MSK chest, ribs, T-spine Flashcards
What is the pain pattern for cardiac involvement?
- radiating to one or both UEs
- precipitated by exertion
- no TTP
Ease: supine
What is the pain pattern for pulmonary involvement?
- exacerbation by deep breathing
- no TTP
Ease: upright
What is the pain pattern for food?
pain after food
Ease: upright
30 mins: esophagus
30-90 mins: stomach
90-4 hours: Lower GI system
What are red flags for possible SC joint arthritis?
- TTP at SC joint
- limited shoulder movement
- swelling
- fever
- insidious onset of chest pain localized to the SC joint
Patient interview: HX of IV drug use, DM, trauma, and infection
What is mastitis?
Inflammation/obstruction of the mammary duct
What is mastitis associated with in females?
lactation
What are s/s of mastitis?
- red and warm
- swollen
- painful
- fever and chills
- flu-like s/s
What are risk factors for mastitis?
- female
- PMH of mastitis
- stress
- fatigue
- trauma
(true/false) Males can get mastitis
true
What are cyclical breast cysts?
Cysts that are hormonally induced cysts that resolve within 2-3 menstrual cycles
Less common after menopause
What is a rare form of ductal carcinoma?
paget’s disease
What are the sxs of paget’s disease?
- itching
- redness
- flaking skin
- occasional bleeding
(true/false) Paget’s disease in the breast is the same as paget’s disease in the bone
FALSE
it is not
What is the 2nd most common site of cancer and cause of death in women?
breast cancer
What are risk factors for breast cancer?
- PMH
- white, 45-70 y/o
- genetics
- estrogen exposure
Where does breast cancer commonly occur?
upper outer segment of the breast
What are signs of breast cancer?
- Nipple discharge
- nipple erosion
- breast enlargement
- breast shrinkage
- orange peel appearance
~~~~~~~ “BREAST”
Breast mass
Retraction
Edema
Axillary mass
Scaly Nipple
Tender breast and breast pain
What is mastodynia?
Irritation of the upper dorsal intercostal nerve causing chest pain
What are s/s of mastodynia?
- unilateral chest pain
- becomes more persistent during menstrual cycle
When does mastodynia occur initially?
definition: upper dorsal intercostal nerve irritation
Premenstrual period (ovulatory cycles)
What is Tietze’s Syndrome?
Inflammation of a rib and its cartilage in those < 40 y/o WITH swelling
What are the sxs of Tietze’s syndrome?
- < 40 y/o
- swelling
- single site of involvement
- pain worsened with sneezing, coughing, deep inspiration, trunk twisting, and horiz. ABD/ADD
Where is Tietze’s syndrome commonly found in the rib cage?
2nd and 3rd costal cartilage
What is costochondritis?
Inflammation of one or more costal cartilages…refers to pain the costochondral articulations without swelling in those > 40 y/o
Where in the rib cage is costochondritis commonly found?
2nd to 5th costochondral joints
What are the s/s of costochondritis?
- Sharp pain along the sternal borders
- burning breast pain
What is the cause of Tietze’s syndrome?
Unknown
What is the cause of costochondritis?
Trauma
surgery
sports
repetitive motion
What is slipping rib syndrome?
“clicking rib syndrome” or “lower rib hypermobility”
Subluxation of the anterior rib’s costal cartilage tips due to rupture/inadequacy of interchondral fibrous attachments
Impinges the intercostal nerves
Common during mid-life
What are the causes of intercostal neuritis?
Herpes Zoster (Shingles)
What are s/s of herpes zoster?
- Fever and chills
- HA and malaise
- pain
- itching
- hyperesthesias prior to lesions (1-2 days)
- skin eruptions along the dermatome (4-5 days after other s/s)
What portion of the spine are tumors commonly found?
lower T-spine
What amount of displacement is seen with compression Fx in the T-spine?
> 3 mm
What are Schmori’s nodes?
Protrusion of the the vertebral disc into the growth cartilage of the vertebrae above or below the disc
T-spine disc disease
Compression Fx are commonly seen on the (anterior/posterior) vertebral bodies.
anterior vertebral bodies
What are red flags for spinal fx?
- midline TTP at level of fx
- bruising
- LE neuro deficits
- Thoracic kyphosis
Interview red flags:
- fall or MVA
- > 70 y/o
- PMH of osteoporosis
- prolonged steroid use
- loss of function and/or mobility
What medication type relieves GI pain?
antacids
