Regional pain Flashcards
1
Q
What are some red flags for back pain?
A
- history of weight loss
- fevers
- persistent pain not affected by movement
- history of malignancy
- associated progressive neurology (bowel/bladder dysfunction, saddle anaesthesia)
- night pain
2
Q
What does back pain radiating to the legs suggest?
A
- nerve root entrapment (eg. sciatica, spinal stenosis)
3
Q
‘winking owl sign’, malignancy of the spine (pedicle destroyed due to metastasis)…
A
4
Q
What does a joint aspiration tell us (normal, inflammation, infection, haemarthrosis/trauma)?
A
- using aseptic technique, anaesthetic is injected and joint fluid is aspirated
- normal fluid: yellowish/straw coloured
- inflammation: slightly clouded yellow
- infection: greenish/pus-like fluid
- haemarthrosis/trauma: blood-stained fluid
5
Q
What are the 4 features of inflammation/infection?
A
- Dolor: pain
- Rubor: redness
- Calor: heat
- Tumor: swelling
6
Q
What does coldness, pallor (paleness), or ulcers on the ankle/foot suggest?
A
- peripheral vascular disease
7
Q
What does burning and numbness in the ankle/foot suggest (name some differentials)?
A
- Morton neuroma: nerve pathology of intermetatarsal plantar nerve
- tarsal tunnel syndrome: compression of tibial nerve passing through the tarsal tunnel
- diabetic neuropathy
8
Q
What does posterior pain of the ankle when walking suggest, and what does discomfort on the sole of the foot suggest?
A
- Achilles tendinopathy
- plantar fasciitis (sole of foot)
9
Q
What does severe pain in the foot (especially 1st MTP joint) suggest?
A
- crystal arthropathy (gout)
10
Q
What is complex regional pain syndrome (CRPS), symptoms, and treatment?
A
- CRPS = a differential for regional pain after a fracture (usually upper limb)
- Symptoms: severe out of context pain, neuropathy, hypersensitivity
- Treatment: bisphosphonates and neuropathic pain killers
