Week 3 Flashcards
Rheumatoid arthritis Sx include what bilaterally in the hands?
Distal stiffness
Prodrome for Herpes Zoster that comes from the history?
3-5 days earlier they would have had vesicles
William Rubin didn’t have nerve pain, why?
Because leg pain was NOT worse than back pain and there was no paresthesia.
What does MCID mean
Minimal Clinically Important Difference
What MCID is generally recommended for MSK pain in general?
An MCID between 2-3 is commonly recommended
- 2 points for average of all activities OR
- 3 points for single activity
Example:
• Putting pants on 4/10 PFSF
• Putting on shoes 4/10 PFSF
• Getting in car 7/10 PFSF
15/3 = 5 average and look for improvement in 2 points.
MCID 2 points if you’re monitoring 3 things. MCID 1 point for solo item.
What MCIDs are suggested for LBP with baseline score above 5 vs below 5?
Patients with LBP who have baseline score of 5+, a change of at least 2 points is necessary to denote MCID
When baseline score is below 5, a change would need to be 1 point more more.
How do pain faces images convert to numerical scores?
Faces Pain Scale-Revised (FPS-R) scored 0-10
What 3 populations do well to use the faces pain scale
Children
Elderly
Cognitive and communication impaired
What is the difference between using P “intensity” and P “unpleasantness?” When might pain unpleasantness be used?
Unpleasantness of pain represents a different dimension of the pain experience. Although the intensity of the pain may remain unchanged, the patients pain tolerance may improve.
Pain unpleasantness may be a good choice for patients with chronic, debilitating pain.
What are the different items measured in a triple pain scale?
In patients with severe, chronic LBP, which combination of triple pain scale items is suggested to be best?
Current
Average
Worst
Chronic LBP:
In chronic pain cases, there is evidence to suggest that “usual” rather than “current” pain is more strongly associated with the actual pain levels the patient is generally experiencing.
Generally speaking, if only asking the patient to rate their pain based on one item, which would be best:
Current pain
Usual pain
Average pain
?
Under what circumstances should 4 or 5 activities be measured for PSFS? Why?
If baseline scores all received a score of 0, then PSFS score will not be able to detect worsening of condition because the score cannot go any lower. To avoid this shortcoming, ask a follow up question:
“Are there any other activities [up to 2] that you are having difficulty with since your last visit?”
What are the most common lumbar diagnoses?
Disc herniation
Stenosis
What are the most common SI diagnoses?
SI Syndrome
SI joint dysfunction
SI Sprain
