Lecture 5 - Arthrological Scan Flashcards
Why use arthrological scan exams?
Starting point for the assessment
Determine lesion site when ambiguous S&S
Myotomes, dermatomes, and sclerotomes correspond to;
C1-T2 and extend into the whole upper quadrant
L2-S2 extend into the lower quadrant
Disorders of the extremity can refer pain _______
proximally
Eg. Carpal tunnel syndrome can refer pain up the forearm, arm, scapula, shoulder and cervical spine
And vice versa
When to use an arthrological scan:
When the history does not give the exact location of the problem.
When there are multiple joints involved.
When there is insidious onset and no direct mechanism.
When the area of pain is diffuse and may extend into the extremity.
Suspicious disorders to scan:
- Spine problems with extremity signs.
- Lateral epicondylitis with cervical dysfunction.
- Shoulder pain or restriction with cervical restrictions or symptoms.
- Carpal Tunnel Syndrome with proximal involvement.
- Two upper quadrant joint problems.
- Two lower quadrant joint problems.
- Weakness in muscle groups served by the same spinal segment.
- Knee pain (chondromalacia) and lumbar spine problems.
- Greater Trochanteric Bursitis and lumbar spine problems.
- Reoccurring ankle instability and history of lumbar spine dysfunction (L5, S1).
- SI joint, hip and lumbar spine problems.
- Reoccurring ankle instability and history of lumbar spine dysfunction (L5, S1).
- SI joint, hip and lumbar spine problems.
Define arthrology:
is the science concerned with the study of anatomy, function, dysfunction and treatment of joints and articulations.
What is the purpose of an arthrological exam:
To determine which joint is involved.
To scan the joints of the upper and lower quadrant for pain and dysfunction.
Can be used later for rule outs.
To determine if there is joint pain.
To determine if there is joint dysfunction.
To determine a limitation in range.
To determine the end-feel.
Arthrological exam method:
The patient goes through the active ranges.
If the movement demonstrates no signs or symptoms then increased stress is applied to the joint by adding overpressure to assess the end-feel.
If the athlete has no pain or movement dysfunction and a normal end-feel then the joint is normal.
If the athlete has pain, movement dysfunction or an abnormal end-feel then the joint is in dysfunction.
arthrological exam upper quadrant areas to scan:
TMJ Cervical spine Shoulder complex Elbow complex Wrist complex Hand and fingers Thoracic spine
arthrological exam lower quadrant areas to scan:
Thoracic spine Lumbar spine Sacroiliac joint Hip joint Knee joint Ankle and foot
arthrological scan movements: cervical spine
Cervical Spine: Forward Bend -OP if full and painfree Back Bend -No OP Side Bend -Right and Left -OP if full and painfree Rotation -Right and Left -OP if full and painfree
arthrological scan movements: shoulder complex
Shoulder Complex: Forward Flexion Abduction -Apply OP if painfree and ROM is full. This tests the: Glenohumeral joint Scapulothoracic Sternoclavicular Acromioclavicular joints
Palpate SC joint during movements:
- They should drop
- If not there is some dysfunction
arthrological scan movements: elbow complex
Elbow Complex: Elbow flexion then overpressure Elbow extension then overpressure Pronation then overpressure Supination then overpressure
This tests the:
Humeroulnar
Humeroradial
Superior and inferior radioulnar joints
Arthrological scan movements: wrist complex
Wrist complex: Wrist flexion then overpressure Wrist extension then overpressure Radial deviation then overpressure Ulnar deviation then overpressure
Arthrological scan movements: hand and finger complex
Full fist -Then OP Half fist -PIP and DIP flexion -Then OP Thumb full flexion -Then OP
