MSK Muscle Aches and Pain Flashcards
State the 5 causes of muscle aches and pain
- polymyalgia rheumatica
- fibromyalgia
- myofascial pain syndrome
- drug-induced myopathy
- rhabdomyolysis
Polymyalgia rheumatica is the ____ muscle ____ and ____ without specific muscle weakness.
Polymyalgia rheumatica is the PROXIMAL muscle MYALGIA and STIFFNESS without specific muscle weakness.
State what demographic polymyalgia rheumatica commonly affects.
Where is the pain commonly localised to?
Common in older patients.
Pain is diffuse across the limb girdles (shoulder and hips)
State the investigations used for polymyalgia rheumatica.
State the presentation of patient.
State the appropriate treatment to be adminstered.
Investigations:
- elevated ESR
- elevated WBC count
- elevated CRP
(no elevation of RF due to RF only affecting smaller joints of hands and feet symmetrically)
Presentation:
1. reduced ROM
2. morning stiffness for >30 minutes
3. pain and stiffness over hips and shoulders and neck
4. fever, loss of weight, fatigue
5. jaw claudication (due to demand ischaemia)
Treatment: low dose corticosteroids (prednisolone) + methotrexate
Fibromyalgia is the ____ ____ pain affecting multiple areas as ____ ache and ____ for more than ____ months.
Fibromyalgia is the WIDESPREAD CHRONIC pain affecting multiple areas as DULL ache and STIFFNESS for more than 3 months.
State what demographic fibromyalgia commonly affects.
Where is the pain commonly localised to?
Common in younger patients.
Pain localised to both sides of body, above and below waist, axial skeleton
Myofascial pain syndrome is the ____ areas of ____ muscle ____ and ____.
Myofascial pain syndrome is the LOCALISED areas of CHRONIC muscle TENDERNESS and TIGHTNESS.
State the investigations used for fibromyalgia
State the presentation of patient.
State the appropriate treatment to be adminstered.
Investigations:
- normal ESR
- normal CBC/FBC
Presentation:
1. normal ROM, normal muscle strength
2. decreased pain threshould and tolerance
3. tenderness in >= 11/18 tender points
4. associated faituge, sleep and somatic complaints
5. difficulty concentrating, headaches
6. IBS
Treat with exercise, NSAIDs and antidepressants. (avoid corticosteroids and narcotic agents)
State the nature of pain in myofascial pain syndrome
Pain is dull, aching or sharp depending on extent of activity. Active trigger points cause pain at rest or palpation.
State the investigations used for myofascial pain syndrome
State the presentation of patient.
State the appropriate treatment to be adminstered.
Investigations:
- normal ESR
- normal FBC/CBC
Presentation:
1. reduced ROM in trigger points, normal muscle strength
2. headache, sleep distubrances, fatigue
3. pain localised over trigger points
Treatment: corticosteroid injections in affected areas, exercise, NSAIDs, muscle relaxants, antidepressants
State the drug used in inducing drug-induced myopathy
HMG-CoA reductase inhibitors (statins)
or
- zidovudine (AVT)
- ethanol
- ciclosporin A
- penicillamine
- clofibrate
Rhabdomyolysis is the ____ of the ____ muscle and muscle ____.
Rhabdomyolysis is the DEGENERATION of the SKELETAL muscle and muscle DEATH.
Compartment syndrome is when ____ within the ____ compartment builds up to a dangerous level.
Compartment syndrome is when PRESSURE within the MUSCULAR compartment builds up to a dangerous level.
State the investigations used for rhabdomyolysis
State the presentation of patient.
State the appropriate treatment to be adminstered.
Investigations:
- raised serum CK
- raised urine RBC count
Presentation:
1. reduced power of hip flexion
2. distal lower limnb pulse felt
3. red/dark coloured urine <– conjugated bilirubin shunted to kidneys
4. (complication) hypocalcaemia -> influx of ca2+ into cell due to cell memrbane damage
5. (complication) hyperkalaemia, hyperphosphataemia, acidaemia –> release of intracellular contents into blood
Treatment: aggresive hydration by IV, bedrest
