Orthopedic Pathology

Created by thepal819 

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40 terms

Arthrogryposis

Congenital Disorder characterized by rigid joints of all extremities (symmetrical)
-Characterized by sausage like shapeless limbs and weak muscles
-Hip dislocation/contractures, shoulder contracture and club feet
Treatment
i. ROM, splinting, positioning, adaptive devices

Complex Regional Pain Syndrome

A sympathetic reflex resulting in a persistent lesion
- Signs - Pain, edema, decreased circulation, skin dryness atrophy of muscles in close proximity
Treatment - modalities to decrease pain, jt mobilization, closed chain

Colle's Fracture

Most common wrist fx 2nd to FOOSH
- Cast wrist and do ROM early with closed chain stabilization exercises

Osteoarthritis

Affects weight-bearing joint by degeneration of articular cartilage
- Morning stiffness but goes away with movement
- Treatment - NSAIDS, ROM, Exercises ADL

Fibromyalgia

Unknown origin - tenerness, pain and stiffness in muscles
- Related to stress, anxiety, fatigue and sleeplessness
- Burning in the muscles and tender points
- 11/18 tender points

Gout

Metabolic disease with elevated levels of uric acid and urate crystals
- Affects feet, especially - great toe, ankles and mid foot
- Diagnose with elevated serum urate and xray
- Immobilize and symptoms go away with change in diet

Hemophilia

Hereditary hemorrhagic disorder/no clotting factor
- Treatment - splint, RICE

IT Band Syndrome

Irritation of ITB over the lateral epicondyle
- Occurs with runners and overuse syndrome
- Diagnose with - Positive Obers, Excessive IR, Palpate over ITB
- Treatment - Modalities (over muscle belly), stretching, shoe orthosis

Myositis Ossificans

Formation of bone spurs in muscle belly
- Xray will show calcium deposits
- Gentle AAROM
- Don't PROM!
- No Manual Stretch with overpressure

Osteochondritis Dessecans

Separation of the articular cartilage from bone - Bone fell off because of lack of blood supply
- If X-ray shows the bone separated then sx in indicated

Osteomalacia

Decalcification of the bone causing deformities, fx or pain
- Results from vitamin D deficiency

Osteoporosis

Metabolic bone disease - bones aren't strong/dense enough
- May be predisposed to fx - (commonly in t-spine/check for dowagers hump)

Paget's Disease

Slowly progressing bone disease - body reabsorbs and forms bone. New bone structure is fragile and weak causing deformities
- Usually in spine, pelvis, femur and skull
- When associated with CHF can be deadly

Patellofemoral Dysfunction

Patella fails to track properly
- Pain is usually present at first 30 degrees of knee flexion
- Stair climbing, prolonged sitting, squatting or jumping hurts
- Q angle is greater than 18 degrees
- Pain under patella with compression and quad contraction
- Treatment: McConnell's Tape, strengthen VMO, stretch ITB/TFL

Patella Baja

Patella lower than normal

Patella Alta

Patella higher than normal

Scleroderma

Fibrosis and changes in the internal organs and skin
- Accompanied with Raynaud's (limited circulation because small arteries don't work)
- RA factor tests come out positive
- Treatment - maintain ROM, and strengthen

Pronator Teres Syndrome

Median Nerve is trapped in pronator teres muscle
- Resist pronation and if tingling or paresthesia is provoked in the forearm and hand it is positive
- Treat with nerve glides, Friction

RA

Chronic inflammatory disease
- Occurs in women 30s/40s
- Symmetrical in the synovial tissues of the hands, wrists, elbows, shoulders, knees, ankles and feet
- Eye lesions could occur
- Juvenile RA is characterized by fevers and rash

Scaphoid Fracture

FOOSH of a younger person
- Because of poor blood supply avascular necrosis could occur
- Dx with Radiological studies

Scoliosis

Generally unknown etiology
- Could be caused from structural abnormalities
i. Leg length or herniated lumbar disc
ii. Respiratory care may be needed if Cobb's angle is greater than 40 degrees

Sjogren's Syndrome

Dryness in eyes and mouth
a.Seen with RA
b.Chew sugarless gum to increase moisture
c.Use mothwash

Smith's Fracture

Distal fx of the radius with dislocated dorsal (back)
a.Foosh when supinated

1st Degree (Sprain)

Sprain:
some fibers are torn
i. Tx - Pain free AROM, modalities

2nd Degree (sprain)

Sprain:
portion of the ligament and joint capsule is torn with some functional loss. Joint stability remains
i. Tx - After 2-3 weeks start strengthening

3rd Degree (Sprain)

Sprain:
complete disruption of the ligament or joint capsule with loss of function, joint instability and swelling of the area.
i. Tx - May require sx, cracing or splinting
ii. Rehab could take 5-6 months following a repair of a ligament

SLE (Systemic Lupus Erythematosus)

Chronic, rheumatic inflammatory disorder of connective tissue
a. Affects multiple organs like the skin, joints, kidneys, heard etc
b. Symptoms are malaise, fatigue, fever, arthritis, skin rash (butterfly style over face) anemia, hair loss etc

Synovitis Capsulitis (TMJ)

TMJ:
pain in preauricular (anterior ear)
1. Unable to close back teeth
2. Opens less than 40 mm
3. Pain decreases with rest

Hypermobility (TMJ)

TMJ:
1. Pt reports - my jaw feels out of place
2. Joint noises, short term jaw catching
3. Mandibular opening is greater than 40mm

Disc Displacement (TMJ)

TMJ:
1. Intermittent locking without joint noises
2. Opening of mandible limited to 20-25mm with deflection towards involved side
3. Limited lateral movement toward the opposite side

Torticollis

Sternocleidomastoid muscle continues to contract resulting in lateral bending of the head to the affected side with rotation to opposite side
a. Treatment -
i. Modalities to reduce muscle spasm
ii. Stretch

Total Hip Replacement

a.Precautions for ______ is: Avoid Hip flexion (+90), ADD (past neutral)

Osteomyelitis

Acute or chronic bone infection
- Could result from trauma and infection
- Often times treat with immobilization, traction or bed rest
- If chronic could require amputation

ER

For Total Hip Replacement Anterolateral Approach avoid what?

IR

For total Hip Replacement posterolateral approach avoid what?

Sx Side

for Total Hip Replacement when rolling out of bed, which side do you roll on?

March

Tibial fx:
inferior 3rd of the tibia - common to people who take long walks out of no where

Spiral

Tibial Fx: middle/inferior tibia torsion often during skiing

Compound

Tibial Fx: direct blow to the tibia - bumper of car strikes tibia

Gluteus Medius Gait

With a slipped capital femoral epiphysis look for this type of gait

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