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PTRS 745 Exam 2 > Clinical Syndromes > Flashcards

Clinical Syndromes Flashcards

1
Q

Defn: Avascular Necrosis of the Femoral Head

A

Progressive eschemia and death of bone cells of the femoral head

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2
Q

Etiology: Avascular Necrosis of the Femoral Head

A

Disruption of arterial circulation due to trauma

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3
Q

MOI: Avascular Necrosis of the Femoral Head (2)

A
  1. Trauma - falls causing fx and dislocation causing damage to vessels
  2. Non-traumatic - long term corticosteroids, excessive alcohol causing occlusion of vessels
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4
Q

Symptoms: Avascular Necrosis of the Femoral Head (4)

A
  1. Pain: groin, prox thigh, glutes, increases with WB
  2. Limited ROM
  3. Axial loading increases symptoms
  4. Limb/Antalgic Gait
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5
Q

Modalities: Avascular Necrosis of the Femoral Head (2)

A
  1. Pulsed electromagnetic therapy
  2. Extracoporeal Shock Wave Therapy
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6
Q

TherEx: Avascular Necrosis of the Femoral Head (4)

A
  1. Stretch/ROM
  2. Strengthen
  3. Balance
  4. Gait training
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7
Q

Manual Therapy: Avascular Necrosis of the Femoral Head

A

Possible glides to facilitate ROM (depending on exam)

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8
Q

Education: Avascular Necrosis of the Femoral Head (3)

A
  1. Rest
  2. Limit smoking/drinking/steroid use
  3. Watch cholesterol levels
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9
Q

AD: Avascular Necrosis of the Femoral Head

A

Any device to offload the involved bone (femur)

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10
Q

HEP: Avascular Necrosis of the Femoral Head

A

Emphasis on gait and ROM

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11
Q

Defn: Piriformis Syndrome

A

Irritation or compression of the sciatic nerve caused by spasm or contracture of the piriformis muscle

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12
Q

MOI: Piriformis Syndrome (5)

A
  1. Overuse of glutes
  2. Inadequate stretching before/after activity
  3. Poor posture
  4. Prolonged sitting
  5. Trauma
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13
Q

Q: Who is Piriformis Syndrome more common in?

A

Women

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14
Q

Symptoms: Piriformis Syndrome (3)

A
  1. Pain, Numbness, and tingling over buttocks and down back of thigh
  2. Difficulty sitting
  3. Feeling of soreness
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15
Q

Manual Therapy: Piriformis Syndrome (3)

A
  1. Muscle Energy Techniques
  2. ST massage
  3. Myofasical release
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16
Q

TherEx: Piriformis Syndrome

A

Stretching - Figure 4 stretch

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17
Q

Modalities: Piriformis Syndrome (4)

A
  1. Moist Heat
  2. Ultrasound (+ stretching)
  3. Cold pack
  4. E-stim (after exercise/MT)
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18
Q

Education: Piriformis Syndrome (3)

A
  1. Rest
  2. Light and gradual stretching
  3. Posture
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19
Q

Q: What is the bimodal distribution of Femoral Neck Stress Fx?

A
  1. Young and active
  2. Elderly and osteoporotic
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20
Q

T/F: Men are more affected than women by femoral neck stress fx.

A

False, flip it

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21
Q

Defn: Femoral Neck Stress Fx

A

A Fx of the femoral neck that can be classified as either a compression or tension fx and puts the femoral head at a high risk of avascular necrosis

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22
Q

Classifications: Femoral Neck Stress Fx (2)

A
  1. Compression: inferior aspect of femoral neck
  2. Tension: superior aspect of femoral neck
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23
Q

MOI: Femoral Neck Stress Fx

A

Young = trauma

Older = falls/twisting

Typically fx 1-2 inches from the hip joint

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24
Q

Symptoms: Femoral Neck Stress Fx (4)

A
  1. Groin pain with activities
  2. Deep thigh pain
  3. May limp
  4. Pain eases with rest
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25
Q

TherEx: Femoral Neck Stress Fx (3)

A

Progressive, always with an emphasis on PAIN FREE movement

Acute (4-6 wk): NWBing to PWBing

Rehab (8-12 wk): FWB, progress from walk to run

Maintenance (12+wk): Monitor activities/form, increase distance

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26
Q

Manual Therapy: Femoral Neck Stress Fx

A

Joint mobilization once fx is healed

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27
Q

Modalities: Femoral Neck Stress Fx

A

Ice

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28
Q

Education: Femoral Neck Stress Fx

A

WB restrictions

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29
Q

AD: Femoral Neck Stress Fx

A

Crutches

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30
Q

Defn: Pubalgia

A

Groin pain in athletic individuals withouth inguinal hernia,

Pain from pubic symphsis to ASIS, can involves abdominal muscles/tendons/sheaths, inguinal ligament, adductor muscles, gracilis, pectineus, and iliopsoas

May also be known as a “sports hernia” (not an actual hernia)

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31
Q

Grades of Pubalgia (3)

A

1 = single/mutliple tears of rectus abdominis or adductor muscles

2 = partial avulsion from pubic symphsis

  1. = comples avulsion with micro tears
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32
Q

MOI: Pubalgia

A

Muscular imbalances between abdominals and adductors

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33
Q

Symptoms: Pubalgia (3)

A
  1. Insidious onset groin pain
  2. Hx of sudden tearing sensation
  3. Pulling sensation in groin with activity
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34
Q

Education: Pubalgia (3)

A
  1. Warm Up
  2. Rest
  3. NSAIDS
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35
Q

Modalities: Pubalgia (4)

A
  1. Ultrasound
  2. E-stim
  3. Hot pack
  4. Cold pack
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36
Q

TherEx: Pubalgia (3)

A
  1. Stretching as tolerated
  2. Strengthening (adductors, hip flexors/IR, abs, glutes)
  3. Proprioceptive training
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37
Q

Manual Therapy: Pubalgia

A

Transverse friction massage

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38
Q

Term: used to describe chronic, intermittent pain accompanied by tenderness to palpation overlying the lateral aspect of the hip

A

Trochanteric bursitis (TB)

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39
Q

Q: What is another name for trochanteric bursitis?

A

Greater trochanteric pain syndrome (GTPS)

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40
Q

Q: What can GTPS associted with? (4)

A
  1. Tendinitis
  2. Muscles tears
  3. Trigger points
  4. IT band disorders
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41
Q

MOI: GTPS (6)

A
  1. Chronic microtrauma
  2. Regional muscle dysfunction
  3. Overuse
  4. Acute injury
  5. Obesity
  6. Muscle fatigue
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42
Q

Q: What’s the profile for GTPS? (2)

A
  1. Femal:Male = 4:1
  2. 40-60 yo
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43
Q

Symptoms: GTPS (3)

A
  1. Persisent pain inthe lateral hip/buttocks
  2. Lying on affected side or prolonged standing provokes pain
  3. Sit>stand, stair climbing, high impact probokes pain
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44
Q

T/F: PT alone will cure GTPS.

A

False: need to eliminate the cause (prolonged standing)

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45
Q

Education: GTPS

A

Avoid MOI, side laying, hard surfaces and lose wieght

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46
Q

Modalities: GTPS (2)

A
  1. TENS
  2. US
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47
Q

AD: GTPS

A

Cusion/pads for protection, insoles if leng length discrepancy

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48
Q

TherEx: GTPS (3)

A
  1. Stretching
  2. Strengthening
  3. Functional exercises
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49
Q

MT: GTPS

A

Manipulations for mobility if needed

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50
Q

Symptoms: Hip Muscular Strain (Pull or Tear) (4)

A
  1. Pain over injured muscle
  2. Increased pain with contraction
  3. Swelling
  4. Loss of strength
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51
Q

Q: What muscles are commonly affected in Hip Muscular Strain (Pull or Tear) (3)

A
  1. Hamstrings (high speed movement)
  2. Quadriceps
  3. Adductors (socer/ice hockey)
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52
Q

MOI: Hip Muscular Strain (Pull or Tear) (6)

A
  1. Stretched muscled forced to suddenly contract
  2. Overstretching/Overuse
  3. Fall/direct blow
  4. Inadequate warm up
  5. Lack of flexibilty
  6. Poor posture
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53
Q

Grade 1 Hip Muscular Strain (Pull or Tear) (2)

A
  1. Small tears in fibers
  2. Pain but minimal strength and ROM loss
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54
Q

Grade 2 Hip Muscular Strain (Pull or Tear) (3)

A
  1. More fibers torn, but lesion not complete
  2. Pain, swelling, and bruisin may occur
  3. Compromised strength, but still within NFL
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55
Q

Grade 3 Hip Muscular Strain (Pull or Tear) (2)

A
  1. Most fibers torn, in some cases complete ruptured
  2. Movement is difficult, not impossible, but loss of function
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56
Q

Education: Hip Muscular Strain (Pull or Tear)

A

RICE 48 hours after injury

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57
Q

Modalities: Hip Muscular Strain (Pull or Tear) (2)

A
  1. TENS
  2. US
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58
Q

MT: Hip Muscular Strain (Pull or Tear)

A

Gentle massage

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59
Q

TherEx: Hip Muscular Strain (Pull or Tear) (4)

A
  1. Isometric > isotonic > functional
  2. Subacute: cycling, treadmill
  3. Plyometric training
  4. Improve flexibility/posture
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60
Q

Defn: Trochanteric Bursitis

A

Inflammation of the bursa located on the superior lateral part of the thigh bone

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61
Q

Q: Apart from the greater trochanteric bursa, what is the other major bursa in the hip?

A

Iliopectineal bursa - front of the hip joint

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62
Q

MOI: Trochanteric Bursitis (5)

A
  1. Prolonged pressure
  2. Overuse
  3. Arthritis
  4. Injury
  5. Infection
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63
Q

Symptoms: Trochanteric Bursitis (3)

A
  1. Pain/tenderness with motion and at rest
  2. Pain over outer thigh
  3. Difficulty walking
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64
Q

Education: Trochanteric Bursitis (2)

A
  1. Explain MOI
  2. Identify and change aggravting factors
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65
Q

Modalities: Trochanteric Bursitis (4)

A
  1. Ice (Massage)
  2. Heat
  3. Ultrasound
  4. TENS
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66
Q

TherEx: Trochanteric Bursitis

A

Emphasize stretching

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67
Q

MT: Trochanteric Bursitis

A

Mobs to improve motion

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68
Q

AD: Trochanteric Bursitis

A

If a leg discrepancy exists gradually increase the height of the insoles

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69
Q

Defn: Baker’s Cyst

A

a fluid filled cyst that causes a bulge and feeling of tightness behind your knee, typically develops in the gastrocnemius-semimembranosus bursa

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70
Q

Q: Who is a Baker’s Cyst more common in?

A

Typically unilateral and medial, twice as common in men

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71
Q

MOI: Baker’s Cyst

A

Inflammation of the joint can cause an excess of synovial fluid

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72
Q

Q: What is the difference between primary and secondary Baker’s Cyst?

A

Primary = no knee pathology

Secondary = underlying knee problem

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73
Q

Symptoms: Baker’s Cyst (4)

A
  1. Swelling
  2. Pain with flexion and extension
  3. Stiffness
  4. Clicking, locking, buckling
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74
Q

Modalities: Baker’s Cyst

A

Ice and Compression (RICE)

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75
Q

TherEx: Baker’s Cyst (2)

A
  1. Strengthening
  2. ROM
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76
Q

Education: Baker’s Cyst (3)

A
  1. RICE
  2. Educate about Cause
  3. Prognosis
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77
Q

Defn: Osgood-Schlatter’s Disease

A

A benign traction apophysitis (inflammation of an apophysis) that occurs in the tibial tubercle

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78
Q

MOI: Osgood-Schlatter’s Disease

A

During periods of rapid growth, stress from repetitive quad contractions is transmitted through the patellar tendon onto the partially developed apophysis

Can result in avulsion fx, inflammation of the tendon, and heterotrophic bone formation

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79
Q

Symptoms: Osgood-Schlatter’s Disease (3)

A
  1. Pain with activities
  2. Viisible lump over site
  3. Pain with knee extension
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80
Q

Q: What is the typical population of Osgood-Schlatter’s Disease?

A

11-18 yo, boys > girls, typically unilateral

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81
Q

Modalities: Osgood-Schlatter’s Disease

A

Ice

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82
Q

Education: Osgood-Schlatter’s Disease

A
  1. Avoid aggravating factors
  2. Rest
  3. Length of recovery (can be 1-2 years)
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83
Q

AD: Osgood-Schlatter’s Disease

A

Infrapatellar strap

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84
Q

MT: Osgood-Schlatter’s Disease

A

Patellar glides

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85
Q

TherEx: Osgood-Schlatter’s Disease (3)

A
  1. SLR
  2. Stretching
  3. Knee stabilization
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86
Q

Defn: Femoral Condyle Injury

A

Focal articular cartilage defect - osteochondritis dissecans lesion

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87
Q

Typical Profile: Femoral Condyle Injury (3)

A
  1. Sports trauma (most common cause)
  2. 12-35 yo
  3. Males > females
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88
Q

Symptoms: Femoral Condyle Injury (5)

A
  1. Focal tenderness
  2. Swelling/Joint effusion
  3. Catching
  4. Limited ROM
  5. Pain with WB
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89
Q

Conservative Treatment: Femoral Condyle Injury (4)

A
  1. Bracing
  2. ROM/Strength
  3. Pt Education
  4. Corticosteroid injections
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90
Q

T/F: Lateral meniscus injuries happen more often then medial meniscus injuries.

A

False: Flip It

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91
Q

MOI: Meniscus Injury (2)

A
  1. Trauma/Sports (Non-Contact)
  2. Degenerative
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92
Q

Q: What type of forces can cause traumatic meniscus injury? (3)

A
  1. Compression + rotation
  2. Flexion OR extension + rotation during WB
  3. Sudden acceleration/deceleration with direction change
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93
Q

T/F: Meniscal injuries are associated with cruciate ligament injuries.

A

True

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94
Q

Q: Who typically has degenerative meniscal injuries? (3)

A
  1. > 40 yo
  2. Menisci are stiff and less compliant
  3. Minimum to no healing potential
95
Q

Diagram: Identify the types of meniscal injury

A

A = Bucket handle

B = Oblique

C = Radial

D = Longitudinal

E = Degenerative

96
Q

Symptoms: Mensicus Injury (4)

A
  1. Pain
  2. Limited extension
  3. Hard end feel with extension
  4. Locking, giving out
97
Q

Q: What is the healing response of meniscal injuries influenced by? (2)

A
  1. Location
  2. Extent of injury/protection
98
Q

AD: Mensicus Injury

A

Progressive PWB > WBAT with brace and crutches

99
Q

Modalities: Mensicus Injury

A

Ice and E-stim

100
Q

MT: Mensicus Injury

A

Patellar mob

101
Q

Education: Mensicus Injury

A

WB compliance

102
Q

TherEx: Mensicus Injury

A

Strengthen quadriceps and hamstrings and ROM

103
Q

MOI: ACL injury

A

Non-contact:

  1. Hyperextension with anterior translation (anterior tilt of femur stretches posterior part of ACL)
  2. Sudden deceleration (most commont)

Contact:

  1. Excessive twisting of the knee or valgus stress on the knee (usually = ACL + other structures)
104
Q

MOI: PCL Injury

A

Hyperflexion with posterior translation

105
Q

MOI: MCL Injury

A

Valgus stress

106
Q

MOI: LCL Injury

A

Varus stress

107
Q

MOI: ACL + medial meniscus

A

Hyperextension with rotation

108
Q

MOI: ACL + medial meniscus + MCL

A

Extension, valgus with rotation

109
Q

Symptoms: ACL Injury (6)

A
  1. Knee giving out (#1 complaint of complete or partial tear)
  2. Pain, edema, joint stiffness
  3. Lack of quad control
  4. Gait deviation
  5. Pop with MOI?
  6. Ability to walk with extended knee (extend of injury)
110
Q

Conservative Treatment: ACL Injury (4)

A
  1. Full extension, quad control
  2. Proprioceptive training to max dynamic stability (ligaments major source of proprioception)
  3. Sports restriction
  4. Risk of developing joint degeneration
111
Q

Presurgical Requirements: ACL Injury (4)

A
  1. Edema control
  2. Gain full extension and quad tone
  3. Pt. education
  4. Quad and Hamstring strengthening
112
Q

Q: What are the options for ACL reconstruction? (2)

A
  1. Bone, Patellar tendon, Bone
  2. Hamstring Tendon
113
Q

Rehab: ACL Injury (3)

A
  1. Usually spancs 3-6 mo
  2. Protective, rehab, functional phases
  3. Return to sport 6-12 mo
114
Q

Modalities: ACL Injury (2)

115
Q

MT: ACL Injury

A

Patellar mobilization

116
Q

Education: ACL Injury

A

Protection, importance of exercises, expectation

117
Q

MOI: PCL Injury (2)

A
  1. Forceful posterior translation of tibia (“Dashboard Injury”)
  2. Falling onto flexed knee
118
Q

MOI: MCL/LCL Injury

A

Excessive valgus/varus force with planted foot

119
Q

AD: MCL/LCL Injury

A

Bracing to limit extension and minimize valgus/varus forces

120
Q

TherEx: MCL/LCL Injury

A

Strengthening, proprioception, functional/agility training

121
Q

Defn: Patellofemoral (PF) pain syndrome

A

Patellar tracking problem (dislocation)

122
Q

Contributing factors: PF syndrome (4)

A
  1. Anatomical abnormalities: increased Q angle, patella alta, pes planus
  2. Muscle weakness: hip ABD/ER, quads (VMO)
  3. Flexibility: tight ITB
  4. Poor motor control
123
Q

Symtpoms: PF syndrome (4)

A
  1. Anterior/lateral/retro-patellar pain
  2. Dull ache
  3. Clicking/popping
  4. Knee giving out
124
Q

Aggravating Factors: PF syndrome (4)

A
  1. Walking
  2. Stair climbing
  3. Kneeling
  4. Squatting/sit to stand
125
Q

Q: What muscle strength is important to assess with PF syndrome?

126
Q

AD: PF Syndrome

A

Patellar taping (for pain control)

Bracing (provides stability)

127
Q

Education: PF Syndrome

A

Activity modification

128
Q

TherEx: PF Syndrome (3)

A
  1. Quad, Hip ABD, Hip ER strengthening
  2. Flexibility: ITB, HS, quads
  3. Motor control: squatting, landing, running
129
Q

Q: What are other names for patellar tendinopathy?

A

Jumper’s knee

130
Q

Defn: Patellar Tendinopathy

A

Chronic degeneration of patellar tendon due to overuse and microtrauma

Not to be confused with patellar tendinitis (inflammation of the tendon)

131
Q

Q: Where is patellar tendinopathy most common?

A

Posterior proximal portion of tendon - tender and thickened

132
Q

Contributing factors: Patellar Tendinopathy (4)

A
  1. Lack of flexibility/strangth can resist ROM and increase load on anterior knee
  2. High patella/patella alta
  3. Overuse
  4. Postural alignment, reduced patellar glide, foot structure
133
Q

Symptoms: Patellar Tendinopathy (4)

A
  1. Pain over posterior tendon
  2. Mild stiffness after prolonged sitting
  3. Pain worse with activity
  4. Palpable tenderness
134
Q

Aggravating Factors: Patellar Tendinopathy (2)

A
  1. Jumping
  2. Landing
135
Q

Modalities: Patellar Tendinopathy

136
Q

MT: Patellar Tendinopathy

A

Friction massage

137
Q

AD: Patellar Tendinopathy

A

Patellar tendon strap or taping

138
Q

TherEx: Patellar Tendinopathy

A

Stretching and eccentric strengthening

139
Q

Goal of Treatment: Patellar Tendinopathy

A

Initially reduce symptoms, then progress strengthening of muscles and quad tendon

140
Q

Defn: IT Band Syndrome

A

Overuse of the TFL results in pain and inflammation at the outer thigh/knee

141
Q

MOI: IT Band Syndrome (5)

A
  1. Overuse
  2. Poor flexibility
  3. Muscle imbalances
  4. Leg length discrepancy
  5. Bowed legs
142
Q

Symptoms: IT Band Syndrome (3)

A
  1. Pain on outer knee/greater trochanter
  2. Snapping or popping
  3. Swelling
143
Q

Modalities: IT Band Syndrome (3)

A
  1. Ultrasound
  2. Iontophoresis
  3. Ice
144
Q

MT: IT Band Syndrome

A

Myofascial release

145
Q

TherEx: IT Band Syndrome

A

Stretching and strengthening

146
Q

AD: IT Band Syndrome

A

Shoe orthotic to control gait problem/pelvic tilt/leg length

147
Q

Defn: Osteoarthritis

A

Worn down cartilage of the end of bones

148
Q

MOI/Risk Factors: Osteoarthritis

A

MOI: Occurs gradually over time

Risk factors: overweight, age, joint injury, joint stress

149
Q

Symptoms: Osteoarthritis (4)

A
  1. Pain and Tenderness
  2. Stiffness
  3. Loss of flexibility
  4. Grating sensation
150
Q

T/F: There is a cure for Osteoarthritis.

A

False, no cure

151
Q

TherEx: Osteoarthritis

A

LOW IMPACT stretching and strengthening

152
Q

AD: Osteoarthritis

A

Orthotics, braces, canes, crutches, walker

153
Q

MT: Osteoarthritis (2)

A
  1. Joint distraction to decrease pain and stiffess
  2. Glides to improve ROM
154
Q

Modalities: Osteoarthritis

155
Q

Q: For tendon issues what type of exercise should you focus on?

A

Eccentric exercises

  • decline board more specfically targets patellar tendon with squats
    progression: bilat > unilat > eccentric > concentric > PWB > FWB > resistance/increased speed
156
Q

Defn: Heel Spur

A

Bony formation on the medial plantar aspect of the calcaneal tubercle

157
Q

MOI: Heel Spur (3)

A
  1. Stress
  2. Inadequate footwear/Poor gait mechanics
  3. Prolonged standing
158
Q

Symptoms: Heel Spur (3)

A
  1. Presents in similar fashioin as plantar fasciitis - pain in morning
  2. Pain with WB, heel strike, palpation
  3. Inflammation of Achilles Tendon
159
Q

Modalities: Heel Spur (2)

A
  1. Ionto
  2. Ice massage/moist heat
160
Q

MT: Heel Spur

A

Deep friction massage

Soft tissue mob

Manipulation

161
Q

AD: Heel Spur

A

Shoe modifications: orthotic, heel cup, taping

162
Q

TherEx: Heel Spur (3)

A
  1. Foot stabilization exercises for motor control
  2. Strengthening
  3. Achilles stretching
163
Q

Defn: Achilles Tendinopathy

A

Tendinitis or Tendinosis of the Achilles tendon

Can be inserstional or non-insertional

164
Q

MOI: Achilles Tendinopathy

A

Quick repetitive pronation/supination cuasing whipping/twisting effect of Achilles tendon

165
Q

Symptoms: Achilles Tendinopathy (3)

A
  1. Pain stiffness along tendon
  2. Increasing pain with activity
  3. Thickening of tendon
166
Q

Education: Achilles Tendinopathy

A

Rest and activity modification

167
Q

Modalities: Achilles Tendinopathy (3)

A
  1. Ionto
  2. Ultrasound
  3. Ice
168
Q

TherEx: Achilles Tendinopathy

A

Eccentric strenghtening and ROM

169
Q

MT: Achilles Tendinopathy

A

PNF stretching

170
Q

Defn: Ankle Sprain

A

Stretching or tearing of latera/medial ligaments of the ankle joint

171
Q

MOI: Ankle Sprain (2)

A
  1. IR, PF, inverted (rolling foot inward) - 85%
  2. ER, DF, everted (rolling foot outward)
172
Q

Education: Ankle Sprain

A

Resting and NWB

173
Q

Modalities: Ankle Sprain

174
Q

MT: Ankle Sprain

A

Acute phase = gentle massage, grade 1-2 mob

Grade 3-4 when pain decreases

175
Q

TherEx: Ankle Sprain

A

Early - limit inv/ever and WB, DF/PF ROM, stretching

Late - Isotonic, isokinetic, WB, total ROM including inv/ever, balance

Functional - running, jumping, stairs, balance

176
Q

Defn: Functional Ankle Instability

A

A condition in which pts. experience recurrent sprains and/or a feeling of their ankle “giving way”

177
Q

Symptoms: Functional Ankle Instability

A

Recurrent ankle sprain and sensation of ankle instability

178
Q

MOI: Functional ankle instability (4)

A
  1. Increased joint flexibility/stiffness
  2. Muscular weakness
  3. Proprioceptive/balance impairments
  4. Delayed peroneal activation time
179
Q

MT: Functional Ankle Instability

A

Grad 3-4 mob when hypomobile

180
Q

TherEx: Functional Ankle Instability

A

Balance, proprioception, strengthening exercises

181
Q

Term: a slowly progressive joint disease typically seen in middle-aged to elderly people.

A

Osteoarthritis

182
Q

MOI: Osteoarthritis (Hip) (5)

A
  1. Aging process
  2. Joint trauma
  3. Repetitive abnormal stress
  4. Obesity
  5. Systemic diseases (RA)
183
Q

Symptoms: Osteoarthritis (Hip) (2)

A
  1. Insidious onset of pain anterolateral hip and groin
  2. Decreased ROM
184
Q

Aggravating factors: Osteoarthritis (Hip) (5)

A
  1. Standing, walking, or sitting for a long time
  2. Squatting
  3. Active hip flexion causing lateral hip pain
  4. Scour test with adduction causing lateral hip/groin pain
  5. Active hip extension causing pain
185
Q

Education: Osetoarthritis (Hip)

A

Lose weight, yoga, tai chi classes

186
Q

Modalities: Osetoarthritis (Hip)

A

Thermal agents or ice

187
Q

MT: Osetoarthritis (Hip)

A

Maneuvers for general mobility and traction manipulation

188
Q

TherEx: Osetoarthritis (Hip)

A

Stretching, strengthening, endurance, aerobic exercise

189
Q

AD: Osetoarthritis (Hip)

A

Walking aids and cane

190
Q

Defn: Labral Tear

A

Tear of the acetabular labrum resulted from excessive forces at the hip joint

191
Q

Symptoms: Hip Labral Tear (5)

A
  1. Pain is usually anterior/groin (90%)
  2. Clicking
  3. Catching
  4. Giving way
  5. Stiffness
192
Q

MOI: Labral Tear of the Hip (5)

A
  1. Motor vehicle accidents/slipping/falling (with or without hip dislocation)
  2. Sporting activities (that require frequent ER)
  3. Forces movements (torsion/twisting, hyperABD, hyperEXT, hyperEXT with ER)
  4. Repetitive microtrauma
  5. Hip dysplasia (lead to bone abnormalities)
193
Q

Education: Hip labral tear

A

Limited WB, avoid pivoting (under load with extension)

194
Q

Modalities: Hip labral tear

195
Q

MT: Hip labral tear

A

Depending on the PAM examination

196
Q

TherEx: Hip labral tear (5)

A
  1. Optimize control of hip ABD, deep ER, Glute Max and Iliopsoas
  2. Correction of dominant participation of quads and hams
  3. Correct gait (hyperEXT)
  4. Avoid exercises causing hip hyperEXT
  5. Avoid weight training of quads and hams
197
Q

AD: Hip labral tear

A

Crutches and cane in acute phase

198
Q

Defn: What is Legg-Calve-Perthes

A

Disease casuing decreased blood supply to the femoral head

199
Q

Education: Foot Deformities

A

Rest, activity modification, shoe wear

200
Q

TherEx: Foot Deformities

A

Stretching, strengthenin, proprioception

201
Q

MT: Foot Deformities

A

Massage, mobilization, manipulation

202
Q

AD: Foot Deformities

A

Orthotics!!

203
Q

Defn: LE Compartment Syndrome

A

Increase pressure in small fascia compartment due to edema or hypertrophy of muscle

204
Q

MOI: LE Compartment Syndrome

A

Acute - vascular impairment, fx, soft tissue injury

Chronic - bilateral, hypertrophy/overuse

205
Q

Symptoms: LE Compartment Syndrome

A

Early = pain, swelling

Late = paraesthesia, reduced pulse, paralysis

206
Q

Education: LE Compartment Syndrome

A

Stop painful activity

207
Q

Modalities: LE Compartment Syndrome

A

Acute - DO NOT ice/elevate

208
Q

MT: LE Compartment Syndrome

A

Rare, maybe massage or mob

209
Q

TherEx: LE Compartment Syndrome

A

Stretching, typical post-op recovery

210
Q

AD: LE Compartment Syndrome

A

Maybe orthotics

211
Q

Defn: Calcaneal Fx

A

Fx of calcaneous or tarsal

212
Q

MOI: Calcaneal Fx

A

Most often due to high impact/traumatic events

213
Q

Symptoms: Calcaneal Fx (4)

A
  1. Sudden onset heel pain
  2. Swelling
  3. Ankle bruising
  4. Pain with palpation
214
Q

TherEx: Calcaneal Fx (4)

A
  1. Early ROM
  2. Progressive WB
  3. Strengthening
  4. Gait/Balance training
215
Q

Education: Calcaneal Fx

A

REST is key

216
Q

MT: Calcaneal Fx

A

Joint mob, soft tissue massage

217
Q

Modalities: Calcaneal Fx

A

Ice/Heat, E-stim, Ultrasound

218
Q

Defn: Plantar Fasciitis

A

Inflammation of the plantar fascia (shock absorber and arch support)

219
Q

MOI: Plantar Fasciitis (4)

A
  1. Overstretch/strain which produces microtears
  2. Prolonged standing/walking
  3. High arches or flat feet
  4. Poor shoe support
220
Q

Symptoms: Plantar Fasciitis (2)

A
  1. Pain and stiffness on the bottom of the foot, slightly anterior to the heel
  2. Pain with first steps in the morning
221
Q

Modalities: Plantar Fasciitis

A

Ice, Ionto, Corticosteriod injections, Ultrasound

222
Q

MT: Plantar Fasciitis

A

Soft tissue mobilization (myofasical release, massage, etc)

223
Q

TherEx: Plantar Fasciitis

A

Stretching, strengthening, rolling massage

224
Q

AD: Plantar Fasciitis

A

Foot orthotics or heel cup, strap sock, night splint/brace

225
Q

Education: Plantar Fasciitis

A

Proper foot wear, avoid aggravating factors

226
Q

Defn: Cuboid Syndrome

A

Distruption of the arthrokinematics of structural congruity of the calcaneocuboid joint (due to tearing of supporting soft tissue)

227
Q

MOI: Cuboid Syndrome

A

Trauma (sprain) or repetitive use

228
Q

Symptoms: Cuboid Syndrome (4)

A
  1. Pain on lateral foot
  2. Restricted ROM
  3. Inflammation
  4. Antalgic gait
229
Q

Education: Cuboid Syndrome

230
Q

Modalities: Cuboid Syndrome

A

Taping, Ice, Ultrasound

231
Q

TherEx: Cuboid Syndrome

A

Stretching, Strengthening, Proprioception

232
Q

MT: Cuboid Syndrome

A

Cuboid whip and cuboid squeeze

233
Q

AD: Cuboid Syndrome

A

Orthosis, Cuboid padding

PTRS 745 Exam 2 (12 decks)

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