Musculoskeletal and Joint Conditions

Adhesive Capsulitis: Frozen shoulder

  • Low-grade inflammatory response that develops in joint capsule, synovial membrane and rotator cuff 

Bursitis: Inflammation of bursa caused from overuse 

Contusions : Bruise (ecchymosis)

Dislocation: Temporary displacement of 2 bones where the two bones lose contact completely

Strains: Injury to musculotendinous unit

  • from over-stretching or excessive contraction of muscle against heavy resistance 
  • Grade 1 Strain : minor stretch to musculotendinous unit with small loss of strength 
  • Grade 2 strain : various degrees of tearing, palpable gap
  • Grade 3 strain : complete rupture

Sprain : Injury to ligament 

  • Grade 1 sprain : minor stretching or tearing in ligament, no instability in joint 
  • Grade 2 sprain : various degrees of tearing to ligament, joint laxity present with pain
  • Grade 3 sprain : complete rupture of ligament, significant joint instability 

Subluxation: Temporary displacement of 2 bones where the two bones partially lose contact

Tendinitis (old term) : inflammation of tendon 

Tendinosis : Chronic overuse of tendon injuries without inflammation (tennis elbow, golfers elbow, jumpers knee) 

Tenosynovitis: Inflammation of tendon sheath – De Quervain’s 

Joint Conditions 

ConditionDescriptionCauseManifestationTreatment
Ankylosing SpondylitisBamboo Spine. Chronic inflammatory disease affecting the vertebral column Idiopathic Low back, morning stiffness, loss of lumbar lordosisNo cure, exercises, NSAIDS for pain management
GoutInflammation due to uric acid
Stages:
1. Asymptomatic Hyperuricemia
2. Acute gouty arthritis
3. Intercritical gout
4. Chronic tophaceous gout
Too much uric acid in the body AS: no clinical signs
AGA: weight bearing joints (big toe) affected
IG: intervals between gout attacks and damage to joints
CTG: depositions of crystals and chronic inflammation in joints, achilles tendon and aorta
Reduce attacks with NSAIDs, Diet
Psoriatic ArthritisSwelling and pain in joints linked with psoriasisUnknownPain and swelling in fingers, toes, knees, ankles, asymmetric NSAIDs, DMARDS, skin care, exercise
Infections Arthritisinflammation caused by bacteria, virus or fungalbacteria, virus, fungalBacteria: pain in one joint with fever
Virus: pain all over with no fever
Fungal: Pain and swelling comes on slowly with mild fever
NSAIDs, antibiotics, anti-fungal, heat/cold
SclerodermaBuild up of tough scar-like tissue on skinUnknown, autoimmuneLocalized: only on skin of hands and feet
Generalized: organs, widespread skin, limited or diffused
NSAIDS, corticosteroids, DMARDs, keep skin moist, relaxation
OsteoarthritisBreakdown of articular cartilage unilaterally or bilaterallyjoint damage, ageCrepitus, loss of mobility, loss of stability, inflammation, painlifestyle changes, NSAIDs, joint replacement
Rheumatoid ArthritisChronic inflammatory disease of connective tissue affecting primarily synovial joints AutoimmuneSymmetrical involvement of small joints, stiff joints, decrease ROM, joint subluxation, Reduce inflammation, DMARDS, NSAIDs, joint replacement
Degenerative Disk DiseaseBreakdown of spinal disks due to loss of wateragedisk protrusion, spondylothesis, spinal stenosis
Osteoporosis Increased porosity of bone due to loss of bone massbeing female, poor nutrition, age, lack of sunlight exposure, corticosteroidsPain associated with skeletal fractures, weakness and weight loss weight-bearing exercises, Vitamin D and calcium supplements
OsteomalaciaSoftening of bones with no loss to bone matrixinsufficient calcium absorption from intestines, phosphate deficiencyBone tenderness and pain, fractures, muscle weakness, bone deformitiesTreat the underlying cause, nutrition
Rickets Inadequate calcium absorption and impaired mineralization of bones in childrendietary deficiency in calcium and phosphate stunted growth, lethargy, bowed legs or knock knees, slow teeth developmentnutrition, exposure to sunlight, maintain good posture
Paget’s DiseaseProgressive skeletal disorder that is characterized by excessive bone destruction followed by repair unknownasymptomatic, skull thickening, tinnitus, vertigono cure, NSAIDs
Legg- Calve- Perthes DiseaseOsteonecrotic disease of proximal femoral epiphysisUnknownpain in groin, thigh and knee, aggravaated by activity, painless limp with limited abductin, medial rrotation and flexion of hipreduce deformity, bracing
Osgoode-Schlatters DiseaseOsteochondrosis in area where patella tendon inserts into tibial tuberosityPain in area of patellar tendon, sudden onset of pain, inflammation of patellar tendon Release tension in quads to permit re-vascularization tibial tuberosity
Scheuermann’s DiseaseJuvenile kyphosisunknownPoor posture, fatigue and pain in area of kyphosisrelieve pain, correct kyphosis, exercises
Osteomyelitisacute or chronic pyrogenic infection of bonecontamination of open fracture of woundchills, fever, malaiseantibiotics, rest, find causative agent
Muscular Dystrophya number of genetic disorders that results in progressive deterioration of skeletal muscles
Duchenne’s Muscular DystrophyMost CommonInherited as a recessive gene, mutation to the dystrophin proteinpostural muscles of hips and shoulders affected first, frequent falling around 3 years, imbalances between agonist and antagonist musclesno cure, maintain movement, passive stretching, correct and counter posturing
Myasthenia GravisAutoimmune disorder of neuromuscular junction leading to muscle weaknessAutoimmuneMuscular fatigue and progressive weakness, starts with weakness in ocular muscles corticosteroids, immunosuppressive drugs
PolymyositisGeneralized muscle inflammation
Dermatomyositis: polymyositis with skin lesions
symmetrical, proximal muscle weakness, malaise, fever, muscle swelling, dysphagiaimmunosuppressive drugs, DMARDS, exercise
FibromyalgiaChronic musculoskeletal condition that shows diffused pain in soft tissuediffused, chronic pain in joints and muscles, gnawing, burning painNSAIDS, SSRIs, exercise
Amylotrophic Lateral Sclerosis (ALS)Neurological disorder that selectively affects motor function. Affects motor neurons in anterior horn cells of spinal cord, motor unit of brainstem and upper motor neurons in cerebral cortexUpper motor neuron: weakness, spasticity or stiffness, impaired fine motor skills, dysphagia
Lower motor neuron: fasciculations, weakness, flaccidity, muscle atrophy
no cure, rehab for management
Marfan’s SyndromeConnective tissue disorder that displays changes in skeleton, eyes and Cardiovascular systemSkeleton: long, thin body with long extremities, hyper-mobile joints, spinal deformities, chest deformity
Eyes: decreased connective tissue supported around the eye, can lead to dislocation of lens
CV: valve problems with the heart, weakness of aorta and other arteries

Fractures

Causes: sudden injury, fatigue or stress fracture, pathological fracture 

Classifications: 

  • Communication with external environment:
    • open aka compound: through the skin
    • closed aka simple: not through skin 
  • Location: proximal, distal, mid shaft
  • Direction of break: transverse, oblique, spiral, linear 
  • Degree of break: complete, incomplete 

Character of fracture pieces: 

  • Comminuted : 2 fragments
  • Impacted: 1 fragment driven into the other
  • Segmental : break occurs in 2 adjacent areas
  • Compression – occurs in vertebral bodies
  • Avulsion– fragments pulled from normal position by muscle contraction
  • Eponyms: colle’s  fracture and port’s fractures 
  • Position of bone ends after fracture: non displaced, displaced 

Manifestations: pain, tenderness, swelling, loss of function, crepitus

Treatment: reduction, immobilization, preservation of function 

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