tendon (flexor carpi radialis)
A
  1. lateral epicondylitis (tennis elbow)

2. Medial epicondylitis (golfer’s elbow)

28
Q

“Golfball on the elbow”

A

olecranon bursitis

29
Q

causes of olecranon bursitis

A

septic/infective, due to gout, or trauma

30
Q

Pain with Forced forearm pronation and resisted wrist flexion

A

Medial epicondylitis (Golfer’s Elbow)

31
Q

Localized tenderness anteriorly to lateral epicondyle. What muscle inserts here?

A

lateral epicondylitis

extensor carpi radialis brevis

32
Q

Overuse injury of the elbow

A

lateral and medial epicondylitis

and ulnar N entrapment (kinda)

33
Q

Localized tenderness anteriorly to medial epicondyle. What muscle inserts here?

A

Medial epicondylitis

flexor carpi radialis

34
Q
Nocturnal parathesis (of affected digits)
Intermittent pain and parasthesia during the day → clumsiness
A

carpal tunnel

35
Q

Pain in the palm of hand, mainly with flexion of digits

A

Flexor Tenosynovitis:

36
Q

mucous filled cysts arising from a joint or tendon sheath

A

Ganglion

37
Q

wrist pain

+ finkelstein test = tumb war position then ulnar deviate … elicits pain

A

deQuervain’s Tenosynovitis

38
Q

Caused by thickening of the A1 retinacular pully in the palm

Treated with CCS and splining

A

Trigger fingers

39
Q

Tender over “volar tendon sheath”

A

Flexor Tenosynovitis:

40
Q

Postive Tinel: pins and needles in fingers with percussion of flexor retinaculuim

A

Carpel Tunnel

41
Q

What lines the mucous filled cysts in “ganglion”

A

synovium

42
Q

Positive Phalen: forced flexion of both wrists and hold them together with dorsal side

A

carpel tunnel

43
Q

Where does ganglion commonly present

A

dorsum of the wrist

44
Q

Tx for ganglion

A

corticosterioids then surgery

45
Q

Pain and tenderness of medial flexor surface of wrist and sometimes elbow and shoulder pain with physical activity

A

carpel tunnel

46
Q

Flexor tenosynovitis is inflammation of the tendon sheaths of what muscles?

deQuervain’s tenosynovitis is inflammation of the tendon sheaths of what muscles?

A

FT: flexor digitorum superficialis and profundus

dT: extensor pollicis brevis and abductor pollicis brevis

47
Q

assc with triggering of the fingers

A

Flexor Tenosynovitis

48
Q

What is thought to cause ganglion?

A

trauma

49
Q

Whats systemic conditions are assc with carpel tunnel?

A
CHF
multiple myeloma
TB
pregancy
DM
RA
gout
Obesity
50
Q

What N is being compressed in carpal tunnel?

A

median

51
Q

Tx for carpel tunnel?

A

night splints, corticosteriod injections

surgery release only for pts with failed conservative therapy and sensory loss or thenar atrophy

52
Q

Painful OA involving carpometacarpal joint of the thumb can often be treated successfully with

A

splinting

53
Q

Lateral thigh pain that stops at the knee

A

trocanteric bursitis

54
Q

Diffuse lateral thigh pain (burning or numbness)

A

Meralgia perasthetica (entrapment of lateral femoral cutaneous N)

55
Q

What structures compress the nerve in meralgia perasthetica (lat fem cut N)

A

inguinal ligament or psoas inserion

56
Q

What are common causes of Meralgia perasthetica

A

pregnancy
obesity
DM

57
Q

Cystic swelling or discomfort behind the knee

A

Popliteal Cysts (Baker’s cyst)

58
Q

Swelling superficial to kneecap

A

Prepatellar bursitis (Housemaid’s knee)

59
Q

pain (esp when climbing stairs), tenderness and swelling on medial side of knee

A

Anserine Bursitis

60
Q

What muscles insert on the pes anserinus

A

SGT pes anserinus

Sartorius
Gracilis
SemiTendinosis

61
Q

Pain/discomfort seeming to originate from the contact of the posterior surface of the patella with the femur

A

Patellar tendonitis

62
Q

What causes Patellar tendonitis

A

frequent jumping

aka jumper’s knee

63
Q

Rubor, calor, dolor over patellar and adjacent tissue but non-tender

A

septic prepatellar bursitis

64
Q

+ Thompson’s sign: squeeze gastromenius and foot does NOT plantar flex

A

achillies tendon rupture

65
Q
  1. diagnosis?
    Pain, swelling, and tenderness over Achilles tendon
  2. What intensifies this pain?
A

achillies tendonitis

dorsiflexion

66
Q

Follows chronic foot strain or improper footwear (cramped toes or pointed shoes)
+ Pain at MTP joints

A

Metatarsalgia

67
Q

Sesamoiditis is…

Damage to articular surface between sesamoids and __________ –> pain and inflammation

A

1st metatarsal head

68
Q

aching or burning that radiates from web to affected toes

A

morton’s neuroma

69
Q

flexion of PIP joint + tip of toe points downward

A

hammertoe

70
Q

Characteristic pain worse with first step in the morning

A

plantar fascitis

71
Q

What is a bunionette? What is it assc with?

A

prominence of metatarsal head; hammertoe

72
Q

What is cavus feet?

A

high arches (hereditary)

73
Q

What is Morton’s Neuroma

A

entrapment of interdigial plantar N in the web space between the 3rd and 4th toes

74
Q

Also assc with poliomyelitis, Friedreich’s ataxia, spina bifida

A

cavus feet

75
Q

Calcaneus is everted and out toeing is seen on ambulation

A

flat feet (pes planus)

76
Q

Pain on the undersurface of heal with weight bearing

A

plantar fasciitis

77
Q

A tendon swelling behind the ankle with bulging on both sides of the tendon

A

Achillies Bursitits

78
Q

Localized tenderness (without swelling) on the anteriomedial portion of the plantar surface of the calcaneus

A

plantar fasciitis

79
Q

dorsiflexion will make the pain worse with

A

plantar fasciitis and achillies tendonitis

achillies bursitis if passive

80
Q

What is the cause/pathophys of plantar fasciitis?

A

repetitive microtrauma → tearing and stretching of the fibers of the plantar fascia and its narrow calcaneal attachment

81
Q

Loss of longitudinal arch on medial side of foot

A

flat feet (pes planus)

82
Q

rupture of the tibilais tendon can cause this

A

flat feet

83
Q

chronic irritation → neuroma in foot

A

morton’s neuroma

84
Q

can lead to chondromalacia or OA in the foot

A

seasmoiditis

85
Q

Diagnosis:
Non-restorative sleep pattern; tender points, widespread pain for > 3 mos, athralgias, burning and parathesias in extremeties, IBS, migraanes, medicanion sensitivities, depression/anxiety

A

fibromyalgia

86
Q

Neuroimaging in fibromyalgia pts shows

A

increased gray matter and dysfunction of hypocampus

87
Q

Causes of lumbar spinal stenosis

A
Idiopathinc
Congenital (achondroplasia) 
Hypertrophy of ligamentum flavium or facet joint
Disk herniation 
Spondylolisthesis 
Scoliosis 
Pagets, ankylosing spondylitis
88
Q

noctournal pain

Unexplained weight loss

A

infection or cancer (in spine i guess)

89
Q
Urinary retention 
Outflow incontinence 
Fecal incontinence
Bilateral or progressive motor deficit 
Saddle anesthesia
A

cauda equina

90
Q

Severe morning stiffness
Pain that improves with exercise not rest
Pain during 2nd half of night
Alternanting buttock pain

A

Spondyloarthritis

91
Q

Fecal incontinence

A

cauda equina

92
Q

Pain that improves with exercise not rest

A

Spondyloarthritis

93
Q

Saddle anesthesia

A

cauda equina

94
Q

Outflow incontinence

A

cauda equina

95
Q

noctournal pain

A

infection or cancer (in spine i guess)

96
Q

Severe morning stiffness

A

Spondyloarthritis

97
Q

Alternanting buttock pain

A

Spondyloarthritis