MSK Spinal Pathologies Flashcards
Define ankylosis spondylitis
Inflammatory condition affecting spine and sacroiliac joints occurring between vertebral bodies and discs, characterised by bony growths and results in fusion of vertebrae
AS- indicator
HLA-B27 positive- an antigen present on white blood cells indicated immune response.
Affects males mainly. Average age onset 24
AS symptoms
SI joint pain, early morning stiffness, loss of spinal curvatures
Define spinal stenosis
Narrowing of vertebral foremen, irritating the spinal cord
Spinal stenosis causes
Osteoarthritis bony growths
Tumours
Herniated discs
Thickened ligaments
Spinal stenosis presentation- lumbar and cervical
Gradual onset
Cervical- sensation changes, weakness, balance changes in upper and lower limb
Lumbar- neurogenic Claudication: pain in legs standing for a long time or walking, eased by positional changes. Weakness and back pain
Disc herniation definition
Where nucleus pulposa protrudes into annulus fibrosis and this can put pressure onto nerves within spinal cord
Disc herniation symptoms
Leg, buttock pain if lumbar
Numbness and weakness
Rapidly worsening Shoulder pain. Worse in extension, pain to cough/ sneeze
Herniated disc causes
30s - age, smoking
More common in lumbar
Lifting and twisting heavy objects
Overweight
Radiculopathy definition
Nerve root entrapment, caused by irritation or inflammation.
Nerve root entrapment causes
Disc herniation
Trauma
Muscle spasms
Nerve root entrapment presentation
Myotomes and dermatomal changes
Muscle weakness
Altered sensation
Spondylolithesis definition
Vertebrae shifting, usually anteriorly
Graded 1-5 depending on severity and percentage shift from the vertebrae below
How to classify lower back pain
Specific or non specific
Maladaptive or adaptive
Movement impairment or control behaviour
Spondylosis definition
Degenerative disc disorder affecting intervertebral joint.
Commonlower cervical c5-6, 6-7
Can lead to nerve root entrapment due to foraminal narrowing.
Spondylisis symptoms
Loss of ROM - side flex and rotation
Painful PAIVM passive accessory movements
Pain in neck and refer to shoulder
Dermatome changes if nerve root entrapment
Degenerative changes on X-ray
Spondylisis causes
Most common in 45 plus and lumbar spine
Due to disc degeneration with age
Myelopathy
Compression of spinal cord centrally
Causes: severe degenerative changes, large central disc prolapse
Signs: chronic neck pain, clumsy, bladder dysfunction, gait disturbance
Medical emergency like cauda equina
Whiplash MOI
Acceleration, deceleration injury. Often injury is anterior due to the hyper extension of neck.
Full resolution 3 months but depends on psychosocial factors
Whiplash symptoms and signs
Neck pain, stiffness, headaches, nausea, dizziness and blurred vision
How are whiplash injuries classified
Whiplash association disorder
Most common is 2A - neck pain, local hyperalgesia
Cervicogenic headache cause
Irritation of cranial nerves or transgeminal nuclei in upper cervical spine. Symptoms radiate up into a tension headache
Or trigger point referral patterns often upper traps
Cervicogenic headache special questions
5d 2n
5D- dysphasia, dysphagia, dizziness, Diplopia, drop attacks
2N- nausea, nyestagmus (pupils flicker)
Cervicogenic headache symptoms
Unilateral neck pain that spreads up, treat with MWM
