Dylan Crake RMT & R.KIN

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 

Condition	Description	Cause	Manifestation	Treatment
Ankylosing Spondylitis	Bamboo Spine. Chronic inflammatory disease affecting the vertebral column	Idiopathic	Low back, morning stiffness, loss of lumbar lordosis	No cure, exercises, NSAIDS for pain management
Gout	Inflammation 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 Arthritis	Swelling and pain in joints linked with psoriasis	Unknown	Pain and swelling in fingers, toes, knees, ankles, asymmetric	NSAIDs, DMARDS, skin care, exercise
Infections Arthritis	Inflammation caused by bacteria, virus or fungal	bacteria, virus, fungal	Bacteria: 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
Scleroderma	Build up of tough scar-like tissue on skin	Unknown, autoimmune	Localized: only on skin of hands and feet Generalized: organs, widespread skin, limited or diffused	NSAIDS, corticosteroids, DMARDs, keep skin moist, relaxation
Osteoarthritis	Breakdown of articular cartilage unilaterally or bilaterally	Joint damage, age	Crepitus, loss of mobility, loss of stability, inflammation, pain	Lifestyle changes, NSAIDs, joint replacement
Rheumatoid Arthritis	Chronic inflammatory disease of connective tissue affecting primarily synovial joints	Autoimmune	Symmetrical involvement of small joints, stiff joints, decrease ROM, joint subluxation,	Reduce inflammation, DMARDS, NSAIDs, joint replacement
Degenerative Disk Disease	Breakdown of spinal disks due to loss of water	Age	Disk protrusion, spondylothesis, spinal stenosis
Osteoporosis	Increased porosity of bone due to loss of bone mass	Being female, poor nutrition, age, lack of sunlight exposure, corticosteroids	Pain associated with skeletal fractures, weakness and weight loss	weight-bearing exercises, Vitamin D and calcium supplements
Osteomalacia	Softening of bones with no loss to bone matrix	Insufficient calcium absorption from intestines, phosphate deficiency	Bone tenderness and pain, fractures, muscle weakness, bone deformities	Treat the underlying cause, nutrition
Rickets	Inadequate calcium absorption and impaired mineralization of bones in children	Dietary deficiency in calcium and phosphate	Stunted growth, lethargy, bowed legs or knock knees, slow teeth development	Nutrition, exposure to sunlight, maintain good posture
Paget’s Disease	Progressive skeletal disorder that is characterized by excessive bone destruction followed by repair	Unknown	Asymptomatic, skull thickening, tinnitus, vertigo	No cure, NSAIDs
Legg- Calve- Perthes Disease	Osteonecrotic disease of proximal femoral epiphysis	Unknown	Pain in groin, thigh and knee, aggravaated by activity, painless limp with limited abductin, medial rrotation and flexion of hip	Reduce deformity, bracing
Osgoode-Schlatters Disease	Osteochondrosis in area where patella tendon inserts into tibial tuberosity		Pain 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 Disease	Juvenile kyphosis	Unknown	Poor posture, fatigue and pain in area of kyphosis	Relieve pain, correct kyphosis, exercises
Osteomyelitis	Acute or chronic pyrogenic infection of bone	Contamination of open fracture of wound	Chills, fever, malaise	Antibiotics, rest, find causative agent
Muscular Dystrophy	A number of genetic disorders that results in progressive deterioration of skeletal muscles
Duchenne’s Muscular Dystrophy	Most Common	Inherited as a recessive gene, mutation to the dystrophin protein	Postural muscles of hips and shoulders affected first, frequent falling around 3 years, imbalances between agonist and antagonist muscles	No cure, maintain movement, passive stretching, correct and counter posturing
Myasthenia Gravis	Autoimmune disorder of neuromuscular junction leading to muscle weakness	Autoimmune	Muscular fatigue and progressive weakness, starts with weakness in ocular muscles	Corticosteroids, immunosuppressive drugs
Polymyositis	Generalized muscle inflammation Dermatomyositis: polymyositis with skin lesions		Symmetrical, proximal muscle weakness, malaise, fever, muscle swelling, dysphagia	Immunosuppressive drugs, DMARDS, exercise
Fibromyalgia	Chronic musculoskeletal condition that shows diffused pain in soft tissue		Diffused, chronic pain in joints and muscles, gnawing, burning pain	NSAIDS, 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 cortex		Upper 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 Syndrome	Connective tissue disorder that displays changes in skeleton, eyes and Cardiovascular system		Skeleton: 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