Term
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Definition
| synovial lined structure that cushions boney prominences |
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Term
| periph nerves multiple entrapment syndromes |
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Definition
| when periph nerves are compressed, they produce paresthesias in distribution of the nerve |
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Term
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Definition
| peripheral nerve pain (burning, tingling or shock-like) can be reproduced by tapping over nerve |
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Term
| trigger finger (flexor tendonitis) |
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Definition
flexor tendon traverses volar MCP through fibrous tunnel A1 pully>trauma causes fibrous tissue on tendon sheath>sticking of tendon on extension
typical sx: triggering finger sticks in flexion and needs to be snapped open
usually in morning
tenderness over flexor tendon, pain with stretch
can occur w/RA diabetes
Tx w/steroid injection, splinting, surgery |
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Term
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Definition
tendonitis of extensor pollicus brevis and longus tendons
typically from over use
causes pain in radial side of wrist; worse with pinching; can refer up arm or down to thumb
dx with finkelstein's maneuver (wrap fingers around thumb and deviate wrist in ulnar direction; causes pain up radial wrist and forearm)
tx: injection, splinting, rarely surgery |
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Term
| What does the Finkelstein's maneuver diagnose? |
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Definition
| DeQuervain's Tenosynovitis |
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Term
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Definition
| reverse prayer sign: holding back of hands against eachother with wrists fully flexed reproduces the symptoms of carpal tunnel syndrome |
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Term
| atrophy of thenar muscles |
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Definition
| a late finding in carpal tunnel syndrome due to retrograde nerve degeneration and denervation atrophy |
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Term
| How is carpal tunnel syndrome diagnosed? |
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Definition
| EMG showing slowing of nerve conduction across the wrist |
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Term
|
Definition
tennis elbow
injury to proximal tendon of wrist extensors from over stress of forearm extensors
pain at lateral epicondyle with grasp or lifting; referred down forearm |
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Term
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Definition
injury causes effusion: serosangenous or frank blood
synovial fluid is clear
can occur with gout and RA
diagnosis is by aspiration of the bursa |
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Term
| How is an infection differentiated from oleecronon bursitis? |
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Definition
| infection: cellulitis extending out from bursa and synovial fluid is cloud to purulent |
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Term
|
Definition
stabilize the shoulder
supraspinatus
infraspinatus
teres major
subscapularis |
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Term
| List some causes of shoulder pain. |
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Definition
| rotator cuff disease, acromioclavicular arthritis, biceps tendonitis, glenohumeral arthritis, calcific tendonitis, adhesive capsulitis, referred pain |
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Term
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Definition
from over or misuse
most commonly from injury to supraspinatus tendon
pain in upper arm w/internal rotation and abduction
painful arc sign: pain whena rm is abducted from 20-120 degrees as humeral head rotates under acromion |
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Term
|
Definition
pain when arm is abducted from 20-120 degrees as humeral head rotates under acromion
develops from rotator cuff disease |
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Term
| What do you see with partial tear or rotator cuff vs complete tear? |
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Definition
partial tear: weakness of resisted abduction and external rotation
complete tear: unable to initiate abduction and when arm is fully adbcuted and lowered, you will see "drop sign"--arm falls at about 90 degrees as unable to maintain humeral head in acroion |
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Term
| when do you see drop sign in the arm |
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Definition
| complete rotator cuff tear |
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Term
| pain anterior and superior to shoulder |
|
Definition
| acromioclavicular arthritis pain |
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Term
| acromioclavicular arthritis pain |
|
Definition
occurs anterior and superior to the shoulder
can have tenderness over joint and can see subluxation of the joint w/protrusion of distal clavicle
pain elicited w/adduction of shoulder and can feel crepitus over the joint |
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Term
| pain with adduction of the shoulder |
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Definition
| acromioclavicular arthritis pain |
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Term
|
Definition
anterior to the shoulder, tenderness over long head of biceps tendong
pain elicited w/resisted supination of wrist or resisted biceps flexion |
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Term
|
Definition
"frozen shoulder"
diffuse pain around shoulder and upper arm
rapidly develop loss of motion secondary to contraction of the capsule
fairly common in diabetes after trauma |
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Term
|
Definition
uncommon site of osteoarthritis
polymyalgia rheumatica: suggested by morning stiffness in shoulder >1hr |
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Term
|
Definition
form calcium apatite deposits at site of injury
can cause pain from mechanical interference w/shoulder motion or if Ca fragments provoke inflammation and have acute severe shoulder pain |
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Term
| What can cause referred pain in the shoulder? |
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Definition
nerve root impingment in cervical spine (most common)
myocardial ischemia
tumors at lung apex or subdiapragmatic area
hallmarks of referred pain: intermittent and inability to reproduce the pain on examination |
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Term
| intermittent pain with inability to reproduce it upon examination |
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Definition
|
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Term
| What is the most common imaging modality for shoulder pain? |
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Definition
| MRI--can visualize tendons |
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Term
|
Definition
peaks 4th-6th decade
F>M
associated conditions: OA hip, lumbar spondylosis, iliotibial band syndrome, leg length discrepancy, THR
Sxs: pain in lateral thigh, distal to knee, lying on side, rising from seat
pain on palpation over bursae
pain with ER of hip and resisted abduction |
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Term
|
Definition
bursa over medial tibial plateau
pain in medial knee with referred pain down tibia
usually occurs with underlying osteoarthritis of the knee
finding on exam: tenderness over MTP |
|
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Term
| pain in medial knee w/referred pain down tibia |
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Definition
|
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Term
| Where is the anserine bursa? |
|
Definition
| over medial tibial plateau |
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Term
|
Definition
injury or inflamm of attachment of plantar fascia
pain in heel typically w/first step in am
PE: tenderness at attachment
predisposition: trauma, weight, pes planis (flat feet), pes cavus (high arches) |
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Term
|
Definition
chronic generalized pain disorder
w>m
mean age onset: 40s
symptoms: fatigue, AM stiffness, paraesthesias, swelling
associated conditions: irritable bowel, headache, depression |
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