Pathology Flashcards
Achilles Tendonitis-Overview
- repetitive overs druse disorder
- most often impacted in an avascular zone 2-6cm above tendon insertion
Achilles Tendonitis-at risk individuals
- limited flexibility/strength in Gastroc/soleus complex
- pronated or caves foot
Achilles Tendonitis-sx and symptoms
- aching or burning or posterior heel
- swelling and thickening in tendon area
- morning stiffness
Achilles Tendonitis-tx
- initial RICE
- NSAIDs
- analgesics
Adhesive Capsulitis-overview
- loss of ROM in active/passive shoulder motion 2* soft tissue contracture
- caused by adhesive fibrosis and scarring between the capsule, rotator cuff, subacromial bursa and deltoid
Adhesive Capsulitis-symptoms
- night pain
- capsular pattern restricted motion
- insidious onset
ACL Sprain- overview
- ligament prevents anterior translation of the tibia in relation to the femur
- etiology: non-contact twisting injury with s or valgus stress
ACL Sprain-signs and symptoms
-report loud pop or knee “giving way” or buckling followed by dizziness, sweating and swelling
ACL Sprain- tx
- RICE
- NSAIDs
- conservative tx
- surgery (for a complete grade III tear)
Congenital Hip Dysplasia-overview
-malalignment of the femoral head within the acetabulum (develops in the last trimester in utero)
Congenital Hip Dysplasia-presentation
-asymmetrical hip abduction with tightness and apparent femoral shortening of the involved side
Congenital Hip Dysplasia-tx
- 1st: harness, splinting, bracing, traction
- open reduction with subsequent application of a hip spica cast (if conservative tx fails)
Congenital Limb Deficiencies-etiology
- idiopathic or genetic in origin
- could also be due to poor blood supply, constricting amniotic bands, infection, maternal drug exposure
Congenital Limb Deficiencies- symptoms
- structural or acquired abnormality of limb
- phantom limb pain
Congenital Limb Deficiencies- tx
-focus on symmetrical movements, strengthening, ROM, WBing activities, prosthetic training when appropriate
Congenital Torticollis-etiology
Unknown, malpositioning in utero, birth trauma
Congenital Torticollis-clinical presentation
- lateral cervical flexion to SAME side as contracture
- rotation toward the OPPOSITE side
- facial asymmetries
Congenital Torticollis-tx
- conservative: stretching, AROM, positioning, education
- surgery if kid >1 yo, when conservative tx failed
Glenohumeral Instability-etiology
-combination of forces causing humeral to move anteriorly (anterior dislocation is most common and associated with abduction/ER)
Glenohumeral Instability-signs and symptoms
- subluxation:popping in/out, pain, numbness/tingling, positive apprehension test
- dislocation: severe pain, paresthesias, decrease ROM, weakness
Glenohumeral Instability-tx
- initially immobilization with sling 3-6 weeks
- RICE, NSAIDs
- progress to ROM, isometric strengthening, progressive resisted exercises (emphasis on IR/ER)
Impingement Syndrome-etiology
caused by the humeral head and rotator cuff attachments migrate proximally and become impinged under acromion and the coracoacromial ligament
Impingement Syndrome- signs and symptoms
- deep pain
- painful arc (70-120*) abduction
- (+) impingement sign
- tenderness over greater tuberosity and bicipital groove
Impingement Syndrome- tx
- initially: RICE, NSAIDs
- RTC strengthening, scap stab
- continue prevention and alter activities
Juvenile Rheumatoid Arthritis-etiology
- unknown
- theories include-> virus, infection, or trauma may trigger an autoimmune response
Juvenile Rheumatoid Arthritis- signs/symptoms (systemic JRA)
- 10-20% cases
- acute onset, high fevers, rash, enlargement of the spleen and liver, inflammation of the lungs and heart
Juvenile Rheumatoid Arthritis- signs/symptoms (polyarticular JRA)
- 30-40% of cases
- high female incidence
- significant RF and arthritis in >4 joints symmetrically
Juvenile Rheumatoid Arthritis- signs/symptoms (oligoarticular JRA)
- 40-60% of cases
- affects <5 joints asymmetrically
Juvenile Rheumatoid Arthritis- tx
- meds to manage pain/inflammation
- PT: A/PROM, positioning, splinting, strengthening, endurance, WBing activities, postural training, functional mobility
Lateral Epicondylitis-etiology
-eccentri loading of wrist extensors (usually extensor capri radialis brevis) resulting in microtraumas
Lateral Epicondylitis-signs/symptoms
- pain immediately anterior or distal to the lateral epicondyle of the humerus
- pain worsens with repetition and resisted wrist extension
Lateral Epicondylitis-tx
- initially RICE, NSAIDs, activity modifications
- PT: improve strength, flexibility, endurance of wrist extensors
Legg-Calve-Perthes Disease-etiology
-trauma, genetic predisposition, synovitis, vascular abnormalities, infection
Legg-Calve-Perthes Disease- overview
- characterized by degeneration of the femoral head due to a disturbance in the blood supply (avascular necrosis)
- pain, decreased ROM, antalgic gait, Trendelenburg gait
Legg-Calve-Perthes Disease-sign/symptoms
-pain, decreased ROM, antalgic gait, Trendelenburg gait
Legg-Calve-Perthes Disease-tx
- vary, main focus is on pain
- orthotics or surgery may be indicated based on severity
Medial Collateral Ligament Sprain-complete
- etiology: fixed foot associated with valgus force
- knee pain, swelling, antalgic gait, decreased ROM
- strengthening gradually progressing (surgery is rarely required due to being highly vascularized)
Meniscus Tear-complete
- medial meniscus is more commonly injured
- fixed foot rotation while WBing on flexed knee
- conservative tx and surgery ranging from partial meniscectomy to repair
Osgood-Schlatter Disease-complete
- repetitive traction on the tibial tuberosity apophysis (patellar tendon)
- can result in a small avulsion
- point tenderness
- tx: conservative, icing, eliminating exercises
Osteogenesis Imperfecta-overview
-connective tissue disorder that affects the formation of collagen during bone formation/development
Osteogenesis Imperfecta-etiology
- genetic inheritance: type I/IV
- autosomal dominant: type II/III
Osteogenesis Imperfecta-sx/tx
- pathological fx, osteoporosis, hypermobile, bowing of long bones, weakness, scoliosis, impaired respiratory function
- tx: begins at birth, emphasize symmetrical movements, fx management, use orthotics if necessary
Osteogenesis Imperfect Types
most severe to least II III IV I
Plantar Fascitis-overview
- inflammation of the plantar fascia of the proximal insertion on the medial tubercle of the calcaneus
- excessive tension over time creates chronic inflammation and microtears
Posterior Cruciate Ligament Sprain
- most common causes of this injury is landing on the tibia with a flexed knee or hitting a dashboard in MVA with flexed knee
- swelling, mild pain, typically asymptomatic
- conservative tx, or surgery (isolated hamstrings avoided for min 6 weeks if surgery)
Scoliosis
- a spinal orthosis is often warranted with a curve 25-40*
- surgical intervention may be required with curves >40*
Talipes Equinovarus
- “clubfoot”: heel pointing downward and the forefoot turning inward
- unknown etiology
- adduction of forefoot, varus hindfoot, equinus at the ankle
- tx:splinting, serial casting (failed may result in surgery)
