Musculoskeletal Health: Conditions, Symptoms, and Treatments
Synarthrosis Definition and Examples
Synarthrosis: Joints united by tissue, allowing no movement. Example: Skull bones, also known as sutures.
Diarthrosis: Definition and Components
Diarthrosis (Synovial Joints): Characterized by articular cartilage, synovial membrane, joint capsule, and ligaments.
Types of Diarthrosis (Synovial Joints)
- Plane: Carpal bones
- Trochoid (Pivot): Distal radioulnar joint
- Trochlear (Hinge): Humeroulnar joint
- Condyloid: Femorotibial joint
- Spheroid (Ball-and-Socket): Hip joint, glenohumeral joint
Osteoarthritis Definition and Characteristics
Osteoarthritis: A chronic joint disorder characterized by degeneration of articular cartilage and adjacent bone, leading to joint pain and stiffness.
Radiological Characteristics of Osteoarthritis
- Decreased joint space
- Subchondral sclerosis
- Marginal osteophytosis
- Subchondral cysts (e.g., in the hip)
Pharmacological Treatment for Osteoarthritis
- Non-steroidal anti-inflammatory drugs (NSAIDs)
- Analgesics
- Infiltrations (corticosteroids, hyaluronic acid)
- Cartilage protective agents (glucosamine sulfate, chondroitin sulfate)
Arthritis Definition
Arthritis: Inflammation of joints and surrounding tissues.
Septic Arthritis Treatment
- Antibiotics guided by culture results
- Joint lavage and drainage
- Joint immobilization during the acute period
- Mobilization as soon as possible
Hyperuricemia Definition and Symptoms
Hyperuricemia: Excess uric acid in blood and tissues. Clinical manifestations are triggered by crystal deposits in tissues, causing severe acute joint pain and exuberant manifestations.
Rotator Cuff Injury Classification
- Grade 1: Edema
- Grade 2: Partial thickness tear
- Grade 3: Full thickness tear
Importance of the Clinical History Document
- Basis for decision-making
- Understanding the patient
- Avoiding risks
Key Sections of a Nursing Clinical History
- Allergies
- Current and past illnesses
- Medications (regular and exceptional)
Important Elements of a Nursing General Exam
- Blood Pressure (BP)
- Heart Rate (HR)
- Temperature (T°)
- Respiratory Rate (RR)
- Bowel movements
- Fluid intake and output balance
Common Imaging Technologies in Traumatology
- First choice: X-rays (2 projections)
- CT Scan: For bone imaging
- MRI: For soft tissue imaging
Causes of Back Pain and Scoliosis
Causes of Back Pain:
- Mechanical: Due to poor spinal function.
- Organic: Specific pathology (e.g., facet joint issues, bony lesions, distal problems).
Scoliosis: Lateral curvature of the spine in the frontal plane, often of unknown etiology. Characterized by asymmetry, rotation, and wedging.
Osteoporosis and Osteopenia Criteria
Osteoporosis is diagnosed when bone mineral density is 2.5 standard deviations or more below the mean peak bone mass. Bone mineral density between 1 and 2.5 standard deviations below the mean is termed osteopenia.
Osteoporosis Risk Factors Affecting Bone Density
- Age
- Genetics
- Race
- Sedentary lifestyle
- Calcium and Vitamin D deficiency
- Hormonal imbalances (e.g., steroid use)
- Habits: Alcohol consumption, excessive coffee intake
Carpal Tunnel Anatomy
- Floor and Walls: Second row of carpal bones
- Roof: Transverse carpal ligament (annular ligament)
- Contents: Superficial and deep flexor tendons of the fingers, long flexor tendon of the thumb, and the median nerve.
Tarsal Tunnel Syndrome Concept
Tarsal Tunnel Syndrome: Dysfunction of the posterior tibial nerve or one of its branches due to compression at the level of the tarsal canal (formed by the shinbone, talus, and calcaneus).
De Quervain’s Tenosynovitis Concept
De Quervain’s Tenosynovitis: Narrowing of the sheaths surrounding the tendons of the abductor pollicis longus and extensor pollicis brevis.
Fractures: Definition
Fractures: A break or loss of continuity in bone and/or cartilaginous tissue.
Fundamental Principles of Fracture Treatment
- Reduction (realignment)
- Containment (stabilization)
- Consolidation (healing)
General Complications of Fractures
- Traumatic shock
- Fat embolism
- Thromboembolism
- Infection (e.g., tetanus, gas gangrene)
Local Complications of Fractures
- Skin injuries
- Muscle and tendon damage
- Nerve damage
- Vascular injuries
- Visceral damage
- Bone complications (e.g., osteomyelitis, osteonecrosis)
- Joint complications
Fracture Consolidation Complications
- Delayed union
- Nonunion (hypertrophic, atrophic)
Priorities for Open Fractures
Priorities for Open Fractures (in order of importance):
- Save life
- Save limb
- Save function
Emergency Management of Open Fractures
- Interim immobilization
- Control of general vital signs (e.g., circulation, sensation, movement, temperature, pain)
- Always surgical treatment in a sterile environment.
Dislocation Definition
Dislocation: A traumatic injury, often caused by an indirect mechanism, characterized by capsuloligamentous damage where the articular ends permanently lose normal contact.
Clinical Signs of Glenohumeral Dislocation
- Shoulder epaulet sign
- Pressure sign
- Repositioning test
- Sulcus sign
- Anterior and posterior drawer tests
- Neer’s test
Clinical Signs of Posterior Elbow Dislocation
- Loss of Nelaton’s triangle
- Elbow in semiflexion position
- Associated lesions (e.g., brachial artery, median nerve, associated fractures in 12-62% of cases)
Clinical Epicondylitis (Tennis Elbow)
Clinical Epicondylitis (Tennis Elbow): Tendinitis at the insertion site of the common extensor origin (often the second radial extensor). Pain originates from palpation of the epicondyle and the second radial extensor.
Treatment for Coxarthrosis (Hip Osteoarthritis)
- Medical management (NSAIDs, analgesics, cartilage protective agents)
- Hyaluronic acid infiltrations
- Rehabilitation
- Surgical intervention
Clinical Signs of Congenital Hip Dislocation
- Galeazzi sign
- Ortolani maneuver
- Barlow maneuver
- Telescoping
- Asymmetry of gluteal folds
- Limp
When to Treat Congenital Hip Dislocation?
Treatment for Congenital Hip Dislocation should begin as soon as the condition is discovered. Early intervention is crucial.