Elbow - Non-muscular Flashcards
Arthritis
What is the cause of arthritis?
Can be from lots of conditions:
- trauma
- RA
- crystalline diseases (gout, pseudogout)
- infections (septic arthritis)
- OA
Arthritis
What population is arthritis common in?
most common in men
- with hx of strenous work
- throwing sports
- trauma
Arthritis
What age group is athritis prevelant in?
40 to 60 y.o
Arthritis
What is the RA sujective findings?
Pain and swelling
Arthritis
What is the non-RA inflammatory subjective findings?
Acute pain
Swelling
Effusion
Loss of ROM
Warmth
Arthritis
What is the OA subjective findings?
Pain
Stiffness
Mechanical locking
Occasional deformity
Arthritis
What is the subjective findings with septic arthritis?
Acute and severe spain
Stiffness
Warmth
Swelling
Effusion
Constitutional sx of fever
Chills
Malaise
Arthritis
What are the objective findings of RA?
joint swelling
^ Rheumatoid nodules over olecranon and extensor surface of forearm
joint instability (in advanced cases)
Nodules - firm lumps over the skin
Arthritis
What are the objective findings of non-RA and septic arthritis?
hella painful with resisted ROM
can very much see effusion and feel warmth
Arthritis
What are the objective findings of OA?
Min effusion
joint line tenderness
Arthritis
What is the confirmatory/special tests to help dx?
valgus/varus for joint instability
main thing would be diff dx :)
Radiographs are also sufficient enough
Arthritis
What is the primary goal of intervention for OA caused?
Rest
NSAIDs
keep motion w/ soft stretching :0
modify any activity that flares sx
Arthritis
What is the primary goal of intervention for RA caused?
Intra-articular corticosteroid injection :0
gentle PT
static/hinged splints
Arthritis - Prognosis
What can be helpful with OA cases?
Arthroscopic debridement and taking out loose bodies
Arthritis - Prognosis
What seems to be helpful with early stage RA that doesn’t work with conservative measures?
Synovectomy w/ or w/o radial head excision can give them pain relief
Arthritis - Prognosis
What is the best possible option for RA that is too far gone and have severe limitations?
Total elbow athroplasty :(
Fracture of Radial Head-Neck
What is the probable cause?
From a trauma (FOOSH)
Force of impact: hand –> wrist and forearm –> radial head
This basically forces the bone to go up to the capitellum (crazy frfr)
Fracture of Radial Head-Neck
Mason Johnston Fx Type 1
Nondisplaced or minimally displaced Fx
Fracture of Radial Head-Neck
Mason Johnston Fx Type 2
displaced > 2mm @ articular surface
or
angled neck fx = out of place articular surface or mechanical block
Fracture of Radial Head-Neck
Mason Johnston Fx Type 3
Bad bad splinter fx of head and neck
Fracture of Radial Head-Neck
Mason Johnston Fx Type 4
Has to do with ulnohumeral dislocation
Fracture of Radial Head-Neck
What are the subjective findings?
C/O of pain and swelling @ lateral side of elbow
Loss of elbow motion (can be either pain, joint diffusion or mechanical block)
Fracture of Radial Head-Neck
What are the objective findings?
- Palpate for deformities or tenderness @ radial head
- look at neurovascular function of the forearm and hand (can be damaged)
- passive supination/pronation (can be limited) and possibly crepitus
- AROM elbow flexion and extension (can be limited)
Fracture of Radial Head-Neck
What are the confirmatory/special tests?
dx is based on hx, physical exam and imaging
Type 1 fx = can’t see from imaging
Type 2 and 3 fx = obvious on imaging
Fracture of Radial Head-Neck
What is the goal for type 1 fx interventions?
Put in a sling/splint w/ early AROM (do as much as they can tolerate)
Fracture of Radial Head-Neck
When is strength training initated for a type 1 fx intervention?
Isometrics start @ 3 weeks
Concentric @ 5-6 weeks
Resistance @ 8 weeks (w/ imagining confirming healing time)
Fracture of Radial Head-Neck
What is the rule of threes for type 2 intervention?
Conservative if Fx is:
- LESS than 1/3 of articular surface
- LESS than 30 deg of angulation
- Displacement under 3 mm
Fracture of Radial Head-Neck
What is the intervention goal for type 3?
Best treated by early excision of the bone fragments
Fracture of Radial Head-Neck - Type 3
How long does rehab last after internal fixation?
Usually last 12 weeks
Olecranon Bursitis
Where is a bursitis usually seen?
between the olecranon process of ulna and overlying skin
Olecranon Bursitis
What population is it common in?
students athletes
since they have the possibiility of falling and hitting an elbow on a hard surface
athletes like wrestlers, basketball, football, indoor soccer and hockey
Olecranon Bursitis
What is the common MOI?
Through direct trauma or repetitive WB
Olecranon Bursitis
What is the subjective findings?
C/O gradual pain and swelling (chronic) or sudden (acute)
decreased ROM or can’t don a long sleeve shirt
Olecranon Bursitis
What are the objective findings we’ll see?
swelling @ olecranon process - can vary in size
- look for infection = tenderness for trauma or infection
Olecranon Bursitis
How are we able to confirm dx?
I mean just look at it tf???????????????
- literally dont need for imagining
cell count, gram stain or crystal analysis to help rule out gout or infection (but we dont even do that but okkkkk)
Olecranon Bursitis
What can help relieve discomfort and ROM restrictions?
Aspiration
Olecranon Bursitis
What is the principles adapted for intervention?
Protect
Rest
Ice
Compress
Elevate
Manual therapy
early motion
medication
Keep track of infections = medical attention ASAP
Olecranon Bursitis
What is the qualifications for surgery?
- recurring even though 3 or more repeated aspirations
- infection doesn’t go away w/ antibiotics
