MSK Spine Disorders Flashcards
anterior innominate
OE * Palpation: inf ASIS and sup PSIS, longer LE in supine, shortens in long sit
anterior innominate agg factors
gait, stair descent
anterior innominate ease factors
hip flexion, non WB
anterior innominate hx
activity related: ie, kicking a ball
central stenosis agg factors
extension, prolonged postures, standing and walking, lying down flat, walking downhil
central stenosis history
gradual onset
central stenosis pain
back and leg pain, bilateral, extrasegmental
central stenosis profile
60-70
DDD/DJD
OE * palpation: central PA > unilateral PA stiff/pain if acute
DDD/DJD history
episodic due to repeated annular tearing
DDD/DJD profile
55-60
DDD>DJD pain
bilateral blow back symptoms (1 side possibly worse than the other). possible referral to buttock.
disc (IDD, EDD) profile
20-40
disc agg factors
acute - cough/sneeze. repeated bending, sitting, lifting, stooping chronic: sitting in lordosis, carrying in extension, pain with stooping
disc w/ N root involvement: ProL history
typical fast onset
disc w/ N root involvement: ProT history
recurrent episodes
disc w/ nerve root
central and unilateral PA stiff and painful
disc with N root involvement agg factors
flexion, sitting. standing, walking. sneezing
disc with N root involvement: history
bending lifting, episodic
disc with N root irritation: ExT pain
leg pain worse than back pain; polysegmental (radicular and non-radicular pain)
disc with N root irritation: extrusion profile
30-45
disc with N root irritation: PPL pain
little to no lumbar pain; dermatomal pattern
disc with N root irritation: PPL, proT/proL profile
18-35
disc with N root irritation: ProL pain
leg pain worse than back pain; dermatomal pattern
disc with N root irritation: ProT pain
bilateral paravertebral with buttock/leg pain in partial or complete dermatomal line
disc with nerve root involvement, lateral stenosis
which dx have positive SLR, Slump, PKB?
disc with nerve root irritation (central proL/proT) profile
40-45
DJD>DDD pain
facet can be local pain and refer to buttock, posterior thigh, groin
downslip
OE * Palpation: inferior ASIS and PSIS
downslip hx
trauma: being pulled by one extremity
DRG (dorsal root ganglion) pain
paraesthesia and radicular lancinating pattern
ease factor for DDD/DJD, IDD/EDD, and a disc with N root involvement
lying down, unloading
EDD pain
bilateral paravertebral
extension limited and painful, SB/Quadrant
OE * ROM for lateral stenosis
extension limited and painful/SB
OE * ROM for central stenosis
facet
OE * palpation unilateral PA stiff/painful
facet agg factors
more pain in standing vs sitting. 3D motion extension (cartilage) vs. flexion (capsule)
facet ease factor
variable
facet pain
local unilateral pain. can refer to buttock, posterior thigh, groin
facet profile
chronic >55-60
Flexion, SB
OE * ROM for DDD/DJD
IDD pain
local, unilateral pain. Spreads with progression; referral to buttock
IDD/EDD
OE * palpation: central PA> unilateral PA stiff and painful
IDD: negative, EDD: positive
What are the results of a neurodynamic test of IDD/EDD?
inflare
OE * Palpation: medial ASIS and lateral PSIS
inflare ease factors
IR, non WB
inflare hx
activity related: hip in end range IR, ie: kicking a soccer ball while cutting
inflare/outflare, upslip/downslip agg factors
gait
instability
OE * palpation pain/spasm with central PA pressure. Excessive PPIVM and PAIVM findings
instability agg factors
prolonged postures, forward bending, sudden unexpected movements, return to erect posture after FB, lifting, loading in extension. PM s/s: possibly clunking with position change. AM s/s: ache that worsens throughout the day
instability history
gradual or episodic. hx of recurrent dysfunction that becomes worse with each episode. Minor provocations produce disabling pain
instability pain
highly variable. catching, unilateral pain, deep dull ache. back feels weak or feels as if it will “give way” with certain movements. Sharp pain with sudden or unexpected trunk movements.
instability profile
young, older if degenerative
lateral shift to opposite side of s/s, ipsilateral side bending
OE * ROM for shoulder lesion (disc w/ N root)
lateral shift to same side of s/s, contralateral side bending
OE * ROM for axillary lesion (disc w/ N root)
lateral spinal stenosis pain
leg pain (patchy, dermatomal, multi-segmental)
lateral stenosis and central stenosis ease factor
flexing spine (sitting or squatting, walking uphill)
lateral stenosis history
gradual or sudden unguarded movement
limit in sagittal plane movements
OE * ROM for ProL and Ext