NPTEFF Common MSK conditions round 2

PCL Sprain characteristics / presentations / treatments

Characteristics: Landing on tibia with flexed knee; hitting automobile with flexed knee on dash

Presentation: Minimal pain/swelling, positive special tests, MRI is a gold standard for Dx

Treatment: RICE; NSAIDs, LE strengthening with NO HAMSTRING EXERCISES

Meniscus tear characteristics / presentations / treatments

Characteristics: Rotation on fixed foot while bearing weight on flexed knee

Presentation: Swelling, popping, clicking; pain along medial or lateral joint line. Positive special tests

Treatment: RICE, NSAIDs, partial meniscectomy; meniscus repair

Patellofemoral pain syndrome characteristics / presentations / treatments

Character: Pain or discomfort in anterior knee, decreased quad strength, decreased flexibility, increased tibial torsion or anteversion

Present: Females, growth spurt, excessive weight, runners

Treat: Modalities, medial patellar glides, patella taping, strengthen quads and VMO

OA characteristics / presentations / treatments

Character: Chronic degen of articular cartilage in WB joints; thickening of subchondral bone.

Present: Ages over 65, excessive weight, joint injuries, occupational or athletic overuse. Gradual onset of pain, post activity pain, weather related pain, Heberden and Bouchard nodes. X ray to Dx

Treat: Reduce pain, NSAIDs, Improve lube of knee, improve ROM, endurance, and M strength, TENS, energetic conservation, weight loss, joint protective Strats like bracing and activity mods

RA. characteristics / presentations / treatments

C: Systemic autoimmune disease causing inflammation of synovial lining and connective tissues, common in small joints

P: Age 30-60, female, symmetrical involvement, pain/tender, morning stiff, warm, swan neck / boutonniere

T: Reduce inflame / pain, promote joint function. DMARDs, PROM, AROM, Modalities, joint protection strats

OP characteristics / presentations / treatments

C: Chronic, progressive, metabolic disease with low bone mass = increased risk of fractures

P: Female, loss of height, postural changes, kyphotic, back pain, FXs. T-scores: ≥ -1 is normal. -1 - -2.4 is osteopenia. < -2.5 is OP

T: Calcium, vitamin D, estrogen, weight bearing activity, strengthening, lifestyle mods. Avoid flexion exercises and high impact activities

Congenital hip dysplasia characteristics / presentations / treatments

C: Developmental dysplasia, malalignement of femoral head within acetabulum

P: Female, asymmetrical hip abduction with tightness, apparent femoral shortening

T: Pelvic harness, splinting, traction, bracing, close/open reduction, stretch, strengthen

Congenital Torticollis (wryneck) characteristics / presentations / treatments

C: SCM contracture within first 2mo life

P: Malposition in utero, birth trauma, ipsilateral cervical flexion, contralateral rotation

T: AROM, Positoning, massage, surgical release

Juvenile idiopathic arthritis (JRA) characteristics / presentations / treatments

C: Autoimmune disease; inflammation of joints and connective tissue; can be systemic, polyarticular, or olioarticular

P: Aysmmetrical, multiple joints, most common is oligoarticular (4 or fewer joints)

T: DMARDs, NSAIDs, corticosteroids, PROM and AROM; positioning; splinting; strengthen; postural training increase endurance, modalities