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Boards: Other Systems > Musculoskeletal disorders > Flashcards

Musculoskeletal disorders Flashcards

1
Q

DJD Description

A

Degeneration of articular cartilage with hypertrophy of subchondral bone and joint capsule of WB joints
• Decreased joint space
• Decreased height of articular cartilage
• Presence of osteophytes

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2
Q

DJD Treatment

A

Corticosteriods
NSAIDS
Glucocorticoids (injected)

Common Intervention

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3
Q

DJD Dx

A 
Plane images
Lab tests (rule out RA)
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4
Q

Ankylosing Spondylitis: Description

A

Progressive inflammatory disorder of unkown etiology that intially affects axial skeleton.
Initial onset (mid-LBP approx 3 months) before 40
• Mid and low back pain
• Morning stiffness
• Sacroiliitis
Results in kyphotic deformity or cervical and thoracic spine with flattening of lumbar
Affects men 3x >women

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5
Q

Ankylosing Spondylitis: Tx

A 
NSAIDs
Corticosteroids
Cytotoxic drugs
Tumor Necrosis Inhibitors
Common intervention
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6
Q

Ankylosing Spondylitis: Dx

A

HLA-B27 antigen

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7
Q

Gout: Description

A

Genetic disorder of purine metabolism, characterized by elevated serum uric acis levels; which may form crystals and deposit into peripheral joints etc
Most frequently at the knee and great toe

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8
Q

Gout: Tx

A 
NSAIDs 
Cox II inhibitors 
Colchicine
Corticosteriods
Adrenoacorticotropic hormone ACTH
Allopurinol
Probenecid
Sulfinpyrazone

Patient education
Early identification

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9
Q

Gout: Dx

A

Lab tests to identify monosodium urate cyrstals in synovial fluid and/or connective tissue samples

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10
Q

Psoariatic Arthritis: Description

A

Chronic erosive inflammatory disorder of unknown etiology associated with psoriasis
Erosive degeneration usually occurs in joints of digits and axial skeleton
Male = Female

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11
Q

Psoariatic Arthritis: Tx

A 
Acetominophen
NSAIDs 
Anti rheumatics (DMARDs)
Biological response modifiers (BRMs)
(Enbrel)
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12
Q

Psoariatic Arthritis: Dx

A

Rule out RA

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13
Q

Rheumatoid Arthritis: Description

A

Chronic systemic disorder of unknown etiology involving a symmetrical pattern of dysfunction of synovial tissues and articular cartilage of joints in hands, wrists, elbows, shoulders, knees, ankles and feet
MCP = pannus, ulnar drift, volar sublux
PIP = swan neck, bouteniere, bouchards nodes
Women 2-3x > men
Juvenile RA onset before 16 with complete remission in 75% of children

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14
Q

Rheumatoid Arthritis: Tx

A 
Gold compounds
Antirheumatics
NSAIDs
Immunosuppressive agents
Corticosteroids
Common Intervention
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15
Q

Rheumatoid Arthritis: Dx

A

Plain films (symetrical)
High white blood cell count and erythrocyte sedimentation rate
Elevated hemoglobin and hematocrit levels

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16
Q

Osteoporosis: Description

A

Metabolic disease that depletes bone mineral density/mass, predisposing individual to fracture.
Affects women 10x > than men
Common fracture sites include: lumbar, femoral neck, proximal humerus, proximal tibia, pelvis and distal radius
*primary or post-menopausal osteoporosis is directly related to decrease in estrogen production
*senile osteoporosis occurs from a decrease in bone activity

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17
Q

Osteoporosis: Tx

A 
Calcium
Vitamin D
Estrogen
Calcitonin
Biophosphonates
Common intervention
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18
Q

Osteoporosis: Dx

A

CT scan

Single/Dual photon absorptiometry

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19
Q

Osteomalacia: Description

A 
Characterized by decalcification of bones due to vitamin D deficiency
Symptoms:
	• Severe pain
	• Fractures
	• Weakness
	• Deformities
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20
Q

Osteomalacia: Tx

A

Calcium
Vitamin D
Calciferol (VD injections)
common intervention

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21
Q

Osteomalacia: Dx

A

Plain films
Lab tests
Bone scan
Bone biopsy

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22
Q

Osteomyelitis: Description

A

An inflammatory response within bone caused by an infection (usually staphylococcus aureus)
More common in children and immunosuppressed adults, males > females

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23
Q

Osteomyelitis: Tx

A

Antibiotics
Nutrition

Surgery (if needed)

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24
Q

Osteomyelitis: Dx

A

Lab tets

Bone biopsy

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25
Q

Osteogenesis Imperfecta: Description

A

Inferited disorder transmitted by an autosomal dominant gene
Characterized by abnormal collagen synthesis, leading to an imbalance between bone deposition and reabsorption.
Cortical and cancellous bones become very thin, leading to fx/deformity of WB bones

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26
Q

Osteogenesis Imperfecta: Tx

A 
Calcium
Vitamin D
Estrogen
Calcitonin
Biophosphonates
Common Intervention
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27
Q

Osteogenesis Imperfecta: Dx

A

Bone scan
Plain films
Serological testing

28
Q

Osteochondritis Dissecans: Description

A

A separation of articular cartilage from underlying bone (osteochondral fracture), usually involving medial femoral condyle near intracondylar notch

29
Q

Osteochondritis Dissecans: Tx

A

Surgical intervention is req’d if fx is displaced

Common intervention - strength

30
Q

Osteochondritis Dissecans: Dx

A

Plain film

CT scan

31
Q

Myofascial Pain Syndrome: Description

A

Characterized by clinical entity known as a “trigger point” or palpable band of muscle
Trigger points may be active or latent

32
Q

Myofascial Pain Syndrome: Tx

A

Dry needling
Injected analgesic
Corticosteriod
Flexibility Manual therapy Strength,

33
Q

Myofascial Pain Syndrome: Dx

A

Clinical Assessment

34
Q

Tendonosis or Tendonopathy: Description

A 
Tendon dysfunction whose cause and pathogenesis is still not understood
Includes:
	• Hypercellular 
	• Hypervascularity
	• No indication of inflammation
	• Poor organization

Loosening of collagen fibrils

35
Q

Tendonosis or Tendonopathy: Tx

A 
Acetominophen
NSAIDs
Steriod injection
Common Intervention
Manual Therapy
Thermal agents
Patient education/training
36
Q

Tendonosis or Tendonopathy: Dx

A

MRI

37
Q

Bursitis: Description

A

Inflammation of bursa secondary to overuse, trauma, gout or infection
Symptoms:
• Pain with rest
• PROM and AROM are limited due to pain but not in a capsular pattern

38
Q

Bursitis: Tx

A 
Acetominophen
NSAIDs
Steriod injection
Common Intervention
Manual Therapy
Thermal agents
Patient ed
39
Q

Bursitis: Dx

A

Clinical Exam

40
Q

Myositis Ossificans: Description

A

Painful condition of abnormal calcification within a muscle belly
Usually precipitated by direct trauma that results in hematoma and calcification of the muscle
Common locations include: quads, bicep and brachialis
Can be induced by aggressive physical therapy following trauma

41
Q

Myositis Ossificans: Tx

A 
Acetominophen
NSAIDs
Surgical care is warranted only in patients with nonhereditary MO and only after maturation of the lesion(6-24 mo)
Flexibility
Manual therapy

Aerobic activity

42
Q

Myositis Ossificans: Dx

A

Plain films
CT scan
MRI

43
Q

Complex Regional Pain Syndrome: Description

A

Etiology largely unknown
Results in dysfunction of sympathetic nervous system to include pain, circulation and vasomotor disturbances
Type I: triggered by tissue injury
Type II: clearly associated with nerve injury
Long term changes include muscle wasting, trophic skin changes, decreased bone density, decreased proprioception, loss of strength from disuse and contractures

44
Q

Complex Regional Pain Syndrome: Tx

A 
Sympathetic nerve block
Surgical sympathectomy
SC stimulation
Intrathecal drug pumps
Topical analgesics
Antiseizure drugs
Anti-depressants
Corticosteriods
Opiods
Patient education
Desensitization activity
Flexibility program
TENs for p! relief
45
Q

Complex Regional Pain Syndrome: Dx

A

none

46
Q

Paget’s Disease: Description

A

Etiology largely unknown
Thought to be link to viral/environment
Metabolic bone disease involving abnormal osteoclastic and osteoblastic activity
Results in spinal stenosis, facet arthopathy and possible spinal fracture

47
Q

Paget’s Disease: Tx

A

Drug therapy for p! control

Maybe calcitonin and etidronate disodium since they limit osteoclast activity
Common Intervention

48
Q

Paget’s Disease: Dx

A 
Plain imaging 
Lab tests (alkaline phosphatase and urinary hydroxyproline)
49
Q

Idiopathic Scoliosis: Description

A

Structural: an irreversible lateral curvature of spine with rotational component
Nonstructural: reversible lateral curvature of spine without rotation and straightening as individuals flex

50
Q

Idiopathic Scoliosis: Tx

A 
Bracing
Possible surgery
Placement of harrington rod 
For 45 spinal surgery 
Flexibility
Strength
E-stim

Patient education

51
Q

Idiopathic Scoliosis: Dx

A

Cobb’s Method

CT/MRI to rule out associated conditions

52
Q

Torticollis: Description

A

Spasm or tightness of SCM with varied etiology

Dysfunction observed is side-bend toward and rotate away from affects SCM

53
Q

Torticollis: Tx

A 
Acetominophen
Muscle relaxers
NSAIDs
Flexibility 
Manual Therapy
54
Q

Torticollis: Dx

A

Clinical Assessment

55
Q

Slipped Femoral Epiphysis: Description

A 
Most common hip disorder in children and largely unknown etiology
Males: 10-17 (13)
Females: 8-15 (11) 
Males 2x > females
AROM restricted in ABD, Flex, IR 
Vague knee, thigh, and hip pain 
Trendelenburg sign w/ chronic
56
Q

Slipped Femoral Epiphysis: Tx

A

Acetominophen
NSAIDs
possible surgery

57
Q

Slipped Femoral Epiphysis: Dx

A

Plain films

58
Q

Legg-Calve-Perthes Dx: Description

A

Onset between 2-13 years avg = 6
Occurs 4x more in males
Characteristics
Psoatic limp due to weakness
Affected LE moves in ER, flex, adduction
Gradual onset of aching p! in hip, thigh and knee
AROM limited in ABD and EXT

59
Q

Legg-Calve-Perthes Dx: Tx

A

Acetominophen

NSAIDs for p!/inflam
Common intervention, possible surgery

60
Q

Legg-Calve-Perthes Dx: Dx

A

MRI = (+) bony crescent sign (collapse of subchondral bone at femoral neck Common intervention, possible surgery

61
Q

Arthrogryposis Multiplex Congentia: Description

A

Nonprogressive, non genetic
Congential deformity of skeleton and soft tissues, characterized by limitation in joint motion and a “sausage like” appearance of limbs
Normal development of intelligence

62
Q

Arthrogryposis Multiplex Congentia: Tx

A

Ongoing communication required
Common intervention
AD/Orthosis
Flexibility

63
Q

Arthrogryposis Multiplex Congentia: Dx

A

Plain Films

64
Q

Osgood-Schlatter Dx: Description

A

Mechanical dysfunction resulting in traction apophysitis of tibial tubercle at the patellar tendon insertion

65
Q

Osgood-Schlatter Dx: Tx

A

Early flexibility
Acetominophen
NSAIDs
Modify activities to prevent excess stress

66
Q

Osgood-Schlatter Dx: Dx

A

Plan films indicate irregularities of epiphyseal line

Clinical exam

Boards: Other Systems (10 decks)

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