musculoskeletal

scheurmann’s disease

• juvenile kyphosis

• structural deformity of the spine

• causes wedging of the spine

• vertebral bodies and discs are affected

scoliosis

• abnormal sideway curvature of the thoracic spine

• can look like a C or S curve

• structural or functional

structural scoliosis

curvature will stay the same in any position

functional scoliosis

different position can make the spine appear different

Spondylosis

• progressive degenerative conditions that affect the intervertebral discs and vertebral bodies

• affects the Cervical and Lumbar regions

Spondylolysis

• stress fracture on pars interarticularis (crack)

  • thin piece of bone

• commonly affected the lumbar spine

• males; athletes (weight lifting, football, etc.)

• may be unilateral or bilateral

• can lead to spondylolisthesis

Spondylolithesis

• Vertebral bodies slip forward (degenerative)

• can cause pressure on the spinal nerves (SC)

• can cause stenosis (narrowing)

• females

• detectable in an x-ray

Osteomalacia (Rickets)

• “soft bones”

• weakens bones

  • bone breaks easily

• decreased mineralization

Osteomyelitis

• bone inflammation caused by infections

  • starting from the skin → wound or surgery site

• spreads rapidly

• can cause major issues:

  • necrosis

  • permanent bone loss

Osteoporosis

• fast bone breakdown

  • weak bones

  • absorption and reabsorption process is not balanced

• porous bones; holes

  • decreased bone density

• can affect:

  • hips, wrist, spine

Paget’s disease / osteitis deformas

• metabolic disease of bone overgrowth

  • bone grows faster than it can breakdown

• chronic

• affects:

  • pelvis, skull, spine, leg

• can affect one or multiple bones

• new bone is not as strong

Avascular Necrosis / Osteonecrosis

• blocked blood flow to a bone

  • dead bone tissue

• affects:

  • hips, ankles, jaw, knees, upper arm

  • mostly children

Legg-Calve-Perthes

• “flat hip”

• childhood condition

• blood supply is interrupted

  • supply to the femoral head

  • bone begins to die

Osgood Schlatter

• painful inflammation that affects children and teens

• inflammation of the patellar ligament at the tibial tuberosity

  • most common knee pain in kids and teens

Osteoarthritis (OA)

• common type of arthritis

• degenerative joint disease

• cartilage gets worn down over time (bones rub against each other)

  • loss of cartilage

• leading cause of disability

• on weight bearing joints

  • hips, knees, spine, hands

• older adults older than 55

  • post-menopause

OA S&S

• short duration stiffness after inactivity

  • < 30 minutes

• morning stiffness 5-10 minutes after waking

• unilateral

• crepitus (popping/cracking)

• pain in a joint

• pain after exercise

Rheumatoid Arthritis (RA)

• autoimmune disease (chronic)

• affected multiple joints and connective tissue

  • outside the joint

• commonly affects hands and feet

  • bilateral and symmetrical

• uncontrolled inflammation damaging cartilage

• women > men

• child bearing years 20-50

• pregnancy and oral contraceptive can decrease the risks

RA S&S

• bilateral and symmetrical

  • involving multiple joints

• prolonged stiffness

  • > 30 minutes - several hours

• intense pain and stiffness for several hours each

  • morning

  • for prolonged sitting

gout

• metabolic disorder

• inflammatory and painful arthritis

• build up of uric acid in the body

  • urate crystals in the joints

• more common in men

ankylosis spondylitis (AS)

• type of arthritis

• affects joints in the spine and sacroiliac joint

• joints begin to fuse together

• men; 15-40

• asymmetrical

lateral epicondylitis

• overuse of the tendon (extensor muscle tendon)

• pain and inflammation of the elbow

• older than 40; athletes

• “tennis elbow”

Herniated Nucleus Pulposus

• nucleus pulposus (gelatinous substance) forced through a weak portion of bone

  • from the intervertebral disk

• occur mostly in lower back

carpal tunnel syndrome

• common hand/wrist condition

• pressure or irritation on the median nerve

• develops slowly (gets worse over time)

Adhesive Capsulitis

• “frozen shoulder”

• pain and stiffness in the shoulder joint

  • CT in the joint becomes stiff and inflamed

• ages 40-60

• women > men

polymyositis

• severe muscle weakness; inflammatory

  • trunk/torso

• progressive and can cause functional limitations

• symmetrical

Myositis Ossificans / Heterotypic Ossification

• bone formation in soft tissue (forming where it shouldn’t)

• often affecting large muscles

• affects hips more commonly

  • & TMJ, shoulder, elbow

• 2 wks after injury

• caused by surgery, fracture, direct trauma

Rhabdomyolysis

• rapid skeletal muscle breakdown

• toxic components from the muscles go through the kidneys → damage kidneys

  • acute renal failure

compartment syndrome

• myofascial compartment syndrome

• increased interstitial pressure around muscles

• affects function of nerves, muscle, and vessels

  • lead to nerve and muscle damage

Scleroderma / Systemic Sclerosis

• producing thicker tissue

  • cells produce too much collagen

• CT disease

• affects skin, but can affects other parts of body

  • blood vessels, organs, joints

• localized or diffuse to all body

• females; AA; ages 30-50

• rare

Systemic Lupus Erythematosus

• autoimmune disease causes inflammation

• women; ages 15-40

• joint, muscle, or chest pain

• lifelong condition

• butterfly rash on the face

fibromyalgia

• long term health condition

• causes flare ups

• widespread pain in the muscles

• noninflammatory

• older than 40

• women

Myofascial pain syndrome

• inflammation of muscles and fascia

  • muscle stress of overuse

• can occur in one area or multiple areas

  • usually on the same side of the body

• common

• there are trigger points

Complex Regional Pain Syndrome (CRPS)

• chronic pain syndrome

• affects the extremities the most

• can impact the function of the limb

• can be affected by CNS or PNS

• women

• 4-6 wks after injury

strain = …

muscles

sprain = …

ligaments

tendonosis (chronic)

• later stages of tenonitis

• TX: rest, ice packs, analgesics, NSAIDs, ROM, surgery if needed