Exit exam musculoskeletal

Arthritis in which symptoms worse with activity and relieved with rest. morning stiffness typically improves within 30 min. usually asymmetric w/o any warmth, redness, or systemic symptoms

osteoarthritis

Bouchard nodes affect_______ joint and are common in what condition

proximal interphalangeal joint - both oa and ra

herbenden nodes affect ___________ and are acommon in what condition

distal interphalangeal joint; oa

what will xray show on xray of oa

joint space narrowing

treatment for oa

nsaids; topical for one or two joints (diclofenac); oral for hip or more widespread (ibuprofen, naproxen, aleve, indomethacin)

uspstf guidelines for screening for osteoporosis

screen women 65 and older, as well as those women under 65 with a higher risk based on FRAX tool

normal, osteopenia, osteoporosis values of dexa scan

normal: -1 or greater

osteopenia: -1 to -2.5

osteoporosis: -2.5 or less

first line drug class for osteoporosis

bisphosphonates (drugs that end in dronate)

patient education for osteoporosis drugs

take with full glass of water first thing in morning by itself and stay upright for at least 30 min

test used to diagnose acl injury. pt lays supine, clinicia puts one hand on lower thigh and one on lower leg. knee is bent to 20 degree angle as you pull lower leg forward while keeping thigh stable. feeling for increased joint laxity. positive result is when there is a “soft end point” when compared to intact knee. in a completely torn acl, no end point at all

lachman test

test that tests for acl tear. knee is flexed to 90 degrees

anterior drawer test

test to diagnose meniscal injury. pt lays supine, grab heel with one hand and knee with the other. internally and externally rotate leg to see if there’s reproduction of pain or if there’s clicking

mcmurray

test that suggests shoulder impingement syndrome. have pt sit with arms at side in neutral position. raise affected arm to 90 degrees. if there is pain as they raise arm, suggests impingement

painful arc test

tests for a rotator cuff tear. as pt to slowly lower arm. if unable to lower slowly and smoothly, positive

drop arm test

test that assesses supraspinatus. ask pt to extend arm to 90 degrees of abduction, internally rotate arms. once internally rotated, clinician provides downward pressure on arms. positive if there’s pain or weakness

jobe test/ empty can test

test for carpal tunnel. pt presses back of their hands together. if pain/tingling, positive

phalen test

test for carpal tunnel. tap wrist. if pain/tingling, positive

tinel test

test used to diagnose de quervain tenosynovitis. make a fist with fingers covering thum and move wrist down into ulner deviation

finkelstein test

test to assess for lumbar radiculopathy (sciatica) - slowly raise leg from supine

straight leg test

what does FABER test stand for and what does it test for

flexion, abduction, external rotation. have pt lie supine on table. place foot of affected side on the opposite knee, making a figure 4. this flexes, abducts, and externally rotates the hip. if there’s pain in groin, suggests hip issue and not spine issue. you can then press down flxed kene while pressing down on opposite hip. if this causes pain in lower back, suggests issue in si joint.

test that checks for weakness in hip abductor muscles. pt stands up and faces away from you. stand on bad leg. postiive test result - opposite hip drops. normal: hips stay at same level or slight elevation on opposite side

trendelendburg test

condition characterized by point tenderness in soft tissue areas

fibromyalgia

medication options for fibromyalgia

tricyclic antidepressants, snris (cymbalta), pregabalin

foot condition that presents as pain or feeling like there’s a pebble between the third and fourth toe, with numbness and tingling. more common in people who wear high heels and narrow toed shoes

morton’s neuroma

fracture from a fall on outstretched hand

snuff box fracture - thumb spica cast

condition in which femoral head slips out of place

slipped capital femoral epiphysis - potential for damage to growth plate

what gait abnormality may be present

trendelenburg