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LOCO 2 > Soft Tissue Diseases > Flashcards

Soft Tissue Diseases Flashcards

1
Q

What is the prevalence of inflammatory disorders?

A

1%

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2
Q

What is the prevalence of OA?

A

5%

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3
Q

What is the prevalence of back pain?

A

15%

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4
Q

What is the prevalence of soft tissue disorders?

A

5%

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5
Q

What are the four sources of musculoskeletal pain?

A

Referred/central
Bone
Joint
Soft tissue

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6
Q

What does a musculoskeletal history provide?

A

Information on pathologic process/diagnosis

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7
Q

What does a musculoskeletal examination provide?

A

Defines anatomic site of the problem

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8
Q

What does a musculoskeletal history AND examination provide?

A

Determines disability

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9
Q

What are some red flags? (6)

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
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10
Q

What affects symptom reporting and disability?

A

Environmental factors and constitutional factors, as well as tissue pathophysiology

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11
Q

Define ‘yellow flags’.

A

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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12
Q

List some psychosocial ‘yellow flags’. (6)

A 
History of numerous episodes
Duration of symptoms
Intensity of symptoms
Anxiety / depression
Locus of control (not able to look after their lives/accept responsibility for their illness)
Catastrophizing
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13
Q

What does peri-articular mean?

A

From around the joints

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14
Q

Local pain can be either…?

A

Peri-articular or articular

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15
Q

Articular pain can be either…?

A

Inflammatory or degenerative

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16
Q

What is an enthesis?

A

A ligamentous attachment to bone.

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17
Q

What is the characteristic clinical feature of tendinopathies/enethesitis?

A

Pain on resisted movement

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18
Q

Name four causes of soft tissue pain in the wrist and hand.

A

De Quervains tenosynovitis
Trigger finger
Carpal tunnel syndrome
Duputren’s contracture

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19
Q

What is De Quervain’s tenosynovitis?

A

Tendonitis of thumb extensors and abductor (extensor pollicis brevis, extensor pollicis longus, abductor pollicis longus)

20
Q

What can be seen on examination with De Quervain’s tenosynovitis? (3)

A

Pain on resisted movement
Crepitus
Finkelstein’s test

21
Q

How is De Quervain’s tenosynovitis treated?

A

Put in splint, give ibuprofen – sorted in a week

22
Q

What is trigger finger also called?

A

Flexor tendinosis

23
Q

What is trigger finger?

A

Nodule on flexor tendon, gets stuck going in/out of discontinuous tendon sheath.

24
Q

How is trigger finger treated?

A

Treat with topical anti-inflammatories or can inject around nodule

25
Q

What are the differential diagnoses for carpal tunnel syndrome? (3)

A

Cx radiculopathy
Diabetic neuropathy
MS

26
Q

What is prevalence of carpal tunnel syndrome in women vs men?

A

3% compared to 2%

27
Q

What is associated with carpal tunnel syndrome? (8)

A 
Hypothyroidism
Rheumatoid arthritis
Diabetes
Pregnancy
Amyloidosis
Acromegaly
Use of vibrating tools
Computer use (?)
28
Q

How is carpal tunnel syndrome diagnosed? (5)

A

History - pain and paraesthesia, sensory loss, tingling
Phalen’s test - hyperflexes the wrist, mechanical compression
Tinel’s test
Nerve conduction studies - to classify it as mild or severe
FBC, ESR, T4, RF

29
Q

What nerve is compressed in carpal tunnel syndrome?

A

Median nerve

30
Q

How is carpal tunnel syndrome treated?

A

Injection of steroid

31
Q

What structures are affected by carpal tunnel syndrome?

A

Thumb and first two fingers

Can get atrophy of thenar muscles

32
Q

What is Dupuytren’s contracture?

A

Fibrosis of palmar aponeurosis

33
Q

Dupuytren’s contracture is more common in… (4)

A

Men
Heavy drinkers
Smokers
Diabetics

34
Q

What are the causes of pain at the elbow?

A 
Referred pain (neck, shoulder)
Peri-articular pain (epicondylitis, bursitis)
Articular pain (trauma, OA)
35
Q

What is tennis elbow also called?

A

Lateral epicondylitis

36
Q

What are the signs/symptoms of tennis elbow?

A

Local pain on side of the elbow, tenderness, pain on resisted movement (wrist extension)

37
Q

How is tennis elbow treated?

A

Rest / topical NSAIDs
Massage
Injection
Surgery

38
Q

Give some examples of wwellings & rashes over the extensor surface of the elbow. (5)

A 
Olecronon bursitis
Rheumatoid nodule
Gouty tophus
Psoriatic plaques
Vasculitic rash
39
Q

List some causes of pain in the shoulder. (5)

A 
Rotator cuff tendinitis
Bicipital tendinitis
Frozen shoulder
Subacromial bursitis
Degenerative arthritis (acromioclavicular joint)
40
Q

What is frozen shoulder?

A

Adhesive capsulitis - the capsule becomes thickened and adherent. There is loss of movement. It produces a lot of night pain. The pain can last up to 1.5 years, but stiffness goes on for even longer.

41
Q

What movements (in what order) are lost in frozen shoulder?

A

External rotation lost first, then internal rotation and then abduction.

42
Q

How is frozen shoulder treated? (4)

A

Re-assurance / education
Analgesia
Injection
Physiotherapy

43
Q

What is seen with rotator cuff tendonitis on abduction?

A

Painful arc and pain on resisted abduction

44
Q

How is rotator cuff tendonitis treated? (3)

A

Physiotherapy
Steroid injection
Surgery

45
Q

What are the causes of pain in the hip? (3)

A 
Referred pain (pelvis, spine, meralgia paraesthesia)
Articular pain (OA, inflammatory arthritis, irritable hip)
Peri-articular pain (trochanteric bursitis, ischial bursitis, adductor tendinopathy, bone disease)
46
Q

What is meralgia paraesthetica?

A

This is like carpal tunnel but in the hip. It is the lateral cutaneous nerve that is compressed.

47
Q

Name causes of pain in the foot/ankle. (4)

A

Achilles tendinopathy
Plantar fasciitis
March fracture (hairline fracture in metatarsal)
Morton’s neuroma (from wearing tight shoes)

LOCO 2 (28 decks)

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