Red flags Flashcards
What is myelopathy?
Any neurologic deficit related to the spinal cord. Usually due to compression and could be due to a #, space occupying lesion, disc prolapse, spondylitis. Most commonly localised in cervical spine.
What are the common symptoms of myelopathy?
Muscle weakness, altered muscle tones, sensory loss (in trunk and legs) and spasticity, impaired coordination, gait disturbances, spinal pain, urinary disturbances.
What is cervical artery dysfunction (CAD) ?
Umbrella term used to cover range of vascular pathologies which may lead to cervico-cranial ischaemia (decreased blood flow to brain). It is inclusive of all known vascular pathologies & anatomical structures that may be compromised by movement or manual therapy.
What is the pathology and what are the presentations of CAD?
Pathologies range from pre-existing underlying anatomical anomalies, vasospasm, atherosclerosis, through to giant cell arteritis or arterial dissection.
Symptoms: pain, through to cranial nerve dysfunctions, sympathetic nerve dysfunction, blindness, stroke, or at worst death.
What are the risk factors of CAD?
Previous trauma to Cx spine, migraines, hypertension, high cholesterol, cardiac/vascular diseases, diabetes, blood clotting disorders, anti-coagulant therapy, long term use of steroids, smoking history, recent infection, immediately post-partum, absence of plausible mechanical explanation of symptoms.
What is malignancy?
Cancer - normal cells change; divide and grow uncontrollably forming malignant tumours. Most cancers start in once place (primary tumour). They then spread to nearby areas by pushing through healthy parts of the body and damaging them (local spread). They can also spread to distant parts through the blood stream or lymphatic system. They can then grow in new areas forming secondary tumours.
What is metastatic spinal cord compression?
It’s an oncological emergency. If not caught early enough MSCC can lead to permanent paralysis from the level of compression. Most commonly occurs in patients with metastatic lung, breast or prostate cancer, lymphoma and multiple myeloma. Most common sit is thoracic spine followed by lumbosacral spine.
What are the general signs and symptoms of malignancy?
Non-mechanical pain, constant night pain, unexplained weight less, general fatigue or feeling unwell, previous Hx of cancer, night sweats, unusual lumps/bumps/swelling.
What is DVT?
Sometimes occurs after surgery, e.g. TKR.
Venous thrombosis involving formation of blood clot in a deep vein, most commonly in legs or pelvis. Minority in arms.
Symptoms of DVT
pain, swelling, redness, and enlarged veins in affected area but some cases have no symptoms.
Risk factors of DVT
pregnancy, surgery, malignancy, genetics, hospitalisation.
How can DVT be managed?
anti-coagulants, physical activity and compression stockings
What are inflammatory conditions?
The immune system mistakenly attacks your body’s own cells or tissues. This causes abnormal inflammation that can result in chronic pain, redness, swelling, stiffness & damage to healthy tissues.
What is RA?
Systemic auto-immune disease characterised by inflammatory arthritis with extra-articular involvement. Synovium is infiltrated by immune cells. Fibroblasts & inflammatory cells lead to osteoclast generation resulting in bone erosion and loss of joint integrity. Systemic inflammation and autoimmunity start long before onset of joint inflammation.
What is the epidemiology of RA?
Most prevalent in North America & Northern Europe.
More females than males affected (2-3:1)
Increases w age
