Exam 3 CTS, AS, plantar fasciitis Flashcards
pathophys of AS
inflammation at insertion site of ligament and tendon into bone. ossification then happens
bamboo spine
ossification of annular fibrosus. late finding
presentation of AS
proximally progressing low back pain lasting longer than an hour. usually low back. +sytemic Sx
extra articular AS Sx
usually unilateral acute iritis, ciliary flush. cardiac AV blocks and aortic regurg
physical exam finding AS
always limited spinal motion
tenderness at SI joint
loss of lordosis
lab testing for AS
no specific test. normocytic/chromic anemia. HLA-B27 antigen in most.
Tx of AS
NSAIDs first line, indomethacin, celebrex. Rheumatology referral.
other Tx concerns for AS
anti depressants, surgery, daily exercise
pathophys CTS
compression of median nerve. many associated causes
acute CTS a/w
trauma. distal radial fractures, hamate dislocation. swelling and pain.
chronic CTS presentation
Motor/sensory disruption
pain radiation up the arm.
Sx worse at night. parasthesia. (-) swelling
Dx tests for CTS
phalen’s, tinel’s tests. nerve conduction velocity.
Tx of chronic CTS
anti-inflammatory, corticosteroid injection, splinting in neutral position
Dequervain Tenosynovitis definition
inflammation of EPB and APL. pain at dorsolateral aspect of thumb just below anatomical snuff box
presentation of dequervain
pain at dorsolateral aspect of thumb. difficulty gripping.
testing for dequervain
finkelstein test
Dx of dequervain
rule out median/radial nerve pathology. rule out cervical radiculopathy.
Tx of dequervain
rest, ice, NSAIDs.
plantar fasciitis
swelling of the bottom of the foot a/w strain, standing, hard floors
bilateral plantar fasciitis
may be early sign of inflammatory condition
presentation of plantar fasciitis
first step pain, pain beneath arch, calcaneus
Tx of plantar fascitis
orthotics, non pharm, then NSAID anti-inflammatories PRN, then surgery
