Orthopedics/Rheumatology Flashcards by Viviana Castaneda

s/s of acute low back pain

-aching
-radiating
-worse with movement
-improvement with position change

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diagnosis of acute low back pain

-typically order xray but mostly clinical

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management of acute low back pain

-reassurance
-symptom control

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indications for referral of acute low back pain

-neuro dysfunction
-unable to return to work after 4 weeks

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chronic low back pain

> 12 weeks

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s/s of chronic low back pain

-aching
-radiating
-worsened with movement

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diagnosis of chronic low back pain

-xray

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treatment of chronic low back pain

-pain management

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etiology of bursitis

trauma

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s/s of bursitis

-swelling of the area
-pain, tenderness, limited ROM

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indications for aspiration of bursa

-inflamed and red and warm
-significant swelling

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management of bursitis

-activity modification and NSAIDs
-cold compress
-compression bandages

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treatment of septic bursitis

-mild: bactrim
-severe: IV vanc

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etiology of tendonitis

repetitive overuse

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s/s of tendonitis

-aching and soreness with activity
-pain with ADLs
-loss of ROM
-tenderness on palpation

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treatment of tendonitis

-rest
-Ice and NSAIDs
-physical therapy

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etiology of costochondritis

-trauma
-infection

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s/s of costochondritis

-pain and tenderness
-pain when taking a deep breath or coughing

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treatment of costochondritis

NSAIDs
rest
reassurance

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fibromyalgia

widespread musculoskeletal pain with multiple tender points but no clear objective findings

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s/s of fibromyalgia

-chronic fatigue and generalized aching pain
-worsens with exertion
-normal exam
-associated psych conditions
-at least 3 months

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diagnosis of fibromyalgia

diagnosis of exclusion

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treatment of fibromyalgia

-aerobic activity/Pt education/CBT
-amytriptyline
-cymbalta
-cyclobenzaprine

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cause of ganglion cyst

fluid filled swelling over a joint or tendon sheath

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s/s of ganglion cyst

-firm, smooth, and rubbery -**transilluminates**

management of ganglion cyst

-observation -aspiration -surgical removal

etiology of gout

increased uric acid

s/s of gout

-**pain and inflammation of joint** -redness and tenderness -**MC on great toe**

dx of gout

**negatively** birefringent needle shaped crystals

pseudogout

**Positively** birefringent **rhomboid-shaped** crystals

tx of gout

-low purine diet -NSAIDs -Colchicine

etiology of osteoarthritis

-mechanical stress

s/s of osteoarthritis

pain, stiffness, enlargement, tenderness, limited range of motion, and deformity **`(<30 min, asymmetrical)`**

diagnosis of osteoarthritis

xray

treatment of osteoarthritis

-tylenol -NSAIDs -joint injection -joint replacement

etiology of osteoporosis

-medications -hormones -old age -malnutrition

s/s of osteoporosis

-pathologic fracture -loss of vertebral height -back pain

pathologic fractures

-compression fracture of **vertebrae** -**hip fracture** -**distal radius fracture**

dx of osteoporosis

T score <-2.5

normal T score

T>-1.0

tx of osteoporosis

-lifestyle modifications -vitamin D -bisphosphonates (-dronate)

overuse syndrome

injury caused by accumulated microtraumatic stress placed on a structure or body area

treatment of overuse syndrome

-reassurance -NSAIDs -rest

MCC of heel pain

plantar fasciitis

s/s of plantar fasciitis

-**heel pain** when walking -**most severe first thing in morning** -tenderness along plantar fascia

treatment of plantar fasciitis

-OTC orthotic heel pad -home stretching program -NSAIDs

s/s of reactive arthritis

-arthritis -**urethritis** -conjunctivitis -**uveitis** -mouth ulcers

diagnosis of reactive arthritis

**HLA-B27 positive, negative synovial fluid culture**

treatment of reactive arthritis

-NSAIDs -anti-TNF

s/s of rheumatoid arthritis

-**symmetrical swelling** of multiple joints -**stiffness for first 30+ minutes** in morning and after inactivity -hand deformities -rheumatoid nodules

diagnosis of RA

-**anti-CCP** and RF

treatment of RA

-methotrexate

sprain vs strain

-sprain: ligament -strain: muscle

s/s of sprains/strains

-swelling -tenderness -pain -bruising

grading of muscle strains

-1: **few fibers torn**, fascia intact -2: **moderate** amount of fibers torn, fascia intact -3: **all or most of fibers torn**, *fascia intact* -4: tear of all fibers, **fascia torn**

grading of ligament sprains

-1: few fibers torn -2: partial tear of ligament -3: complete tear of ligament

treatment of strains and sprains

-RICE -work on ROM after a couple days

s/s of SLE

-low grade fever -joint pain -**butterfly rash**

diagnosis of SLE | This is from UTD dont come for me...i feel like you'd see it

**SLICC criteria:** either that a patient satisfy at least **4 of 17 criteria**, including **at least 1 of the 11 clinical criteria** and **one of the six immunologic criteria,** or that the patient has biopsy-proven nephritis compatible with SLE in the presence of antinuclear antibodies (ANA) or anti-double-stranded DNA (anti-dsDNA) antibodies. **EULAR/ACR** criteria: a patient can be classified as having SLE if they have a **positive ANA ≥1:80** and **score 10 or more points** -anti-smith -ANA | -anti-dsDNA

treatment of lupus

-hydroxychloroquine