Introduction Flashcards
Synovium
Connective tissue that lines the inside of joint capsule, providing lubrication and nutrition to cartilage by synovial fluid
Bursa
small fluid filled sac provides cushioning and reduces friction between moving parts of joints
Tenosynovitis
Inflammation of tendon sheath
Enthesis
Anatomical site of attachment of ligament, tendon, joint capsule, or fascia to bone
Spondylitis
Inflammation of axial vertebrae and related discs and ligaments
Spondylosis
Degenerative changes of vertebrae ex. OA
Spondylodiskitis
Inflammation of both vertebrae and disk
Spondylolisthesis
Stress fracture and sliding of vertebra
Subluxation
Malalignment of joint
Joint pain classified into
- Inflammatory
- Non-inflammatory ‘mechanical’ OA, trauma
Number of joints involved
Monoarticular - one joint
Oligoarticular - 1-4 joints
Polyarticular - >4 joints
Non articular diffuse MSK pain
Fibromyalgia
Non articular localized MSK pain
Tendinitis
Enthesitis
Articular pain characteristics
- diffuse pain and tenderness all over joint line
- aggravated by both active and passive joint movement
- generalized joint swelling
Low back pain
- mechanical (OA, Degenerative)
- muscle spasm, spondylolesthesis, discogenic
- congenital structural
-rheumatic (Spa, fibromyalgia)
-neoplastic
Inflammatory pain
- morning stiffness >30 mins
- profound fatigue
- improves with activity
- worsens with rest
Red flags of spinal pain
- age <20 >50
- constant, progressive pain unrelieved by rest
- thoracic region pain
- PMH of CA, TB, HIV, steroid use
- Sweating, weight loss, fatigue
- major trauma
Cauda equina syndrome
- difficulty with micturition
- fecal incontinence
- saddle anesthesia
- motor weakness
- sensory loss
Thoracic outlet syndrome
Compression of neurovascular structures as they transverse thoracic outlet ( scalene muscles, 1st rib, clavicle) 1. Vascular 2. Neurological
Olecranon Bursitis
Inflammation of subcutaneous bursa overlying the olecranon
De quervein tenosynovitis
Entrapment tendinitis of APL, EPB by overlying extensor retinaculum, pain at thumb motion with radial or ulnar deviation of wrist tx by splint, heat, nsaid
Trigger finger (stenosing tenosynovitis)
Pain, stiffness, sensation of locking and catching when digit flexed and extended, mostly affect ring finger and thumb
Dupuytren disease
Fibrosing disorder that result in thickening and shortening of palmar fascia and lead to contractures of MCP or PIP, commonly affects ring finger
Conditions associated with Dupuytren disease
- diabetes
- alcohol abuse
- hiv
- epilepsy
- trauma
- manual labor with vibratory exposure
- smoking
Trochaneteric bursitis
Pain on upper lateral thigh, tenderness over greater trochanter
Gluteal enthesopathy
Pain on upper lateral thigh, worse on active resisted hip abduction
Adductor tendinitis
Pain on upper inner thigh, sports related, pain by active resisted hip adduction
Ischiogluteal bursitis
Pain on buttock worse in sitting, tenderness over ischial prominence
Iliopectineal bursitis
Anterior groin pain, tenderness lateral to femoral pulse
Meralgia paresthetica
Pain,numbness, tingling in anterior and lateral parts of thigh, compression of lateral femoral cutaneous nerve
Prepatellar bursitis
Pain in anterior patella
Infrapatellar bursitis
Anterior knee pain inferior to patella
Anserine bursitis
Upper medial tibia pain
Inferior medial collateral ligament enthesopathy
Upper medial tibia pain
Popliteal baker cyst
Pain in popliteal fossa, reducible by massage
Patella tendon enthesopathy
Osgood schlatter disease, anterior upper tibia pain and swelling of tibial tubercle, pain on knee extension
Pain in ankle joint
Anterior pain between two malleoli worse on standing/ walking
Subtalar pain
Posterior between two malleoli and aggravated by walking on uneven surfaces
MTP pain
Metatarsalgia, described as walking on marbles
Pes cavus may be associated with
Neurological disorders such as fredreich ataxia, spina bifida, or polio
Morton’s neuroma
Entrapment neuropathy of interdigital nerves, between 3rd and 4th metatarsal heads in middle aged women with ill fitting shoes
Plantar fasciitis
Pain under heel worse on standing and walking
Subcalcaneal bursitis
Pain under heel worse on standing and walking, tender under middle of calcaneus
Achilles tendinitis
Tender on squeezing tendon, pain reproduced by standing on toes
Achilles enthesopathy
Pain on site of tendon insertion, reproduced by standing on toes
Retroachilles bursitis
Posterior heel pain, tenderness and swelling posterior to tendon
Pre Achilles bursitis
Posterior heel pain, tenderness and swelling anterior to tendon
Tarsal tunnel syndrome
Compression of tibial nerve in flexor retinaculum ligament
