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40 terms

Orthopedic Pathology

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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