Approach To Patient With Joint Pain Flashcards
Questions to ask for joint pain
Any activity out of the ordinary?
Any injury with daily usual activity?
Mechanism of injury questions to ask
What was direction of force What did your joint do What did it feel like Did you hear anything? Was there bruising? When did this happen? Can you still walk now?
Strain vs sprain
Strain - occurs when muscle is over stretched (tendon) (grabbing sensation)
Sprain - ligament is over stretched (hear the pop)
What should you observe in patient
Bi-lateral, both extremities
Which side to start on for exam
Normal side
What to watch for in range of motion
S/S for pain and asymmetric motion
Monoarticular
One joint
Polyarticular
Multiple joints
Migratory
Moves from one joint to another
Extra articular
Bones, muscles, tendons, bursa, skin
Myalgia
Muscle pain
Arthralgia
Joint pain
Effusion
Fluid escape from blood vessels or lympthatic into the tissues or a cavity
Tnedonitis
Inflammation of the tendon
Bursitis
Inflammation of the bursa
Valgus
Knees knocked together
Varus
Bowed legs
Sensitivity
The proportion of patients with with the diagnosis that also have the physical sign
Negative results rules things out
Specificity
The proportion of patients without the diagnosis tho lack the physical sign
Positive result rules things in
Synovial joint movement
Freely movable
Cartilaginous joint movement
Slightly moveable
Fibrous joint movement
Immovable
Examples of red flags for joint pain
Very young or very old Cancer Unexplained weight loss or fatigue Pain > 1month IV drug use Pain at rest Long-term steroid use Neuro deficit
