Musculoskeletal Diseases and Disorders Flashcards
What are the etiologies of lordosis?
excessive weight gain (obesity, tumor, pregnancy), excessive bone growth, osteoporosis -> spine posture compensates
What are the clinical features of lordosis?
S/S:
- exaggerated inward bend of lumbar spine
- asymptomatic or lower back pain
DIAGNOSTIC TESTS:
- visual examination reveals bend
- radiographic studies reveals extent of lordosis
What’s the treatment and prognosis of lordosis?
TREATMENT:
- encourage weight loss, ab exercises, corrective brace
PROGNOSIS:
- responds well to treatment
What are the etiologies of kyphosis?
developmental deformities, osteoporosis, ankylosing spondylitis -> excess curvature of thoracic spine
What are the clinical features of kyphosis?
S/S:
- exaggerated posterior thoracic curve, mild pain
DIAGNOSTIC TESTS
- deformity seen through visual examination and radiographic studies
What’s the treatment and prognosis of kyphosis?
TREATMENT:
- exercise, corrective brace
- possible spinal fusion
- (if osteoporosis) vertebroplasty
PROGNOSIS:
- may respond well to therapy
What are the etiologies of scoliosis?
possible genetic factors, osteoporosis, muscle degeneration -> sideways bend of spine
What are the clinical features of scoliosis?
S/S:
- lateral curve of spine
- back pain, fatigue
DIAGNOSTIC TESTS:
- visual examination and radiographic studies reveal extent of curvature
What’s the treatment and prognosis of scoliosis?
TREATMENT:
- physical exercises with corrective braces
- possible spinal fusion
PROGNOSIS:
- best with earliest diagnosis and treatment
What are the etiologies of osteoarthritis?
age-related degeneration and continuous friction of joints -> inflammation and loss of cartilage
What are the clinical features of osteoarthritis?
S/S:
- joint stiffness and aching, crepitation
- Herberden nodes (ostephytes at phalangeal distal joints)
DIAGNOSTIC TESTS:
- radiographic studies may reveal severity of degeneration
What’s the treatment and prognosis of osteoarthritis?
TREATMENT:
- physical therapy
- NSAIDs, corticosteroids, analgesics, muscle relaxants
PROGNOSIS:
- best with earliest diagnosis and treatment
What are the etiologies of Lyme disease
Borrelia burgdorferi bacterium transmitted via tick bite -> infection of internal organs?
What are the clinical features of Lyme disease/
S/S:
- characteristic bullseye rash, arthritis and flu-like symptoms
- neruologic conditions, paralysis, encephalitis, carditis
DIAGNOSTIC TESTS:
- blood tests positive for Lyme antibodies
What’s the treatment and prognosis of Lyme disease?
TREATMENT:
- doxycycline, antipyretics
- NSAIDs for arthritis
PROGNOSIS:
- best with earliest diagnosis and treatment, later stages may leave residual cardiac or neural damage
What are the etiologies of bursitis?
cumulative trauma, infection -> inflammation of bursae of synovial joint
What are the clinical features of bursiitis?
S/S:
- tenderness, pain with movement, limited ROM, edema
DIAGNOSTIC TESTS:
- radiography may reveal severity of bursitis and possible calcificaiton
- aspiration can rule out septic arthritis
Whats the treatment and prognosis of bursitis?
TREATMENT:
- NSAIDs, corticosteroid injections, exercises
- surgical excision of any calcifications
PROGNOSIS:
- excellent :DD with treatment
What are the etiologies of osteomyelitis?
(usually) staphylococcal aureus infects proximal humerus or tibia through direct wound or systemic infection -> subperiosteal abscess may form and fragment bone
What are the clinical features of osteomyelitis?
S/S:
- fever, malaise, sweating
- swelling, redness, and pain at site of infection
DIAGNOSTIC TESTS:
- aspiration may reveal pathogen
- radiography may reveal extent of infection
What’s the treatment and prognosis of osteomyelitis?
TREATMENT:
- long-term antibiotics
- possible surgical drainage and/or bone graft
PROGNOSIS:
- curable, but risk of long-term bone deformities
What are the etiologies of gout?
inherited uric acid cycle defects, kidney dysfunction, cytotoxic chemotherapy -> buildup of uric acid in joints
What are the clinical features of gout?
S/S:
- excruciating pain in synovial joints, slight fever, nausea, renal calculi
DIAGNOSTIC TESTS:
- aspiration reveals uric acid crystals
What’s the treatment and prognosis of gout?
TREATMENT:
- NSAIDs, corticosteroids, colchicine
- low-purine diet
PROGNOSIS:
- good with treatmment, risk of bone and joint damage without
What are the clinical featurs of Paget’s disease (or osteitis deformans)?
S/S:
- susceptibility to fractures, local bone pain that’s prominent at night, possible deafness
DIAGNOSTIC TESTS:
- blood tests show elevated alkaline phosphatase
- urinalysis reveals elevated hydroxyproline
What’s the treatment and prognosis of Paget’s disease (or osteitis deformans)?
TREATMENT:
- calcitonin, biphosphinate drugs
- high-vitamin D, high-calcium, high-protein diet
PROGNOSIS:
- generally good, especially if treated early
- slight risk of osteosarcoma
What’s the etiology of Marfan syndrome?
autosomal dominant gene on chromosome 15 -> defect of fibrillin protein
What are the clinical features of Marfan syndrome?
S/S:
- abnormally long extremities, subluxation of lens, hear and vascular anomalies, hyperextensible joints
DIAGNOSTIC TESTS:
- family history, presence of signs/symptoms may indicate syndomre
- echocardiogram may identify aortic abnormalities
What’s the treatment and prognosis of Marfan syndrome?
TREATMENT:
- growth hormone blockers
- possible aortic bypass graft surgery
- possible valve replacement
PROGNOSIS:
- heart and vascular defects carry high risk of complications
What are the etiologies of bone cancers?
- (if primary) growth spurts, being male, Pagets disease, or prior radiation/chemotherapy -> osteosarcoma, chondrosarcoma, or Ewing sarcoma
- (if secondary) Paget’s disease, prior radiation/chemotherapy, other cancers -> metastasis to bone
What are the clinical features of bone cancers?
S/S:
- asymptomatic OR localized pain, swelling, pathologic fractures
- (if Ewing) fever, fatigue, anemia
DIAGNOSTIC TESTS:
- radiographic (CT, MRI, PET, radionuclide scanning) studies reveal tumor
- “sunburst” if osteosarcoma, “onion-skin” if Ewing’s
- biopsy reveals type and histology
What’s the treatment and prognosis of bone cancers?
TREATMENT:
- surgical resection or amputation
- chemotherapy and/or radiation therapy
PROGNOSIS:
- poor if high-grade, large tumor size, and metastatic
What are the risk factors of muscle tumors?
being older than 50, prior radiation therapy, carcinogen exposure -> leiomyoma or rhabdomyoma (benign) or leiosarcoma or rhabdosarcoma (malignant, less common)
What are the etiologies of muscle tumors?
being older than 50, prior radiation therapy, carcinogen exposure -> leiomyoma or rhabdomyoma (benign) or leiosarcoma or rhabdosarcoma (malignant, less common)
What are the clinical features of muscle tumors?
S/S:
- asymptomatic OR present lump, erythema, pain
DIAGNOSTIC TESTS:
- preferably, MRI reveals tumor
- biopsy reveals histology
- radiographic studies reveal metastasis
What’s the treatment and prognosis of muscle tumors?
TREATMENT:
- surgical resection
- radiation and possible chemotherapy therapy (if sarcoma)
PROGNOSIS:
- poor if tumor is deep, large, and metastatic
What are the etiologies of osteoporosis?
dietary deficiencies, malabsorption, low estrogen, low testosterone, alcohol abuse, smoking, certain medications -> imbalance of osteogenesis to bone resorption
What are the clinical features of osteoporosis?
S/S:
- asymptomatic until fractures
- possible loss of height
DIAGNOSTIC TESTS:
- DEXA reveals porous bones
- blood serum tests urinalysis indicate excessive bone resorption
What’s the treatment and prognosis of osteoporosis?
TREATMENT:
- calcium supplements, phosphate supplements, and vitamin D supplements
- androgen replacement therapy
PROGNOSIS:
- varies with etiology, but usually responds well to appropriate treatments
What are the etiologies of osteomalacia (and rickets)?
dietary deficiency of vitamin D, malabsorption of vD, inadequate sunlight exposure -> improper mineralization and osteogenesis
What are the clinical features of osteomalacia (and rickets)?
S/S:
- fatigue, bone pain, loss of height, bowing of legs
- (if rickets) impacted growth
DIAGNOSTIC TESTS:
- blood tests reveal low calcium, alkaline phosphatase, and vitamin D levels
What’s the treatment and prognosis of osteomalacia?
TREATMENT:
- vitamin D, calcium, and calcitonin supplementation
PROGNOSIS
- depends greatly on early diagnosis and treatment
What are the etiologies of hallux valgus?
genetic factors, flat feet, improperly fitting shoes, rheumatoid arthritis -> enlargement of first metatarsophalangeal (MTP) joint
What are the clinical features of hallux valgus?
S/S:
- enlargement of first MTP joint, inflammation, pain
DIAGNOSTIC TESTS:
- signs/symptoms may be present, physical examination reveals inward bend
What’s the treatment and prognosis of hallux valgus?
TREATMENT:
- orthopedic interventions, NSAIDs. corticosteroids
- possible bunionectomy
PROGNOSIS:
- relieved by treatment
- risk of secondary toe deformities
What are the etiologies of hallux rigidus?
injury or osteoarthritis of MTP joint -> osteophytes restrict ROM
What are the clinical features of hallux rigidus?
S/S:
- pain, limiited ROM, swelling
DIAGNOSTIC TESTS:
- physical examincation reveals enlarged and tender 1st MTP joint
What’s the treatment and prognosis of hallux rigidus?
TREATMENT:
- orthopedic interventions, antiinflammatory drugs
- cheilectomy
- arthrodesis
PROGNOSIS:
- responds well to treatment
What are the etiologies of hammer toe?
congenital long second metatarsal bone, ill-fitting shoes, rheumatoid arthritis -> hyperextension of MTP joint and flexion of PIP joint
What are the clinical features of a hammer toe?
S/S:
- pain, inflammation, frequent abrasions, tyloma and helome formation
DIAGNOSTIC TESTS:
- signs/symptoms present and physical examination suggests hammer toe
What’s the treatment and prognosis of a hammer toe?
TREATMENT:
- (if early) orthopedic intervention sufficient
- possible arthroplasty or athrodesis
PROGNOSIS:
- usually responds very well to treatment
What are the types of fractures and their usual mechanism of injury?
- Colles: (fracture of distal radius) falling on hand of outstretched arm
- LeFort: (bilateral horizontal fracture of maxilla) usually from facial impact during MVA
- Pott: (fracture of distal fibula) usually from rolling ankle during fall
What are the clinical features of a fracture?
S/S:
- pain, edema, discoloration, loss of function
DIAGNOSTIC TESTS:
- radionuclide bone scan or MRI may help define fracture
What’s the treatment and prognosis of a fracture?
TREATMENT:
- (if simple) reduction and immobilization, possible internal fixation
- (if compound) debridement, reduction, immobilization, and internal fixation
PROGNOSIS:
- varies with affected bone and extent of injury
- risk of stunted growth if child
What are the etiologies of strains and sprains?
acute trauma or cumulative trauma -> overstretching of tendon or muscle (strain) or tear of ligament (sprain)
What are the clinical features of strains and sprains?
S/S:
- pain, warmth, discoloration, edema, loss of function
DIAGNOSTIC TESTS:
- physical examination indicated sprain or strain
- radiographic studies rule out fracture
What’s the treatment and prognosis of a strain or sprain
TREATMENT:
- RICE (rest, icepacks, compression, elevation)
- possible analgesics or antiinflammatory drugs
PROGNOSIS:
- best with rehabilitative program, may heal within 2-4 weeks
What are the etiologies of a dislocation?
trauma tears joint ligaments, congenital weakness -> displacement of bone from joint
What are the clinical features of a dislocation?
S/S:
- pain, edema, ecchymosis, loss of function
DIAGNOSTIC TESTS:
- physical examination indicates dislocation
- radiographic studies may define dislocation and identify possible fractures
What’s the treatment and prognosis of a dislocation?
TREATMENT:
- reduction and possible surgical intervention
PROGNOSIS:
- depends on exent of tissue damage, may increase risk of future osteoarthritis
What are the etiologies of adhesive capsulitis?
bursitis, tendinitis, inflammatory conditions -> secondary scarring of shoulder joint capsule
What are the clinical features of adhesive capsulitis?
S/S:
- pain and stiffness of shouler
DIAGNOSTIC TESTS:
- signs/symptoms indicate adhesive capsulitis
What’s the treatment and prognosis of adhesive capsulitis?
TREATMENT:
- ROM exercisies, analgesics, antiinflammatory agents
PROGNOSIS:
- best with early detection and treatment, usually self-limiting
What are the clinical features of a severed tendon?
S/S:
- severe pain, ecchymosis, edema, loss of function
DIAGNOSTIC TESTS:
- physical examination indicates severed tendon
What’s the treatment and prognosis of a severed tendon?
TREATMENT:
- tenorrhaphy, physical rehabilitaiton
PROGNOSIS:
- varies with extent of injury and tendon affected
- risk of secondary infection
What are the etiologies of shin splints?
cumulative trauma and overpronation -> excessive stress on tendons, muslces, and ligaments of lower leg
What are the clinical features of shin splints?
S/S:
- pain, edema, and warmth of inner tibia
DIAGNOSTIC TESTS:
- physical examination indicates shin splints
What’s the treatment and prognosis of shin splints?
TREATMENT:
- rest, cold and/or heat application, compression, and elevation
- orthopedic interventions, physical therapy, possible analgesics and antinflammitary agents
PROGNOSIS:
- good with proper rest and recovery
- complication of stress fracture if neglected
What are the etiologies of plantar fasciitis (or a calcaneal spur)?
cumulative trauma, flat feet, family history -> inflammation of plantar fascia -> development of cancaneal spur
What are the clinical features of plantar fasciitis (or a calcaneal spur)?
S/S:
- dull-sharp pain, prominent during first waking steps
DIAGNOSTIC TESTS:
- physical examination indicated plantar fasciitis
- radiographic studies may confirm calcaneal spur
What’s the treatment and prognosis of plantar fasciitis (or a calcaneal spur)?
TREATMENT:
- rest. ice application, analgesics or antiinflammatory drugs
- orthotics and physical rehabilitation
PROGNOSIS:
- usually responds great to conservative management
What are the etiologies of a ganglion?
repetitive minor injuries -> cyst forms around joint capsule
What are the clinical features of a ganglion?
S/S:
- small soft or firm cyst, painless or painful with movement
DIAGNOSTIC TESTS:
- apparent with palpation
What’s the treatment and prognosis of a ganglion?
TREATMENT:
- possible aspiration or ganglionectomy
PROGNOSIS:
- usually do not require treatment
What’s the usual mechanism of injury of a torn meniscus?
suddent rotation of leg during knee flexion -> tearing of semilunar knee cartilage (usually medial meniscus) with possible ACL or PCL tear
What are the clinical featurs of a torn meniscus?
S/S:
- sharp pain, crepitations, limited ROM
DIAGNOSTIC TESTS:
- preferably, MRI confirms and defines meniscus tear
What’s the treatment and prognosis of a torn meniscus?
TREATMENT:
- RICE, analgesic or antiinflammatory drugs, physical rehabilitation
- possible arthroscopic surgery or meniscectomy
What are the etiologies of a rotator cuff tear?
degenerative changes, cumulative trauma, cortisone injections -> tears in supraspinatus, infraspinatus, subcapularis, or teres minor tendon
What are the clinical features of a rotator cuff tear?
S/S:
- snapping noise, pain, limited ROM (varies with affected tendons)
DIAGNOSITC TESTS:
- MRI or arthrogram reveals torn rotator cuff
What’s the treatment and prognosis of a rotator cuff tear?
TREATMENT:
- RICE, analgesics and antiinflammatory drugs, possible surgical intervention
- physical rehabilitiation
PROGNOSIS:
- minor tears respond well to conservative treatment, major tears may require surgery
What are the etiologies of rheumatoid arthritis?
unclear, possible genetic factors, triggered by infection -> autoimmune inflammation of synovial membranes
What are the clinical features of rheumatoid arthritis?
S/S:
- persistent fever, malaise, joint stiffness, joint pain, erythema, and edema
DIAGNOSTIC TESTS:
- elevated rheumatoid factor found through blood tests
What’s the treatment and prognosis of rheumatoid arthritis?
TREATMENT:
- antiinflammatory drugs
- disease-modifying antirheumatic drugs (DMARDs)
PROGNOSIS:
- severe joint damage may occur without early diagnosis and aggressive treatment
What are some suspected etiologies of juvenile rheumatoid arthritis (or JRA)?
hereditary factors, being female -> autoimmune activity of joints beginning in early childhood
What are the clinical features of juvenile rheumatoid arthritis?
S/S:
- fever, fatigue, malaise, anorexia, systemic rash, possible stunted growth
- (if pauciarticular) pain, edema, and erythema of <5 joints
- (if polyarticular) pain, edema, and erythema of >5 joints
DIAGNOSTIC TESTS:
- eleveated rheumatoid factor found through blood tests
What’s the treatment and prognosis of juvenile rheumatoid arthritis?
TREATMENT:
- antiinflammatory drugs, disease-modifiable antirheumatic drugs (DMARDs)
PROGNOSIS:
- children may grow up to lead normal lives with early diagnosis and aggressive treatment
What’s the suspected etiology of ankylosing spondylitis?
inheritance of human leukocyte antigen (HLA)-B27, along with other genes -> inflammation and progressive ossification of spine
What are the clinical features of ankylosing spondylitis?
S/S:
- fever, fatigue, malaise, back pain and stiffness, eventual kyphosis
DIAGNOSTIC TESTS:
- no rheumatoid factor but elevated inflammatory markers found through blood tests
What’s the treatment and prognosis of ankylosing spondylitis?
TREATMENT:
- exercises, antiinflammatory drugs
PROGNOSIS:
- episodic in nature, complications may include deformities and systemic changes
What’s the etiology of Duchenne’s muscular dystrophy (or DMD)?
X-linked recessive genes -> defective dystrophin protein -> defective myocyte cytoskeleton
What are the clinical features of Duchenne’s muscular dystrophy?
S/S:
- (early onset) muscular atrophy, spinal deformities, recurrent sinopulmonary infections, contractures
DIAGNOSTIC TESTS:
- DMD indicated through EMG and muscle biopsy
- elevated creatine found through blood tests
What’s the treatment and prognosis of Duchenne’s muscular dystrophy (or DMD)?
TREATMENT:
- corticosteroids, physical therapy
PROGNOSIS:
- death may occur 10 to 15 years after onset
What’s the suspected cause of polymyositis?
autoimmune activity -> WBCs target muscle cells
What are the clinical features of polymyositis?
S/S:
- weakness of muscles near trunk, dermatomyositis
DIAGNOSTIC TESTS:
- elevated creatine found through blood tests
- polyomyositis indicated through EMG and muscle biopsy
What’s the treatment and prognosis of polymyositis?
TREATMENT:
- corticosteroids, immunosuppressive drugs, exercise
PROGNOSIS:
- episodic in nature, but a good outlook is seen with early treatment
What are some physiologic features of myasthenia gravis?
thymus hyperplasia, autoantibodies against acetylcholine receptors -> faulty neuromuscular juntion
What are the clinical features of myasthenia gravis?
S/S:
- (exacerbated by stress, sunlight, cold, and infections) muscular weakness restored by rest, eventual paralysis
DIAGNOSTIC TESTS:
- muscle function improved by Tensilon test
- acetylcholine antibodies found through blood tests
What’s the treatment and prognosis of myasthenia gravis?
TREATMENT:
- pyriodstigmine bromide, corticosteroids, immunosuppressive drugs
- thymectomy
PROGNOSIS:
- episodic in nature, risk of myasthenic crisis
