MSK Tutorial Important Notes

Question 1

What is synovitis and what does it indicate

Answer 1

Inflammation of a synovial membrane around a joint

Indicates RA, Gout and sometimes OA

Question 2

Explain stiffness in OA vs RA

Answer 2

RA - early morning stiffness that eases with movement

OA - stiffness and pain that worsens with movement so worse at night

Question 3

Explain what a reduced/painful active and passive movement may indicate

Answer 3

ACTIVE - muscular or tendon problem, as they are used in active movement

PASSIVE - problems with the joint e.g. bone deformity, inflammation, contracture.

Question 4

What are mechanical symptoms of the knee

Answer 4

Locking or catching of the knee

Question 5

How would you differentiate between bursitis and knee effusion

Answer 5

Effusion - fluid can be moved during the patellar tap and sweep test

Bursitis - swelling is localised to that bursa

Question 6

Which causes of hip pain produce pain in anterior, lateral and posterior hip pain

Answer 6

ANTERIOR - hip joint problem e.g. OA
LATERAL - trochanteric bursitis
POSTERIOR - lumbosacral spine or gluteal muscles

Question 7

What features of a history identify radicular back pain

Answer 7

(impingement of a nerve root)
- shooting or numb quality
- can run all down legs to foot

Question 8

What does painful arc indicate
Where in the arc does it hurt
Which muscles are involved in abduction

Answer 8

Pain in the mid range (45-120 degrees)
Indicates impingement of the supraspinatous nerve

(abduction goes - supraspinatous, deltoid, traps moves scapular)

Question 9

What are other problems that may present with shoulder pain - 4

Answer 9

• cervical spine problems
• MI/Angina
• Pancoasts tumour (lungs)
• Diaphragm pain from hepatitis

Question 10

Differentiate between prx of OA and RA in the hands

Answer 10

OA - nodes on distal IP joint most common, then sometimes nodes on proximal IP joints

RA - may see ulnar deviation of the fingers, swan neck and boutonniere deformities.