Common Ortho Impairments Flashcards
Achilles’ tendon rupture typically in occurs in _ and within _ to _ _ above the tendinous insertion into the _. Incidence? Without?
Typically occurs in MEN and within 1 TO 2 INCHES above the tendinous insertion in to the CALCANEUS.
Incidence: 30-50 years of age
WITHOUT history of heel or calf pain
Patients with Achilles rupture will typically be unable to stand? Tend to exhibit a positive _ test.
Will typically be unable to ON THEIR TOES
Tend to exhibit a positive THOMPSON’S TEST
Describe the THOMPSON’S test. Positive result?
Patient is in prone with feet extended over the edge of the table. PT asks the patient to relax and the proceeds to squeeze the belly of the gastroc and Soleus.
Test is positive if the foot does not plantar flex in response to the pressure on the gastroc/ Soleus
- MAY indicate an Achilles’ tendon rupture
What are some of the possible clinical presentations of a patient with Achilles’ tendon tear?
Swelling over the distal tendon
Palpable defect in the tendon above the calcaneal tuberosity
Pain and weakness in the plantar flexors
Limp
Complaints of snap or pop associated with severe pain
Inability to plantar flex ankle in weight bearing position
Which diagnostic imaging would be ordered to confirm diagnosis of Achilles’ tendon rupture? What other test could be performed by an MD to confirm
First X-Ray to rule out avulsions fracture and/ or bony injury
MRI to locate the presence and severity of tear or rupture
The OBRIEN NEEDLE TEST can be performed by an MD to confirm diagnosis
A patient that manages an Achilles’ tendon rupture/ tear without surgery and allows the tendon to heal on it’s own has a higher rate of? Why? What treatment option has a decreased risk for reinjury and a higher rate of return to athletic activities?
Patient that does not get surgery has a higher rate of rerupture (40% rerupture), and can result in an incomplete return to functional performance
Surgical repair of Achilles’ tendons has the highest success rate, decreased risk of rerupture and higher rate of return to sports.
What is adhesive capsulitis? AKA?
Shoulder disorder that is characterized by inflammation and fibrotic thickening of the anterior joint capsule. Then the inflamed capsule becomes adherent to eh the humeral head and undergoes a contracture, which severely limits shoulder ROM.
AKA: frozen shoulder
How many types of adhesive capsulitis are there? Describe cause of each.
2 types:
Primary adhesive capsulitis- occurs spontaneously (etiology unknown)
Secondary adhesive capsulitis- results from underlying condition (including trauma, immobilization, complex regional pain syndrome, RA, abdominal and psychogenic disorders or orthopedic intrinsic disorders such as supraspinatus or bicipital tendonitis or partial tear of rotator cuff.
Incidence and age and gender that is most affected by adhesive capsulitis?
Occurs in 2% of population; 11% of those with Diaetes
10-15% develop bilateral frozen shoulder
Middle age females have the greatest incidence
What type imaging is used to diagnose adhesive capsulitis. What is it measuring?
Arthro gram
Measuring the amount of fluid within the joint capsule
- normal is 16-20 mL
- adhesive capsulitis 5-10 mL of fluid
Which two motions at the shoulder are most affected with frozen shoulder? Tightness of which areas of the joint capsule will be present?
Abduction and lateral/ external rotation are affected the most however there will be limitations in all planes of movement
Tightness of the anterior and inferior joint capsule will be present
Adhesive capsulitis usually follows a - _ of recovery. What are the 2 phases, and their associated PT treatments? Spontaneous recovery is said to take - _.
Usually follows a NON-LINEAR PATTERN of recovery
2 phases:
ACUTE PHASE: icing/ heat, gentle joint mobs, progressive and isometric strengthening, and pendulum exercises as able.
CHRONIC PHASE: ultrasound, grade III and IV mobs, increasing joint capsule extensiblitity, and techniques such as PNF to restore painless ROM
Spontaneous recover is said to take 12-24 MONTHS
What other impairment has similar characteristics to frozen shoulder? How do they differ?
ACUTE BURSITIS
- intense pain and sometimes throbbing over lateral brachial region, may be secondary to calcific tendinitis
- AROM in all directions is limited by pain, especially abduction over 60 degrees and flexion greater than 90 degrees
DIFFERS: acute pain only lasts for FEW DAYS, unlike frozen shoulder in which the pain often resolves after a FEW WEEKS
Lateral ankle sprain- Grade II usually are caused by? Usually involve which ligaments? Which one is the MOST commonly affected?
Usually caused by significant inversion
Usually involves the lateral ligament complex, which includes the anterior talo fibular (ATFL), calcaneofibular (CFL), and the posterior talo fibular ligaments (PTFL)
ATFL is the MOST likely to become sprained
What is the ligament structure on the medial part of the ankle? Why is it less affected than the lateral structures?
Deltoid ligament
- strongest of the ankle ligaments and resists valgus stress
Less affected because it attaches in part to the medial malleolus and significant valgus stress would typically cause the medial malleolus to fracture before the deltoid ligament would mechanically fail
Describe the clinical presentation of a lateral ankle sprain grade II
Will likely present with:
- significant pain or tenderness along the lateral aspect of the ankle, especially at the ATFL and elicited with inversion and EROM plantar flexion
- pain will typically limit strength testing, but AROM should be fine
- antalgic gait
- discernible laxity with ligament testing and joint mobs
- redness and moderate to severe edema
An _ is not usually used with suspected lateral ligament involvement at the ankle without other extenuating circumstances. Why?
An MRI is not usually used. . . .
Cost prohibitive
What PT assessment can be used to confirm diagnosis of lateral ankle sprain?
Anterior drawer test for ankle (specifically assesses integrity of the ATFL)
Talar tilt (assess the integrity of the CFL as the talus is moved into ABD)
Though rare, neurovascular complications may accompany injury, so you may want to screen for presence of distal pulses and/ or sensory integrity
Medical managment of lateral ankle sprain- grade II?
RICE
-rest, ice, compression, elevation
Limited weight bearing/ use of crutches may be recommended until patient can tolerate/ pain subsides
Supportive taping or bracing may be recommended to prevent reinjury
What is a similar condition that can present with like symptoms? Characteristics.
High ankle sprain (SYNDESMOTIC injury)
- often occur in conjunction with an ankle fracture because a great deal of force is required to injure
- if left untreated severe post-traumatic arthritis will typically occur
- significant tear will require surgery which is NOT typical for other ligamentous injuries at the ankle
The _ _ prevents anterior translation of the tibia on the fixed femur and posterior translation of the of the femur on the fixed tibia.
The ACL LIGAMENT prevents anterior translation . . .
A _ _ _ sprain refers to a complete tear of the ligament with excessive laxity. Most often occur at which location of the ligament?
A GRADE III ACL SPRAIN refers to a complete . . . .
Most often occurs at the middle of the ligament and really at it’s attachment to the femur or tibia
What is the peak age range for ACL tear? Incidence?
14-29 years of age
Occurs more in female athletes than male athletes but currently there is no definitive evidence as to why
Clinical presentation of a Grade III ACL sprain?
Clinical presentation:
- significant pain, effusion and edema that significantly limits ROM
- patient is unable to weight bear on the involved extremity, AD required for ambulation
- ligamentous testing revels visible laxity in the knee compared to uninvolved leg and may exacerbate patients pain
What is the preferred imaging tool to identify presence of ACL tear and possible disruption of other soft tissue structures such as ligaments and Menisci? What may also be used, and why?
MRI is the PREFERRED IMAGING TOOL
X-RAY may also be used to rule out fracture
What additional PT assessments can be used to confirm diagnosis of grade III ACL sprain?
- patient report of loud pop or feeling of buckling is often associated with a complete tear
- special tests such as Lachman’s test, anterior drawer test, and pivot shift test can be used. Be sure to perform ALL SPECIAL TESTS BILATERALLY
Approximately _ of the time during and ACL tear the meniscus is also involved. _ _ may also be involved although _ _ _. What is it called when all 3 structures (ACL, MCL, and medial meniscus) are involved?
Approximately 2/3 of the time ACL tear occurs in conjunction with meniscal tear
COLLATERAL LIGAMENTS may also be involved, although IT’S LESS COMMON
All 3- known as the UNHAPPY TRIAD
What is the most common graft used to repair a torn ACL? Other possibilities?
Most common- PATELLAR TENDON
Other possibilities: IT band, quadicep tendon, hamstring
What is the PT protocol most often used immediately after post ACL repair (Once cleared by MD)? Which type of exercise is preferred in the early stages of rehab? Why?
Protect integrity of the graft
Control edema
Improve ROM
CLOSED CHAIN EXERCISES ARE PREFERRED, minimize anterior translation on the tibia
What are the distinguishing characteristics of a similar condition to ACL grade III sprain?
Grade III PCL ligament sprain
- most commonly due to a ‘dashboard’ injury or forced knee hyper flexion as the foot is plantar flexed
- typically produce effusion, POSTERIOR TENDERNESS, AND POSITIVE POSTERIOR DRAWER TEST
- Knee extension is often limited
- Individuals with isolated PCL sprain may not exhibit any functional performance limitations, and therefore surgical intervention is less common
- does alter the Arthrokinematics of the joint and therefore patient will be susceptible to degenerative changes such as arthritis
Bicipital tendonosis is an _ _ of the tendon of the long head of the biceps. Repeated full abduction and lateral rotation of the humeral head can lead to? Most common cause?
Is an INFLAMMATORY PROCESS of the tendon of the . . .
Repeated full abduction/ lateral rotation can lead to:
-irritation, edema, microscopic tears within the tendon and tendon degeneration
Most common cause: REPEATED OVERHEAD ACTIVITIES
Clinical presentation of bicipital tendonitis? 2 special tests that can help confirm?
Presentation:
- deep ACH directly in the front and on top of the shoulder that may spread into the bicep muscle and is usually irritated by overhead and lifting activities
- resting shoulder reduces pain
- positive Yegrgason’s or Speed’s test
What type of imaging is used to confirm diagnosis? Which is not typically used and why?
X-Ray is most commonly used
-don’t diagnose but may show calcification in the bicipital groove or subacromial spurring
MRI can view tendon but is not commonly used due to cost
What are the most common PT recommendations during early stages of recovery? What is next step After acute phase?When is surgery recommended?
Early recommendations:
- avoid all overhead movement, reaching, and lifting of objects until pain and inflammation subside
- pendulum exercises, modalities
Next step should focus on stretching and strengthening affected muscle groups
Surgery is recommended if patient does not progress with conservative approach after 6 months
What are the distinguishing characteristics of a similar condition to bicipital tendonitis?
GLENOID LABRAL TEAR
- Labral tear is most susceptible with anterior damage or subluxation
- Bankart lesion: avulsions of the Labral ligamentous complex from the anterioinferior aspect of the GLENOID
- most common lesion resulting in anterior joint instability, can be differentially diagnosed via CT scan and repaired surgically
_ _ or _ _ is characterized by inflammation or degenerative changes at the common extensor tendon that attaches to the lateral epicondyle of the elbow. What is the primary symptom of this condition?
LATERAL EPICONDYLITIS OR TENNIS ELBOW is characterized. . .
PAIN is the primary symptom
_ are more likely to develop lateral epicondylitis, and it’s more common for individuals in their _ or _.
MEN are more likely to develop . . . More common for individuals in their 30’S OR 40’S
What is the clinical presentation of lateral epicondylitis?
Presentation:
- pain along the lateral aspect of the elbow especially over the lateral epicondyle that sometimes radiates into the dorsum of the hand
- pain increases with wrist flexion and elbow extension; resisted wrist extension and radial deviation
- may have difficulty gripping or holding objects and insufficient forearm functional strength
- pain increases with activity and also at night
- possible localized swelling
No _ or _ _ are required to diagnose lateral epicondylitis. X-Ray or MRI may be used to? Electro diagnostic tests (nerve conduction) are?
No LAB OR IMAGING STUDIES are required . . .
X-Ray or MRI may be used to rule out other conditions
Electrodiagnostic tests are only beneficial if there is INVOLVEMENT OF THE RADIAL NERVE
What is recommended in the early stages of rehab for lateral epicondylitis?
Treat pain and inflammation through protection and RICE.
Modalities may be used
On occasion resting splints may be used to relieve tension on involved muscles
Lateral epicondylitis will commonly _, however _ _ and _ will decrease the risk. If conservative treatment does not improve symptoms in _ to _ _ surgical intervention may be indicated
Lateral epicondylitis will commonly RECUR, however CONTINUED STRETCHING and EXERCISE will decrease the risk
If conservative treatment does not improve symptoms in 2 TO 3 MONTHS surgical intervention may . . .
The _ _ _is the primary stabilizer of the medial side of the knee against valgus force and lateral rotation of the tibia (especially during knee flexion)
The MEDIAL COLLATERAL LIGAMENT is the primary. ..
What is the common mechanism of injury for the MCL?
Direct blow against the lateral surface of the knee asking valgus stress and subsequent damage to the medial aspect of the knee
A grade II injury of the MCL is characterized by? Resulting in? What other ligament is often involved in a grade II MCL sprain?
Characterized by PARTIAL TEARING OF THE LIGAMENTS FIBERS
Resulting in LAXITY when the ligament is stretched
The MEDIAL CAPSULAR LIGAMENT is often involved
What is the clinical presentation of a MCL grade II injury
Presentation:
- unable to fully extend and flex the knee
- significant tenderness along the medial aspect of the knee
- possible decrease in strength
- potential loss of proprioception
- antalgic gait
- noticeable laxity with valgus testing and instability of the joint
- moderate swelling, more severe swelling may be indicative of meniscus or cruciate ligament involvement
What are 2 additional structures that are commonly injured during a grade II MCL sprain? What are common treatments in the early phases of rehab?
ACL and/ or meniscal damage is common
Common treatments:
- RICE
- full-length knee immobilized or hinge brace and crutches to minimize weight bearing
- focus on increasing ROM including heel slides or stationary cycling without resistance
- begin with functional activity training (stairs, gait, etc)
If there are no other structures that are involved a grade II MCL sprain should? Patient should be able to return to their PLOF within?
Should progress fairly quickly if no other structures are involved.
Patient should return to PLOF within 4-8 weeks following injury
_ collateral ligament injuries are far less common than _ collateral ligament injuries.
LATERAL COLLATERAL LIGAMENTS ARE FAR LESS COMMON THAN MCL
_ _ is a rare congenital disorder of the collagen synthesis that affects all connective tissue in the body. Reduces production of collagen -%. Which genes mutate?
OSTEOGENESIS IMPERFECTA is a rare congenital disorder . . .
Reduces production of collagen by 20-50%
Genes for type I collagen production (COL1A1 and COL1A2) are the genes that mutate as a result of osteogenesis imperfecta
Most children inherit OI from _ as either an _ _ or _ _ trait. 25% of the time it occurs by? Incidence in the US?
Inherit OI from PARENTS as either an AUTOSOMAL RECESSIVE OR AUTOSOMAL DOMINANT trait.
25% of the time it occurs spontaneously
30-50 thousand individuals are living with osteogenesis imperfecta in the US
How many types are there? Clinical range of presentations?
There are 4 types:
- type I: mildest form, has near normal growth and appearance with frequency of fractures usually ceasing after puberty
- type II: most severe form, child dies in utero or in early childhood
- type III: is severe, children present with greater skull ossification, significant growth retardation, progressive deformities, ongoing fractures, severe osteoporosis, triangular face, blue sclera and significant functional mobility limitation
- type IV, milder course, involves mild to moderate fragility and osteoporosis, may or may not have shorter stature, will have bowing of long bones, Barrel shape to rib cage, possible hearing loss, brittle teeth and normal sclera (near normal life expectancy)
What lab or imaging tests are used to confirm diagnosis?
Skin biopsy performed to examine the collagen ad determine which type of OI
X-rays and bone scans may be used for evidence of deformities or past fractures
Bone densitometry may also be used to measure bone mass and estimate risk of fracture for specific sites
General goals for treatment of OI?
Maximizing independence with mobility, improving optimal bone mass and muscle strength, prevention of fractures and deformities.
Incorporation of developmental activities, positioning, weight bearing and activities that facilitate safe movement
What are distinguishing characteristics of a similar condition?
Arthrogyrposis multiplex congenita (AMC) is a non-progressive neuromuscular disorder that results from multiple conditions that ultimately limit fetal movement and cause multiple congenital contractures at birth.
- children are also born with muscle atrophy and weakness and articular rigidity
- some will be able to ambulate and some will require wheelchairs for mobility
_ _ is caused by abnormal tracking of the patellar tendon between the femoral condyle. Commonly occurs when the patella is pulled too far?
PATELLOFEMORAL SYNDROME
Commonly occurs when the patella is pulled too far LATERALLY DURING KNEE EXTENSION
PFS causes damage to the _ _, and the damage can range from _ of the _ to _ _ _ resulting in exposure of subchondral bone.
Causes damage to the ARTICULAR CARTILAGE, and the damage can range from SOFTENING of the CARTILAGE to COMPLETE CARTILAGE LOSS resulting in . . .
PFS is extremely common during _, and is more prevalent in _ than in _. In the older population PFS is commonly associated with?
Is extremely common during ADOLESCENCE and is more prevelant in FEMALES than in MALES.
In the older population PFS is commonly associated with OSTEOARTHRITIS
Clinical presentation of patellofemoral syndrome
Presentation:
- gradual onset of anterior knee pain following physical activity
- retro patellar burning pain that may be exacerbated with activities such as upping and stair climbing, or prolonged sitting with knee at 90 degrees
- point tenderness over lateral border of the patella
- crepitus with manual compression
- visible atrophy of the quadriceps particularly along vastus medialis
Laboratory or imaging studies are _ _ used to diagnose PFS. X-rays can? Arthrogram and arthroscopy can be used to?
. . . Are NOT COMMONLY used to diagnose PFS
X-rays can rule out fracture, examine configuration of patellofemoral joint, and identify potential osteophytes
Arthro gram/ arthroscopy can be used to examine articular cartilage
What special test can be useful to confirm diagnosis of PFS? How is it performed? Test should be performed?
Clarke’s sign can be useful
Performed by applying pressure immediately proximal to the upper pole of the patella and ask the patient to isometrically contract the quadriceps. Positive test is failure to to fully contract the quadriceps or retro patellar pain complaints from patient
Test should be performed at various angles of flexion and extension
Patients with PFS often have an _ _ _. What is normal in males and females?
Often have an INCREASED Q ANGLE
Normal:
Females- 18 degrees
Males- 13 degrees
With PFS, differential diagnostic tests should be performed to rule out other problems such as?
Referred pain from the hip Osgood-Schlatter syndrome Neuroma Patellar tendonitis Plica syndrome Knee joint infection
Rotator cuff tears occur as a result of? Tears may be classified as? Most commonly involve? With more severe or traumatic etiologies which other muscles may be involved?
Occur as a result of acute trauma or du to chronic degenerative pathology such as chronic supraspinatus tendonitis
Tears are classified as: partial thickness, full thickness, acute, chronic or degenerative
Most commonly involve the supraspinatus
With more severe injury/ trauma: infraspinatus and subscapularis can also be involved
Clinical presentation for rotator cuff tear
Presentation:
- pain and weakness
- generalized pain exacerbated by specific movements or functional tasks, typically in the lateral aspect of the shoulder with radiating symptoms into the upper arm and deltoid region
- complaints of shoulder instability or stiffness, sense of GH grinding, crepitus and discomfort when lying on side
Which 2 special tests are used to help confirm diagnosis of rotator cuff tear? What type of imaging is typically used?
Special tests:
- drop arm and empty can test
- pain with resisted muscle testing is likely to be greatest with a partial thickness tear
Imaging:
MRI is typically used to detect the size, location ,and general characteristics as well as possible damage to adjacent structures.
-X-rays may be used to assess possible bones spurs within the joint capsule
Conservative management with PT is typically? Acute phase of PT should include?
Conservative management with PT is typically tried prior to surgical intervention, unless severe trauma was mechanism of injury
Acute phase includes:
-cryotherapy, activity modification, ROM, rest, and gentle isometrics
_ is the forward slippage of one vertebrae on another. Several types that are classified by? Name them. What is the most common type?
SPONDYLOLISTHESIS is forward slippage of . . .
Types are classified by ACUTAL CAUSE OF SLIPPAGE, and include:
-congenital, isthmic, degenerative, post-traumatic, and pathological.
Most common type is DEGENERATIVE
What level of the spinal cord is usually affected by degenerative spondylolisthesis? Can cause? Caused by?
L4-L5 level most commonly affected
Can cause cauda EQUINA symptoms secondary to stenosis of the canal
Caused by arthritis and degenerative changes in the spine.
Degenerative spondylolisthesis affects individuals? Is more common with _ _ and _. Primary symptoms include?
Affects individuals OVER 50 YEARS OF AGE
Is more common with AFRICAN AMERICANS AND WOMEN
Primary symptoms include:
- back pain that increases with exercise, lifting overhead, prolonged standing, getting in/ out of a car, walking up stairs or incline, and extension position
- pain may be severe and may radiate depending on stenosis and slippage
- sensory and motor loss may be significant and follow a myotomal and/ or dermatomal pattern
What type of PT should be initiated after the acute phase?
Williams flexion exercises to strengthen the abdominals and reduce lumbar lordosis
Back school
Modalities
Postural education
External support such as bracing or wearing of corset may reduce intradiscal pressure
When is surgical intervention recommended? What type?
Surgical intervention is recommended if conservative treatment does not work
Usually involves decompression with or without spinal fusion
_ _ is a condition that causes the neck to involuntarily unilaterally contract to one side secondary to contraction of the SCM. Patient presentation?
CONGENITAL TORTICOLLIS is a condition . . .
Patient presentation:
- head is laterally flexed toward the contracted muscle, the chin faces that opposite direction and there may be facial asymmetries
- first sign may be a firm non tender enlargement of the STM visible at birth or within the first few weeks of life and then gradually decreases in size and usually disappears by 6 mos. of age
Congenital Torticollis is usually seen at? Causes?
Usually seen at birth
Causes:
- local trauma to the soft tissue of the neck before or during delivery
- breech or forceps delivery
Medical managment of congenital Torticollis? PT intervention?
usually treated with non-operative intervention for 12-24 months before considering surgical intervention
PT intervention:
- passive stretching
- parent/ caregiver education and training regarding proper positioning during feeding and sleeping
- heat, analgesics, TENS
- AROM exercises with subsequent strengthening
_ _ also known as _ _ _ (_) is a form of peripheral as ulnar disease that produces thickening, hardening and eventual narrowing and occlusion of the arteries. Results in?
ARTERIOSCLEROSIS OBLITERANS, also known as PERIPHERAL ARTERIAL DISEASE (PAD) . . .
Results in:
- ischemia and subsequent ulceration of the affected tissues
- may become necrotic, gangrenous, and require amputation
Risk factors associated with PAD/ arteriosclerosis obliterans
Age over 45, diabetic, smoker, Hyptension, high cholesterol, impaired glucose tolerance, and sedentary lifestyle
Clinical presentation for PAD?
Presentation:
- intermittent claudication that causes cramps and pain in the affected areas (typically gastroc-Soleus complex)
- resting pain
- decreased pulses and skin temperature
- ischemia, pallor skin
What four diagnostic imaging tests are used to confirm PAD? What do they examine?
Doppler ultrasound, ultrasonography, MRI, or arteriography
Examine the degree of blood flow throughout the extremities
_ _, aka _ _ is tendonitis at the flexor tendon of the elbow. Commonly occurs due to ?
MEDIAL EPICONDYLITIS, aka GOLFERS ELBOW is tendonitis. . .
Commonly occurs due to:
- repetitive wrist or elbow motions or gripping
- often seen in golvfers or those who play throwing or racquet sports
Clinical presentation of medial epicondylitis?
Presentation:
- pain and/ or tenderness over the medial epicondyle
- pain with resisted wrist flexion and pronation and with gripping
- may also have weakness associated with above motions
- possible pain and/ or parathesia into the forearm and 4th and 5th digits
What other structure should you rule out that can have similar symptoms to medial epicondylitis?
Ulnar collateral ligament damage (differentiate through palpation and/ or imaging
- _ refers to traction apophysitis occurring at the tibial tuberosity. Which activities often exacerbate?
OSGOOD-SCHLATTER’S DISEASE refers to traction . . .
Often exacerbated by:
-running, jumping and squatting activities
When does Osgood schlatters onset most commonly occur? Incidence?
Most commonly occurs in adolescents following a period of rapid long bone growth
Affects 20% of adolescents involved in running, jumping, and cutting sports (soccer, ballet)
Historically more prevalent in boys, although gender gap is lessening with increased participation in sports for girls
What is the conservative PT management for Osgood Schlatters?
- patient education (avoid or modify pain producing activities)
- ice, rest, otc medication
- knee immobilized may be beneficial to facilitate rest during acute faces
- infrapatellar strap may assist in distributing forces
- pain relieving modalities, activity modification, and gentle stretching and strengthening
_ _ _ is a result of an inflammatory process involving the tendons and synovium of the abductor pollicis longus and extensor pollicis brevis muscles. Typically due to?
DE QUERVAIN’S TENOSYNOVITIS is a result of . . .
Typically due to repetitive activities involving thumb abduction and extension such as racquet sports and repeated heavy lifting
Clinical presentation of De QUERVAIN’S Tenosynovitis. More prevalent in?
Presentation:
- localized tenderness and pain in the anatomical snuff box which may radiate into the forearm on occasion
- onset may be gradual or sudden
- pain typically improves with rest, worsens with activity
- edema at base of thumb
More prevalent in women with higher risk among new mothers due to repeated lifting and carrying of infants
What special test is used to confirm diagnosis of de QUERVAIN’S Tenosynovitis? How is it performed?
Finklesteins test
Patient is in sitting or standing and is asked to make a fist with the thumb tucked inside. The therapist then stabilizes the forearm and ulnarly deviates the wrist
-positive test is pain over the APL and EPB tendons at the wrist
_ _ is a condition characterized by calcification of muscle. Typically caused by failing to treat? Characterized by _ _ in the muscle belly and often occurs in muscles prone to traumatic injury such as muscles of _ and _. Bone will begin to grow in - _ after injury and will mature within - _
MYOSITIS OSSIFICANS is a condition . . .
Typically caused by failing to treat a muscle strain or contusion
Characterized by BONE GROWTH in the muscle belly . . .muscles of the ARM AND LEG
Bone will begin to grow in 2-4 WEEKS after injury and will mature within 3-6 MONTHS
Clinical presentation of myosotis OSSIFICANS?
Presentation:
- in initial stages will present with typical symptoms of contusion
- pain with functional activities
- stiffness and pain after prolonged rest
- swelling, tenderness, and bruising
- later stages, hard lump in the muscle belly
- increase in pain and a decrease in ROM
_ _ is a condition where subchondral bone and it’s associated cartilage crack and seperate from the end of the bone. What special test can be performed to detect _ _ of the knee?
OSTEOCHONDRITIS DESSECANS is a condition where . . .
Special test to detect OSTEOCHONDRITIS DESSECANS of the knee:
-Wilson’s test
_ refers to an infection that occurs within the bone. Most commonly secondary to _ _ infection.
OSTEOMYELITIS
Most commonly secondary to STAPHYLOCOCCUS AUREUS infection
Clinical presentation of osteomyelitis. Confirmed by?
Presentation:
- similar to infection: fever and chills
- pain, edema, erythema
Confirmed by bone biopsy
