Musculoskeletal Flashcards
progressive degeneration and weakening of skeletal muscle
muscular dystrophy
what is the most common form of muscular dystrophy
duchenne MD
cause muscular dystrophy
genetic defect because of absences of dystrophin
how is muscular dystrophy diagnosed
sx, family history, muscle biopsy, EMG, elevated serum creatine kinase level, DNA blood test
tx muscular dystrophy
deflazacort (emfalza), PT, surgery, orthopedic appliances, corticosteroid, feeding tube, anticonvulsants, immunosuppressants
aka club foot
talipes equinovarus
anterior half of foot is adducted and inverted
clubfoot
cause of clubfoot
fetal position and genetics
how is clubfoot diagnosed
- physical exam
- foot resistance to manipulation
- shortened achilles heel
tx clubfoot
cast, splints, surgery
aka developmental dysplasia of hip
conggenital hip dysplasia
abnormal displacement of hip joint
congenital hip dysplasia
cause of congenital hip dysplasia is unknown but what are potential causes
maternal hormone relaxin or breech
congenital hip dysplasia more commonly affects
females
how is congenital hip dysplasia diagnosed
- positive ortolani and barlow maneuvers
- physical exam
- ultrasound of hip
tx congenital hip dysplasia
pavlik harness, plint, cast
aka cleft lip
harelip
sx cleft lip
- obvious deformity
- difficulty w/nasal regurgitation and feeding
cause of cleft lip
genetics
tx cleft lip
- surgery
- feeding devices
- speech therapy
chronic pain condition associated with stiffness, tenderness, restless sleep, depression, fatigue, anxiety, bowel dysfunction
fibromyalgia
cause of fibromyalgia is unknown but what are some theories
change in how brain and spinal cord process pain signals, relatively low serotonin, psychological distress, elevated levels of substance P, trauma, infection
fibromyalgia may be aggravated by these factors
poor posture, inappropriate exercise, weight, smoking
how is fibromyalgia diagnosed
- blood testing and physical exam to rule out other conditions
- diagnostic criteria (widespread pain lasting at least 3 months, other sx, no other underlying conditions)
tx fibromyalgia
- pt education
- stress reduction
- exercise
- meds (antidepressant amitriptyline [elavil], pregabalin [lyrica], duloxetine [cymbalta], milnacipran [savella], NSAIDS, muscle relaxants)
- stress reduction/relaxation techniques
- massage therapy
- acupuncture
aka lordosis
swayback; saddle back deformity
cause of lordosis
excessive abdominal weight (pregnancy, obesity, abdominal tumors), unknown, rapid skeletal growth, osteoporosis
lordosis is often seen in this group
prepubescent girls
how is lordosis diagnosed
observation of spine and xray
tx lordosis
delivery of fetus, weight loss and exercise, spinal fusion and displacement osteotomy
abnormal outward curvature of spine
kyphosis
exaggerated inward curvature of spine
lordosis
cause of kyphosis
development, Scheuermann disease, tumors, TB, ankylosing spondylitis, osteoporosis
how is kyphosis diagnosed
visual inspection, xrays, bone scans
tx kyphosis
exercise, back brace, spinal fusion w/instrumentation and temporary immobilization, vertebroplasty
lateral curvature of spine
scoliosis
cause of scoliosis
idiopathic, genetic, deformed vertebrae, uneven leg lengths, muscle determination
how is scoliosis diagnosed
visual exam of back and xrays
tx scoliosis
milwaukee brace, boston brace, molded plastic clamshell jacket, wilmington brace, exercise program, fusion of vertebrae and internal fixtures, body casts, plstic jackets
type of arthritis involving break down and eventual loss of cartilage
osteoarthritis
cause of osteoarthritis
hormonal disorders, injury, diabetes, obesity
classic bony enlargement
heberden node
aka osteoarthritis
degenerative joint disease; degenerative arthritis
tx osteoarthritis
physical and drug therapy, good diet, supportive care, surgery, massage, heat & cold, elastic bandages/splints, analgesics, muscle relaxants, NSAIDs, intraarticular steroid injections, intraarticular hyaluronic acid, fish oil, food supplementation w/glucosamine and chondroitin, mobility aids, restrict activity, joint fusion, joint replacement
infectious disease caused by Borrelia burgorferi transmitted through ticks
lyme disease
cause of lyme disease
Borrelia burgdorferi (US) or Borrelia afzeli (Europe) transmitted from tick
how is lyme disease diagnosed
pt history, physical exam, lab testing, positive test for lyme antibodies
tx lyme disease
removal of tick, oral antibiotics (doxycycline, amoxicillin, cefuroxime), IV antibiotics, antipyretics, bed rest, physical therapy, anti-inflammatory meds, hydroxychloroquine
inflammation of bursa
bursitis
cause of bursitis
continual or excessive friction, systemic diseases, trauma
how is bursitis diagnosed
pt history, physical exam, impaired ROM, acute pain, MRI, xrays show calcified deposits
tx bursitis
avoid activity, moist heat, immobilize joint,, aspirin/acetaminophen, NSAIds, local injection of corticosteroid, active ROM exercises, surgical excession
serious infection of bone
osteomyelitis
cause of osteomyelitis
staphylococcus aureus or streptococcal bacteria, bloodborne pathogen deposited from surgery or trauma
list risk factors for osteomyelitis
- diabetes mellitus
- peripheral vascular disease
- streptococcal pharyngitis in kids
- sickle cell disease
- prosthetic hardwar
how is osteomyelitis diagnosed
aspiration and culture of material from site of infection, blood culture, WBC, erythrocyte sedimentation rate, MRI, CT< bone scan
tx osteomyelitis
parenteral or local antibiotics (aqueous penicillin, cephalosporin, ampicillin), increased intake of proteins and vitamins A/B/B, bed rest, immobilization, surgical drainage, hyperbaric oxygen
chronic disorder of uric acid metabolism manifesting as acute and episodic form of arthritis
gout