Pathology III Flashcards
What is happening with Osgood-Schlatter disease?
Traction apophysitis occuring at the tibial tuberosity
What is apophysitis?
Inflammation or stress injury to the areas on or around growth plates in children and adolescents.
How could you reproduce symptoms with Osgood-Schlatter disease?
Resist knee extension
What can exacerbate pain with osteoarthritis?
prolonged activity and use
What are Heberden’s and Bouchard’s nodes?
Heberden’s: osteophytes in the DIP joints
Bouchard’s: osteophytes in the PIP joints
–> B is before H in the alphabet,
Usually seen in women but not men with OA
What happens as a result of the loss of cartilage in OA?
There is a loss of joint space and reactive new bone forms in the margins and subchondral areas of the joint
What is Osteochondritis Dissecans?
When subchondral BONE and its associated cartilage crack and separate from the end of the bone
–> in severe cases it may float freely in the joint
What are symptoms of Osteochondritis Dissecans? (5)
What joint is most commonly affected?
- pain with functional activity
- joint popping or locking
- weakness
- swelling
- decreased ROM
KNEE is most commonly affected
Osteogenesis Imperfecta affects the formation of what?
formation of Type I collagen during bone development
How is genetic inheritance related to the type of osteogenesis imperfecta?
Types I and IV are autosomal dominant
Types II and III are autosomal recessive
What are the different types of Osteogenesis Imperfecta?
Type I: mildest form, frequency of fractures decreases after puberty
Type II: most SEVERE, child dies in utero or early childhood
Type III: severe, greater ossification of the skull, growth retardation, ongoing fractures, significant funcitonal limitations
Type IV: mild to moderate fragility (greater than type I), will have bowing of long bones
What is a common cause of Osteomyelitis?
Staphylococcus Aureus microbe
What is the medical term often used for Patellofemoral Syndrome and what does it refer to?
Chondromalacia Patella
-Refers to softening of the articular cartilage of the patella
What is most commonly seen with motion of the patella in patellofemoral syndrome?
The patella is pulled too far laterally, so medial patellar glides may be useful
What age is patellofemoral syndrome extremely common?
Adolescence
In addition to pain what other symptom may occur with prolonged sitting or ascending stairs with patellofemoral pain?
Burning pain
What is a normal Q angle for males and females?
Males 13. Females 18
How long does it take for someone to return to previous functioning with patellofemoral syndrome?
4 to 6 weeks
What foot posture can exacerbate patellofemoral syndrome?
Pronated feet
Piriforomis syndrome causes compression or iritation of what?
the sciatic nerve
What exacerbates symptoms of piriformis syndrome?
prolonged sitting and activities combing internal rotation and adduction
What position will reproduce pain in piriformis syndrome?
Flexion, adduction, and internal rotation
Piriformis syndrome has a near identical presentation to what?
L5-S1 radiculopathy
Where is pain located with plantar fasciitis?
the origin at the medial tubercle of the calcaneous
What are some factors that can lead to the development of plantar fasciitis?
Excessive pronation with gait, tightness of foot and calf musculature, obesity, and a hihg arch
Why is the most severe plantar fascia pain in the morning?
the fascia is contracted, stiff, and cold
What bony hypertrophy may occur with plantar fasciitis?
Heel spur
What stretching should a patient with plantar fasciitis do in the morning?
a plantar fascia and gastrocnemius stretch
What orthotic is often prescribed with plantar fasciitis?
a heel cup
How long does it take for patients to get to a more functional level with plantar fasciitis?
How long does it take for complete resolution of symptoms?
- 8 weeks
2. 1 year
What is the path of PCL?
POSTERIOR intercondylar area of the tibia to the lateral aspect of the medial femoral condyle in the intercondylar notch
What are the two most common causes of a PCL tear?
- landing on the tibia with a flexed knee
2. Hitting a dashboard in a MVA with a flexed knee
What strengthening exercises should be avoided to allow a PCL to heel?
Exercises that place a posterior shear force on the knee
–> open chain hamstring exercises
Posterior shear, like sliding the TIBIA POSTERIOR (lag sign). Hamstrings are attached posteriorly so it’ll pull posterior since hamstrings aren’t counteracting.
What disease is a chronic inflammatory reaction in the synovial tissues of a joint that results in erosion of cartilage and supporting structures within the capsule?
Rehumatoid Arthritis
What are swan neck and boutonniere demority?
Swan neck: DIP flexion, PIP hyperextension
–> need to hyperextend to make a long neck
Boutonniere: DIP extension, PIP flexion
80% of individuals with RA show what blood factor?
Rheumatoid Factor (RF)
What is one example of a DMARD that may be used to treat RA?
methotrexate
During the acute stage or exacerbation of RA what should be avoided in PT?
resisitive exercise, deep heating, and any form of active stretching
During the chronic stage or remission stage of RA what should be avoided in PT?
aggressive stretching
What systemic symptom is common with RA?
low grade fever
After a rotator cuff tear a patients arm is typically positioned in?
Internal rotation and adduction
How long will patients be immobilized after a large rotator cuff repair?
how long does it take for patients to return to dynamic overhead motions?
How long for functional return?
- 4-6 weeks
- 9-12 months
- 4-6 months
What is are the most commonly torn rotator cuff tendons?
Supraspinatus
but also infraspinatus and subscapularis with more severe or traumatic etiologies
Which type of rotator cuff tear causes the most pain and why?
Partial tearing due to increased tension on remaining muscle fibers and associated neural tissue
Failure to adequately treat a rotator cuff can result in what happening to the tendon?
Since the tendon does not heal, it forms scar tissue and there will be an increased risk of rupture or an increase in size of original tear
