Midterm: Musculoskeletal Complaint Flashcards
Radicular pain with weakness and sensory loss over an area innervated by a nerve root (dermatomal distribution) most likely is…
Radiculopathy
What type of pattern do radiculopathies follow?
Dermatomal
What condition involves spinal cord damage or dysfunction?
What does it involve?
Myelopathy
Basically anything involving the spinal cord, meninges and perimeningeal space surrounding spinal cord
Do myelopathies result in loss of function?
Yes, significant
What are some important palpatory landmarks involving the neck?
Spinous Process
Facet Joints
Paracervical muscles
What does a spurling test/maneuver try to elicit?
Radiculopathy
-nerve root compression
What is Spondylosis?
Synonymous for Osteoarthritis of Vertebrae
Defect in Pars interarticulars with subsequent spinal nerve root compression
In advanced spondylosis, what four conditions arise?
Radicular pain
Neuropathy
Compression fractures
Spondylolisthesis (step off)
What specific population is scoliosis most common in?
Adolescent girls
What is the most common way to test for scoliosis?
Forward bending test
-clinical evident for curvatures 30 degrees or more
What positions make lumbar stenosis worse?
Back extension
What back position alleviates lumbar stenosis pain?
Back flexion
This is pain in the lower extremities that is caused by lumbar stenosis. It is relieved almost immediately and is NOT due to vascular compromise?
Pseudoclaudication
How do you differentiate pseudoclaudication (lumbar stenosis) from true claudication?
Pseudoclaudication is relieved immediately and is not associated with vascular compromise
What occurs with Disk herniation?
Pain with flexion/prolonged sitting
Radicular Pain
LE weakness
Straight Leg test with pain at less than 70 degrees
In a disk herniation, will a straight leg raise test of the contralateral leg reproduce symptoms in the affected leg?
Yes
What is sciatica?
Basically disk herniation or piriformis compression that follows the radicular pattern of the sciatic nerve going from butt pain that travels down into knee
If a patient has disk herniation with urinary retention, saddle anesthesia, progressing weakness, and neuro deficits how would you treat?
Surgical emergency
-immediate MRI
Is imaging recommended for back pain within the first six weeks?
Nope, not unless there are red flags
-90% will resolve within 6 weeks
Aggravating symptoms with flexion and prolonged sitting suggest that the lesion is where?
Anterior spine disk problems
Aggravating symptoms with extension suggest that the lesion is where?
Facet joints, stenosis, or SI joint
What are some red flag symptoms for malignancy?
Unexplained weight loss, failure to improve w treatment, pain >6 weeks, pain at night/rest
-pt older than 50 w other risk factors as well
What are some red flag symptoms for infection?
Fever
Rest pain
Recent infection
History of immunocompromised or IVDU
Is nerve root impingement back pain dominant or leg dominant?
Leg
Back is probably more functional impairment
