Musculoskeletal Conditions (3.2) Flashcards
What does the musculoskeletal system conisist of?
Consist of Bone, cartilage and soft tissue (muscles, tendons and ligaments)
- Bones: framework for soft tissue attachment
- Cartilage: semi reigid and slightly flexible structure which acts as a surface for articulating ends of skeletal joints
- Tendons and ligaments: dense connective tissue
Tendon: bone to muscle
Ligaments: Bone to bone
For muscoskeletal pain;
A) What does it affect
B) What is it caused by
C) What are some implications
A)
- Affect bone, muscle, tendon, ligaments and nerves
- Can be acute (sudden onset) or chronic
B)
- Muscle overuse
- Fracture
- Injury
- Infection
- Systemic disorders
- Tumour
C)
- Pain (lower back pain most common)
- Sprain and strain
- Limitation on mobility
- Decreased QOL
- Psychologic effect
What are some sites of muscoskeletal pain?
- Headaches
- neck pain and stiffness
- shouldeer pain and stiffness
- Tennis elbow
- Back pain
- Sciaitica and hip pain
- Arthritis wrist pain
- Carpal tunnel syndrome
- Knee pain
- Sprained ankles
- Post injry pain fibrom yalgia
What is lower back pain caused by? What are some signs for referral
- Caused by muscle strain, muscle overuse, stress fractures, degenerative disc disease, arthritis, spondylitis
- Lower back pain from injury often due to hyperextension of lumbar spine –> Torn muscle or ligaments
Sx for referral:
- Worsening pain over several days
- Pain that radiates to the leg(s)
- Severe shooting pains into the leg(s) with loss of function/weakness in your leg(s)
- Urinary or bowel incontinence
For strains;
A) What is it
B) What is it caused by
C) What are the symptoms
A)
- Defined as local muscle damage due to mechanical overloading
B)
- Often cause by sport related or trauma related injury
- Sudden, forced motion causing muscle to stretch beyond normal capacity
C)
Include pain, swelling and some loss of function
1st degree: Minimal damage (pain but no muscle deformity)
2nd degree: Partial tearing (pain and bruising from some muscle tearing)
3rd degree: Complete tear (Minimal pain, pain fibers torn, marked weakness and muscle deformity
For Sprains;
A) What is it
B) What causes it
C) What are some symptoms
D) How it it different from strains
E) Wher are some common sites?
A)
- Injury to ligaments surrounding the joint
B)
- abnormal or excessive movement in a joint
C)
- Severity of symptoms depend of degree of injury
- Symptoms include pain, rapid swelling, heat and some loss of function
Grade I: ligament stretched/slightly torn
Grade II: ligaments partially torn
Grade III: ligaments completely torn
D)
- Similar to strain but pain and swelling subside more slowly
E)
- Ankle, knee (ACL), elbow, wrist
What is used for differential diagnosis of sprains and strains
Fracture: Severe pain, immediate swelling, loss of function, marked deformity and abnormal mobility
Dislocation: Very obvious, joint appears defomed.
Displaced bone end often causes an abnormal lump or ridge or depression
How to diagnose and manage?
- Diagnosis based on physical signs and symptoms and MRI imaging if necessary
- Supportive management
- Important to allow damaged muscle, tendons and ligaments to heal to restore original tensile strength
When to refer?
- Suspected fracture
- Bone abnormalities
- Accompanying head injury
- Severe pain at rest
- Pain & wt bearing not better within 5-7 days
- Associated injury to skin (may require tetanus prophylaxis)
- Suspected arthritis or other diseases
