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Locomotor 2 > Soft Tissue Disease > Flashcards

Soft Tissue Disease Flashcards

1
Q

what is the prevalence of back pain

A

15%

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2
Q

What is the prevalence of osteoarthritis

A

5%

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3
Q

what is the prevalence of soft tissue disorders

A

5%

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4
Q

What is the prevalence of inflammatory disorders

A

1%

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5
Q

what are the sources of musculoskeletal pain

A
  • Referred
  • Joint
  • Bone
  • Soft tissue
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6
Q

what does the history and examination of musculoskeletal pain show us

A

History : provides information on pathologic process

Examination: defines anatomic site of the problem

History & examination: determine disability

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7
Q

What should you take in a history

A

Evolution of the problems: is it acute or chronic

	- onset (acute, chronic; progression)
	- triggering event (infections, trauma, drugs)
	- treatments

Current symptoms

- pain
- stiffness
- swelling

Involvement of other systems

Impact on the patient

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8
Q

what are the 5 key questions when taking a musculoskeletal history

A

Does the problem arise from the joint

Is the condition acute or chronic

Is the condition inflammatory or non-inflammatory

What is the pattern of the affected joints

What is the impact of the condition on the patient’s life

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9
Q

what are the red flags for musculoskeletal disease

A

fever or unexplained weight loss

history of carcinoma

immuno-supression

ill health or presence of other medical illness

severe night pain / progressive pain

persistent mono-arthritis – persistant localised joint pain

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10
Q

What are yellow flags

A 
Yellow flags are factors 
that increase pain and 
the risk of developing, or 
perpetuating long term 
disability and work loss 
associated with persistent 
pain
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11
Q

name some yellow flags

A

History of numerous episodes

Duration of symptoms

Intensity of symptoms

Anxiety / depression

Locus of control

Catastrophizing

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12
Q

what is periarticular

A

situated or referred around the joint

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13
Q

what is articular

A

in the joint

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14
Q

What can go wrong with per articular soft tissue

A
  • Capsule of the joint fibrous lining
  • ligaments and tendons around the joint
  • bursa
  • synovial lining and sac allows muscles and tendons to slide without friction over the bone
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15
Q

What is the enthesis

A

The enthesis (plural entheses) is the connective tissue between tendon or ligament and bone

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16
Q

what is a frequent site of trauma

A

Enthesis

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17
Q

name 4 causes of pain in the wrist and hand

A

De Quervains tenosynovitis

Trigger finger

Carpal tunnel syndrome

Duputren’s contracture

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18
Q

name some other pain caused in the wrist and hand

A

Ganglion – swelling of the rest

Inflammatory arthritis / OA

Raynaud’s phenomenon – fingers go white due to spasm of the artery

Reflex sympathetic dystrophy – overreaction of the autonomic nerve sytem that interfaces with the pain system leading to local pain post trauma
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19
Q

what is De Quervains Tenosynovitiis

A

affects the extensor an adduct tendons of the thumb

- can also cause pain on resistive movement

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20
Q

how do you treat De Quervains Tenosynovitiis

A
  • rest the thumb

- if it doesn’t settle dow you can cut the tendon sheath and operate but in rare occasion s

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21
Q

What is trigger finger

A

This is a nodule on one of the extensor tendons and the finger gets tuck and they have to manually exert to push the finger up

The tendon gets stuck as the tendon comes in and out of the sheath

22
Q

what nerve is compressed in carpal tunnel syndrome

A
  • Median nerve
23
Q

what is the prevalence of carpal tunnel syndrome

A

3% women

2% men

24
Q

what is the range of age for caporal tunnel syndrome

A

40 - 60 yrs

25
Q

what increases your risk of carpal tunnel syndrome

A

Idiopathic

Pregnancy – common in pregnancy

Hypothyroidism

Rheumatoid arthritis

Diabetes

Vibrating tools

Computer use

26
Q

Symptoms of carpal tunnel

A
  • atrophy of the thumb

- loss of sensation

27
Q

What are the tests you do for the diagnosis of carpal tunnel syndrome

A

History

Phalen’s test

Tinel’s test

Nerve conduction studies

FBC, ESR, T4, RF

28
Q

How do you treat carpal tunnel syndrome

A

injecting it with a steroid

29
Q

What is dupuytren’s contracture

A
  • fibrosis of palmar aponeurosis
30
Q

what is dupuytren’s contracture more common in

A

man,
heavy drinkers
smokers
diabetics

31
Q

where does dupuytren’s contracture feature

A

sole of feet, Garrod’s pads, Peyronie’s disease

32
Q

What is the cause of peri-articular pain in the elbow

A

epicondylitis bursitis

33
Q

what is the cause of articular pain in the elbow

A

trauma

OA

34
Q

what is tennis elbow

A
  • effects the lateral epicondylie

- causes lateral epicondylitis

35
Q

what two things do you look for in tennis elbow

A

local tenderness

pain resisted wrist extension

36
Q

what are the treatments for tennis elbow

A

Rest / topical NSAIDs

Massage

Injection

(Surgery)

37
Q

name some swellings and rashes over the extensor surface of the elbow

A

gouty tophus

psoriatic plaques

vasculitic rash

olecranon bursitis

rheumatoid norudle

38
Q

What are the causes of pain in the shoulder

A

Rotator cuff tendinitis

Bicipital tendinitis

Frozen shoulder

Subacromial bursitis

Degenerative arthritis
- acromioclavicular joint

39
Q

What is there referred pain patterns in the arm

A

Acromoclavicualr joint is anterior pain

Neck pain classically refers posteriorly into he upper trapezius and down the arm

True shoulder pathology refers to the deltoid area to the elbow

40
Q

What is frozen shoulder

A

A condition where the capsule becomes thickened and fibrotic and shrinks down

The capacity of the shoulder to move is just reduced

Therefore there is no movement possible

Characteristic feature is limited movement due to the capsule becoming shrunk

41
Q

describe the pain and limitation of frozen shoulder

A

Extremely pain for 9 months to a year or more

And limited movement can continue for 2 years

42
Q

How do you treat frozen shoulder

A

re-assurance / education

analgesia

injection

physiotherapy

43
Q

what is shoulder impingement

A

As the shoulder abducts the supraspinatus becomes squashed between the under surface of the acrominoum and the top surface of the humerus

The net result is as you abduct the shoulder the supraspinatus muscle gets squashed

44
Q

what are the signs of rotator cuff tenditits

A

painful arc on active abduction

pain on resisted abduction

45
Q

how do you treat rotator cuff tendinitis

A

physiotherapy

steroid injection

surgery

46
Q

what are causes of referred pain in the hip

A

pelvis
spine / SIJ’s
meralgia paraesthetica

47
Q

What are the causes of articular pain in the hip

A

OA
Inflammatory arthritis
Irritable hip (children

48
Q

What are the periarticular pain in the hip

A

trochanteric bursitis
ischial bursitis
adductor tendinopathy
bone disease

49
Q

What is achilles tendiopathy

A
  • when the achilles becomes inflamed and swollen
50
Q

what are other food issues

A

Plantar fasciitis

March fracture = get asymptomatic fracture metatarsal pain, callus has to form that the diagnosis is made

Mortons neuroma = Neuroma on the interplanted nerves producing paraethesia or local pain

Locomotor 2 (30 decks)

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