MSK Disorders Flashcards
What is sprain?
Sprain is stretched or torn ligament
Occurs due to falling, twisting or getting hit
Ankle and wrist sprain most commin
What are the symptoms of sprain
Pain, swelling, bruising and inability to move a joint may feel a pop or tear with injury
What is strain?
Stretch or torn Muscle or tendon
Sudden force of motion(twisting or pulling)
Muscle stretched beyond normal capacity
May take up to 6 weeks for muscle cells to regenerate
Could be acute or chronic injury
Common injury area are back and hamstring
What are the symptoms of strain?
Pain, muscle spasms, swelling and difficulty moving muscle
What are the differences between 1st, 2nd and 3rd degree sprain
1st degree sprain- mildest for , little tearing, pain and swelling and joint stability is good
2nd degree sprain: moderate instability and moderate to severe pain and swelling
3rd degree- most severe, ligament has completely ruptured. The joint is unstable, severe pain, swelling there may be other tissue damage
Treatment of sprain and strains
RICE or PRICE
R = rest, restrict activity
I = ice die 1st 48-72 hrs until swelling decreases
C=compression, elastic compression wrap for 1st 24-36hrs +- may need braces
E= elevate above heat level
PRICE
P= protest from further injury and then same as above
NSAID or acetaminophen for pain control
Note severe strain or sprain may require surgery, immobilization or physical therapy
Tendonipathy is what?
Tendinitis is inflammation of Tendon
Epicondylitis is what?
Inflammation of tendon where it attaches to bone
Tennis elbow (lateral epicondylitis)
Golfer’s elbow (medial epicondylitis)
What are the causes of Tendinopathy? What are the common site of injury?
Causes- injury, overuse, aging
Common sites of injury- elbow, heel, shoulder wrists
What are the symptoms of tendinopathy
Pain (dull ache) tenderness along tendon near joint,
pain that increases with activity
Mild swelling
What’s the treatment for tendinopathy
Rest, immobilize (splint, removable brace) avoid repetitive movement
NSAID (ibuprofen, asprin) steroid injection
If it does not improve in few weeks - referral to physical therapy
What is bursa?
The bursa are small sac lined with a synovial membrane and filled with synovial fluid
Located between tendons, muscles and bony prominence
159 bursa in the body
What is bursitis?
Inflammation of the bursal sac and is usually the result of trauma (too much friction)
What are the common sites of bursitis
Knee, elbow, heel shoulder
What is housemaid’s knee
Bursitis secondary to domestic work done on hands and knee
What are the symptoms of bursitis
Pain occur suddenly or gradual
Redness/warmth or swelling
Evaluate for infectious vs non infectious etiology
Septic bursitis
A wound (bacteria on skin) result in infection
Traumatic bursitis
Often seen In athletes- football players wrestlers
Treatment of chronic bursitis
Modify activity that cause injury
Immobilize extremity
Use knees/ elbow pad
Ice 2-3x per day for 20-30min each time to reduce swelling
Do NOT use heat as this will increase inflammation
Analgesic NSAID (ibuprofen)
2nd line inject corticosteroids
Physical therapy
Infectious bursitis treatment
Aspirate bursa to diagnose cause
Antibiotics to prevent bacteriemia (cover streptococci and staphylococci)
Treatment of traumatic bursitis
Aspirate bursa, ice, NSAIDs compress area with elastic bandage, use of padding/spots protection
What is the cause of gout
Gout is the result of a defect in purine metabolism
Gout occurs due to accumulation and crystallization of Uric acid which is deposited in the tissues and fluid of the body
Uric acid is a waste product of protein metabolism and has no physiological role
Gout occur due to overproduction or under excretion of Uric acid
Majority patient has gout due to under excretion
What is found in blood of those with gout
Increased levels of uric acid - hyperuremia
What are the 4 clinical stages of gout
Asymptomatic tissue deposition
Acute flares
Inter critical segments
Chronic gout
What happens in the asymptomatic tissue deposition of gout
Patient has no overt symptoms but does have huperuremia and crystals in tissues which cause damage
Acute flare stage of gout
Affected joint will be red, warm and painful. This phase can last days, weeks.
Uric acid levels can be normal in some patient
Inter critical segmentation stage of gout
Occurs after acute flare has subsided
Pt continues to have hyperuremic
Chronic gout stage
Patient develops chronic arthritis
May have tophi with common site being elbow ears and distal fingers
What is tophi
Crystal deposit in tissue which form small white nodules
What is podagra?
50% of patient present with gout the great toe (podagra) is the presenting joint
What are the risk factors for gout
ETOH (beer or spirit) high meat/ seafood diet, obesity, HTN diuretics use
