MSK Flashcards
What questions should you ask in a MSK history?
Do you any pain, swelling, stiffness in your muscles, joints or back?
Can you dress yourself completely without any difficulty?
Can you walk up and down stairs without any difficulty?
Whatis used to detect significant MSK abnormalities?
GALS
What are you looking for in the G part of GALS
Gait- whether it is symmetrical and smooth, ability to turn quickly
What is the diagnosis if someone presents with a temporal headache w jaw claudication and visual symptoms?
GCA
What is the diagnosis if the patient has back pain with bladder and bowel incontinence and saddle disturbance?
Compression cauda equina
What is Radiculopathy?
Conduction block in spinal/nerve roots
Usually nerve compression
What is sciatica?
Pain tingling numbness down a nerve root
What is spondylolysis?
Stress fracture in the pars interarticularis
What are the causes of sciatica?
Commonly a herniated disc, spondylolysis, stenosis
What could you give to someone with a muscle spasm?
Benzodiazepine
What does cauda equina usually present with?
Saddle anesthesia Peri anal numbness Urinary/fecal incontience Painless retention urine Bilateral sciatica
What is indicative of a fracture?
Sudden onset back pack pain relieved lying down
What is synovitis and what does it indicate?
Indicates overuse, inflammatory arthritis or rheumatological disease, long term can result in degenerative joint
What does it indicate if there is limited or painful active movement but full pain free passive movement?
It indicates an overuse/ degenerative injury in the joint
What is the who pain ladder?
Work up pain ladder which is used in chronic pain, use minimum analgesia as can give symptom relief
The problem is there is a risk of dependence, need to consider non pharmacological management
What is bursitis and how would you differentiate this from a knee effusion?
Inflammation of Bursa
Do a sweep test examination
What is Morton’s neuroma?
A benign tumour of a nerve
Usually in response to irritation, trauma or excessive pressure
What are the two drugs which can be used in the long term in gout?
Febuxostat
Allopurinol
What is the painful arc and what does it indicate?
Pain abduction 60-120 degrees
Indicates Supraspinatus tendonitis
Other than shoulder pathology, why would you get shoulder pain?
Diaphragm irritation, cardiac referred pain, ovarian cyst rupture
How do the appearances of OA and RA in the hands differ?
In OA you get Bouchard and heberdens, it is assymetrical and affects thumb
In RA you get swan neck and boutonnière deformity, z shaped and ulnar deviation, it is symmetrical.
How can you distinguish between tennis elbow, Golfers elbow and olecranon bursitis?
Tennis elbow- lateral
Golf- medical
Bursitis- on tip of elbow, not associated with exercise
What is a slipped upper femoral epiphysis?
Where the femoral epiphysis (growth plate) slips
What is the problem with a slipped upper femoral epiphysis?
There is a risk of avascular necrosis of the femoral head
What is a trigger finger?
A finger that has become locked after being flexed, it is due to inflammation. Causing swelling of a tendon or tendon sheath, presence of nodules
What is the treatment of trigger finger?
Steroid injection into tendon sheath
What is sciatica?
Pain in back and buttocks which radiates to the dermatome supplied by the affected nerve root (follows root from the back to the dermatome)
What is the cause of sciatica?
When one or more of the nerve roots that contribute to the sciatic nerve (L4, L5, S1, S2) became irritated or compressed, causing pain in its distribution.
How do you diagnose sciatica?
Straight leg raising
What is the most common cause of sciatica
Lumbar disc herniation
