non-articular rheumatism

Question 1

first sign of torticollis

Answer 1

firm, palpable, enlargement of SCM

Question 2

typical position of torticollis

Answer 2

lateral head tilt to same side and rotation to opposite side

Question 3

treatment of torticollis

Answer 3

passive ROM

positioning

cervical collar/tubular orthosis

resolved w/in 3-12 months with conservative treatment

Question 4

bursitis

Answer 4

acute infection affecting the bursae

olecranon and prepatellar are common sites

cellulitis sometimes present on the olecranon

Question 5

tendonitis

Answer 5

acute infection affecting the tendon

finger maintained in slight flexion (fusiform swelling)

Question 6

similarities b/w bursitis and tendonitis

Answer 6

Bursae and tendons close to the skin are more susceptible

Staphylococcus aureus cause ~80% of cases

Infection of hand can spread through synovial sheath, fascial planes,
lymphatic channels

Diagnosis: aspiration of fluid and lab tests

Treatment: antibiotics, surgical incisions/drainage
Non-infectious types treatment: ROM, splinting, orthotics, rest, body mechanics/postural support

Question 7

fibromyalgia

Answer 7

“migraine headache of muscles”

Chronic muscle pain syndrome, defined as pain that is widespread at TENDER POINTS

Abnormal pain modulation with hypersensitivity to painful stimuli and reduced pain inhibition

Neurohormonal dysfunction of the ANS (overactive sympathetic branch)
90% of cases are women (childbearing years)

Strong correlation exists between fibromyalgia and anxiety or depression

GLIA: may be key driving force for the pain created by tissue inflammation and nerve injury because they can increase the release of pain transmitters and cytokines involved in chronic pain

Question 8

diagnostic criteria for fibromyalgia

Answer 8

Four-quadrant pain above and below waist for 3 months

Pain upon pressure to 11 of the 18 common FMS tender points

Question 9

duperntren’s contracture

Answer 9

Idiopathic and reoccurring

Men affected more than women

Small painless lump develops on palm and thickens until cord-like (RING
FINGER MOST AFFECTED)

Difficult to extend finger therefore fasciotomy is sometimes necessary

Collagenases to weaken collagen deposits

Question 10

plantar fasciitis

Answer 10

Inflammation of fascia of foot

Men affected more than females

Exquisite morning pain and stiffness after sleep/inactivity

Risk factors: extremely low/high arches, flip flop, high heels, tight Achilles, sudden weight gain

Treatment: stretching, orthotics, ice, taping night splints, boot

Question 11

PT intervention fibromyalgia

Answer 11

relaxation techniques

soft tissue work

ergonomic instruction

conditioning exercise

rest

Question 12

tendonitis & bursitis pt intervention

Answer 12

rest

splint

rom

exercises

body mechanics