8 articles Musculoskeletal

Osteoarthritis

Osteoarthritis: Noninflammatory Pain in the hands, knees, and hips X-ray of joints: Joint space/articular narrowing, osteophytes, subchondral degenerative cysts and sclerosis Worse: At the end of the day and with activity Improves: With rest Treat osteoarthritis: Mild to moderate pain: Tylenol or NSAIDs Voltaren gel (NSAID) used for the relief of joint pain of osteoarthritis…

Compartment Syndrome

Acute Compartment Syndrome: Causes: (edema or hemorrhage – swelling within a confined muscle compartment, most common in calf or forearm) Trauma with long bone fracture or without fracture (crush injury, thermal (electrical) burn, vascular injury in extremities) Vascular compromise: Hours after a vascular surgery (embolectomy) – severe calf pain and paresthesia Ischemic-reperfusion syndrome: > 4-6…

Restless Legs Syndrome (RLS)

Restless Legs Syndrome: http://www.nhs.uk/Conditions/Restless-leg-syndrome/Pages/Treatment.aspx Often a side effect of medications (especially psych meds). Ropinerole or Pramipexole (start low dose and titrate up) Start: Pramipexole (Mirapex)125mg PO at bedtime. Give patient instructions that if her symptoms still continued after 1 week of Pramipexole 0.125mg PO every night that she is to increase this medication to 2…

Osteoporosis

Osteoporosis: DEXA scan: Screen all women (post-menopausal) +65 years old at least once! T-score compares a patient’s bone mineral density to that of a healthy young adult WHO criteria: T-score within 1 standard deviation (SD) or better is NORMAL. T-score of -1 to -2.5 SD is defined as OSTEOPENIA. T-score of less than -2.5 SD…

Orthopedics

Tensor fascia lata syndrome: Lateral hip Ibuprofen, encourage heating pad, and encourage stretches http://www.humankinetics.com/excerpts/excerpts/stretching-the-tensor-fasciae-latae-and-the-iliotibial-band http://www.rehab4runners.co.uk/running-injuries/hip-groin-pain/tfl-pain/ Patellofemoral Pain Syndrome: Really tight hamstrings and quadriceps. Weak/decrease muscle mass of quadriceps lead to chronic pain in anterior knees, especially with stairs. Pain is worse when person goes from inactivity to activity. NSAIDs: Meloxicam Patient needs to be referred…

Back pain/Musculoskeletal pain/Sciatica

Back pain/Musculoskeletal pain/Sciatica: Assess for “red flag” signs/symptoms to raise suspicion for malignancy, spinal infection, fracture, and cauda equine syndrome and need for early imaging: weight loss, back pain waking patient from sleep, neurological deficits -> perform diagnostic imaging (MRI) to assess. “Red flags” of cauda equine syndrome: Urinary incontinence or retention Diminished perineal sensation (“saddle…