- Symptoms of a stress fracture may include pain and swelling, particularly with weight bearing on the injured bone.
-Stress fractures should be considered in patients who present with tenderness or edema after a recent increase in activity or repeated activity with limited rest.
-The differential diagnosis varies based on location but commonly includes
=compartment syndrome, and
=nerve or artery entrapment syndrome.
-Bone tumor is a possibility but not the most characteristic in this scenario.
Pain may be increased at night.
In this case there was pain at night but not increased.
Activity may also increase the amount of pain.
There may also be swelling with a bone tumor. Imaging is required.
-Compartment syndrome is a painful condition that occurs when pressure within the muscles builds to dangerous levels.
This pressure can decrease blood flow, which prevents nourishment and oxygen from reaching nerve and muscle cells.
Compartment syndrome can be either acute or chronic.
=Acute compartment syndrome is a medical emergency.
It is usually caused by a severe injury.
There may be pain, decreased pulses, paresthesias, pallor, and paralysis.
=Chronic compartment syndrome, also known as exertional compartment syndrome, is usually not a medical emergency.
It is most often caused by athletic exertion.
However, the patient usually complains of a bursting type of pressure and pain,
-Shin splints (medial tibial stress syndrome) is a common condition that can be distinguished from tibial stress fractures by nonfocal tenderness (diffuse along the mid-distal, posteromedial tibia) and a lack of edema.
Correct Answer: Patient fails to recognize the therapist on the third consecutive postoperative visit warrants contact with physician.
- Postoperative delirium is characterized by incoherent thought and speech, disorientation, impaired memory, and attention.
-Elderly patients usually manifest delirium following a lucid interval of 1 postoperative day or more, a condition known as interval delirium.
-Symptoms are often worse at night.
Alternatively, the condition can be silent and unnoticed, or misdiagnosed as depression. However, the effects of elderly postoperative delirium are evident in increased morbidity, delayed functional recovery, and prolonged hospital stay.
Fortunately, the postoperative cognitive dysfunction is a reversible condition in the majority of elderly surgical patients.
-Preoperative risk factors of bilateral total knee arthroplasty are associated with a significantly higher incidence of acute delirium than unilateral total knee arthroplasty in patients over 80 years.
-Failing to recognize the therapist after three visits is an indication of a declining mental condition.
This would definitely be a safety consideration as the patient may not be able to follow all the precautions and may also put himself or herself in danger by walking without an ambulatory aid, etc.
Wound infection is also a consideration. Contacting the surgeon is necessary.
- muscles that contribute to inhalation and exhalation, by aiding in the expansion and contraction of the thoracic cavity.
-The diaphragm and, to a lesser extent, the intercostal muscles drive respiration during quiet breathing.
-Additional accessory muscles of respiration are typically only used under conditions of high metabolic demand (e.g. exercise) or respiratory dysfunction (e.g. an asthma attack
the sternocleidomastoid and the scalene muscles (anterior, middle and posterior scalene) are typically considered accessory muscles of breathing.
Both assist in elevating the rib cage.
= Apart from these neck muscles, the following muscles have also been observed contributing to respiration: serratus muscles, pectoralis major/minor, trapezius, latissimus dorsi, erector spinae, iliocostalis lumborum, quadratus lumborum, levatores costarum, transversus thoracis, subclavius
The MFIS is an appropriate measure to examine the physicaL cognitive, and psychosocial functional limitations of fatigue in patients with MS.
- The FIM is a 7 -level scale of functional performance and includes 18 items on self-care, sphincter control, transfers, locomotion, communication, and social cognition.
-The WAQ examines functional performance of walking skills.
-The OASIS is a measure of function in the home care setting and includes 79 core items, including sociodemographic characteristics, environmental factors, social support, health status, and functional status
1. Functional Independence Measure (FIM).
2. Walking ability questionnaire (WAQ).
3. Outcome and Assessment Information Set (OASIS).
4. Modified fatigue impact scale (MFIS
- This patient is exhibiting several risk factors for osteoporosis: postmenopausal age, low body weight, loss of height, sedentary lifestyle, tobacco use, and hyperthyroidism (Graves' disease).
-Signs and symptoms include
=severe and localized thoracic-lumbar pain,
=increased pain with prolonged upright posture, =decreased pain in hook-lying,
= loss of height, and kyphosis (dowager's hump).
-Grave's diseas and osteoporosis
excessive quantities of thyroid hormone either due to over-production from the thyroid gland or due to excessive intake in the treatment of hypothyroidism can also accelerate bone loss resulting in a decrease of bone density.
This in turn may lead to increased fracture risk.
- Her pain is most likely due to compression fractures, which can be confirmed on x-ray.
Osteoporosis can be confirmed with a bone density scan.
- Osteoarthritis produces asymmetrical pain with typical involvement of large weight-bearing joints.
-Gout pain is limited to only a few joints, typically affecting the first metatarsal, the knee, or the wrist.
-Spinal stenosis typically occurs in the lumbar spine and is accompanied by pain when standing and walking, extending into the buttocks and proximal thigh, nocturnal pain, and lower motor neuron (LMN) signs
- CRPS includes symptoms of pain, vascular changes, and atrophy.
-Early signs (stage 1) include
=hyperalgesia (increased sensitivity to pain),
= allodynia (all stimuli are perceived as painful), and =hyperpathia (increased intensity)
with edema, increased sweating, and thin, shiny skin.
- Later signs and symptoms (stage 2) include increased pain with edema and atrophic skin and nail changes.
- Late stage changes (stage 3) include spreading pain, hardening of edema, cool, dry, and cyanotic skin, developing osteoporosis, and ankylosis