Chronic And Overuse MSK Syndromes

Question 1

What joints/bursa should you not inject?

Answer 1

Patellar tendon and Achilles’ tendon

Question 2

Shoulder impingement syndrome

Answer 2

Inflamed rotator cuff bursa impinges on the acromion and rotator cuff

Symptoms:

• repetitive overhead activities causes pain
• worse at night for pain
• pain reaching overhead
• tenderness w/ palpation of the bursa and pain w/ flexion and abduction

Question 3

Tests for shoulder impingement

Answer 3

Neers, Hawkins, painful arc (pain at 90 degree abduction)

Imaging shows inflamed bursa

Question 4

Adhesive capsulitis causes and tests

Answer 4

Causes are:

Gradual onset or previous surgery

Diabetes, immobility, thyroid, autoimmunity

Age 40-60 is most common

Tests:

Apleys scratch test will show decreased PROM and AROM

Imagining shows adhesive GH joint

Question 5

Treatment for adhesive capsulitis

Answer 5

Therapy, steroids

Basement

Manuipulation when numbed

Question 6

Lateral epicondylosis (tennis elbow) signs and tests

Answer 6

Pain with extension wrist and supination

Palpation produces tenderness around the Lateral epicondyle and ECRB

Tests:

Mills and maudsleys test

Imaging will show hypertrophy and swelling at lateral epicondyle

Question 7

Medial epicondylosis (golfers elbow) signs and tests

Answer 7

Pain with repetitive flexion and pronation

Tenderness with palpation over the FCR and medial epicondyle

Tests:
Reverse cozenz, resist pronation tests

Question 8

Dupuytrens disease symptoms

Answer 8

Fingers are permanently bent in a flexed position with hard nodules and thickening in palmar region

Increased loss of ROM of extension and puckering of the skin over flexes tendons

Question 9

Dupuytrens disease history causes

Answer 9

Men greater w/ 50 years

Diabetes, alcoholism and genetics

Question 10

DeQuervain syndrome sings and symptoms

Answer 10

• Palpation along the snuff box
• Pain swelling just proximal to the radial styloid

Inflammation of two tendons that control movement of the thumb

Question 11

DeQuervian syndrome tests

Answer 11

Finkelstein test and imaging

Question 12

Greater trochanter bursopathy causes and symptoms

Answer 12

Arthritis, Trauma, overuse in training, pressure on lateral hip.

Palpation of bursa and lateral thing produces tenderness

Pain and weakness with hip abduction

Imaging shows inflamed bursa

Question 13

Iliotibial Band syndrome causes and symptoms

Answer 13

Excessive biking activity

Excessive climbing of stairs and hills

Symptoms
-Lateral hip and knee pain with pain on palpation of the IT band

Question 14

Iliotibial band syndrome treatment and tests

Answer 14

Therapy, myofascial techniques and surgery.

Obers test

Question 15

Patellofemoral Pain Syndrome (PFPS) causes and symptoms

Answer 15

Excessive running downhill, stairs, steps and getting up from a chair
- very common in young females

Signs:
Patella Baja or Alta
Pain w/ patellar compression and muscle imbalance within the legs

Tests:
Patella grind tests

Question 16

Patellar tendinosis causes and symptoms

Answer 16

Jumping athletes with anterior knee pain w/ jumping training.

Signs:
Tenderness on palpation of the distal patella

DO NOT USE STEROIDS to treat.

Question 17

Medial tibial stress syndrome

Answer 17

Causes:

• Extreme BMI and poor bone health people who change training habits.
• common after end of the exercise and pain with weight baring

Signs:

• tenderness when palpating the distal medial tibia
• poor ankle flexibility

Tests:
- Hop and tuning fork tests

Question 18

Achilles tendinopathy

Answer 18

Causes:
Rapid increase in activity

Symptoms:

• morning stiffness with gradual onset of pain
• tenderness when palpating distal tendon and insertion

Tests:
- Thompson test

Question 19

Plantar fasciopathy

Answer 19

Causes:
- obesity, heel spurs

Symptoms:
Pain in heel that goes away in with activity but is worse in the morning

Point tenderness with palpation in the ankle

Increased pain with passive extension of 1st digit and dorsiflexion