VIII. Done- Clinical Criteria For Diagnosing Motion Segment Dysfunction Syndrome Flashcards
______ and _______ postures are common in acute presentations but are often within normal limits in mildly symptomatic patients.
Antalgic and asymmetric
_________ is an important etiologic consideration for motion segment pain and dysfunction.
Postural dysfunction
Differential tools are helpful in
differentiating and excluding other conditions
If moderate, midline pressure is uncomfortable, what is it called?
allodynia
Allodynia Definition: pain perceived from stimulus that normally would not provoke pain
In the ______, there are only a couple of degrees of rotation to each side. It’s difficult to palpate loss of ROM. End play is more palpable and valuable diagnostically in this area.
lumbars
Many techniques overemphasize one _____.
diagnostic test
What may be associated with sites of induration, which palpate as deep sites of nodular or rope-like consistency?
Long standing dysfunction
Measuring instruments have played a large part in validating some chiropractic
therapies in recent years. What are some examples?
- Visual Analog Scale (VAS)
- Verbal Numerical Rating Scale (VNRS)
- Oswestry pain questionnaire
- Faces Pain Scale – Revised (FPS-R)
- Patient-Specific Functional Scale (PSFS)
- Pain drawing
Abnormal motion is reflected by _______ to
segmental range of motion, joint play or end play.
altered resistance (decreased or increased)
What are some examples of differential tools?
- Specific orthopedic and Neurologic tests
- Imaging procedures
- Lab tests
What is the SOAP format of recording methods
- Subjective
- Objective
- Assessment/action
- Plan
What is one of the most statistically reliable criteria for underlying dysfunction?
Palpable Pain
What is PARTS?
- Palpable pain
- Asymmetry
- Rang of Motion
- Tone, texture, temperature
- Special tests
Should moderate, midline pressure normally be uncomfortable?
No
How would alterations in segmental alignment be noted?
comparing
adjacent spinous processes and symmetry of transverse processes.
Asymmetry (PARTS) can be found where?
- in posture
- in static abnormalities
At _______, we expect 40 degrees of rotation per side. SROM is
more valuable here than in the lumbars. End play is also valuable.
C1-2
If you have limited movement of a joint, which is more valuable to you as the doctor: segmental ROM or end play?
(a) In the lumbars, there are only a couple of degrees of rotation to
each side. It’s difficult to palpate loss of ROM. End play is more palpable and valuable diagnostically.
(b) At C1-2, we expect 40 degrees of rotation per side. SROM is
more valuable here than in the lumbars. End play is also valuable.
What is a fairly reliable outcome measure?
Increased range of motion, decreased pain
________ is of limited diagnostic value in the absence of other
abnormal physical findings.
Misalignment, because there is some possible normal variation and high prevalence of anomaly
Global movements are characteristically _____ and _____ in acute presentations, but may be within normal limits in mildly symptomatic patients.
guarded and restricted
Examples of lab tests used as differential tools?
Blood work looking for Rheumatoid factor or HLA-B27
Additional physical exam and/or laboratory procedures which aid in the diagnosis of joint dysfunction
Special tests, the “S” in parts
Examples of Specific orthopedic and Neurologic tests used as differential tools?
Deep tendon reflexes (DTRs), Sensory testing, Motor testing and Nerve traction tests
Reactive changes in segmentally related soft tissues often lead to local _______.
muscle spasm
