Elbow - Non-muscular Flashcards by Jawric Cuyzon

Arthritis

What is the cause of arthritis?

Can be from lots of conditions:
- trauma
- RA
- crystalline diseases (gout, pseudogout)
- infections (septic arthritis)
- OA

How well did you know this?

Not at all

Perfectly

Arthritis

What population is arthritis common in?

most common in men
- with hx of strenous work
- throwing sports
- trauma

How well did you know this?

Not at all

Perfectly

Arthritis

What age group is athritis prevelant in?

40 to 60 y.o

How well did you know this?

Not at all

Perfectly

Arthritis

What is the RA sujective findings?

Pain and swelling

How well did you know this?

Not at all

Perfectly

Arthritis

What is the non-RA inflammatory subjective findings?

Acute pain
Swelling
Effusion
Loss of ROM
Warmth

How well did you know this?

Not at all

Perfectly

Arthritis

What is the OA subjective findings?

Pain
Stiffness
Mechanical locking
Occasional deformity

How well did you know this?

Not at all

Perfectly

Arthritis

What is the subjective findings with septic arthritis?

Acute and severe spain
Stiffness
Warmth
Swelling
Effusion
Constitutional sx of fever
Chills
Malaise

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

Arthritis

What are the objective findings of OA?

Min effusion

joint line tenderness

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

Arthritis

What is the primary goal of intervention for RA caused?

Intra-articular corticosteroid injection :0
gentle PT
static/hinged splints

How well did you know this?

Not at all

Perfectly

Arthritis - Prognosis

What can be helpful with OA cases?

Arthroscopic debridement and taking out loose bodies

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

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: 1. LESS than **1/3** of articular surface 2. LESS than **30 deg** of angulation 3. 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 ## Footnote 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 ## Footnote 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