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28 Cards in this Set
- Front
- Back
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Thoracic Outlet Syndrome |
Swelling/puffiness in the arm/hand. Feeling of heaviness in arm/hand. Deep, boring toothache like pain in the neck and shoulder Increased symptoms at night Hand and arm easily fatigues Paraesthesias - medial forearm and hand (palm) Difficulty gripping Cramps of the muscles of medial forearm Arm and hand pain
Examination: ROOS, Wrights hyperabduction, Adsons, Halstead - these tests must reproduce the symptoms and diminish he pulse.
Management: Joint manipulations, first rib mob/manip, exercise/stretches - lengthen short strengthen weak. Restore correct biomechanics. Modalities, NSAIDS. |
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Fibromyalgia |
Widespread pain, stiffness and tenderness of muscles, tendons and joints without signs of inflammation. Fatigue Sleep and mental/emotional disorders are common - mood changes, irritability, depression, anxiety, poor concentration. May have associated migraine, TTHA, numbness and tingling, abdominal pain (IBS), irritable bladder.
11/18 tender spots
Management: NSAIDS to reduce ny inflammation Manipulation as indicated Exercises/stretches Most effective treatment combines patient education, stress reduction, regular exercises and medications. |
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Rheumatoid arthiritis |
Morning stiffness - often takes >1 hour to be able to move joint comfortably. Generalised joint pain (multiple joints) Symmetrical distribution Possible tenderness and sweeling of joints F>M 20-40 years Commonly affects small joints, wrist, MCP
Management plan: NSAIDS for inflammation Manipulation contra-indicated in inflammatory stage. Inflammatory stage is often unpredictable so manual therapies should be administered with caution. |
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Myocardial Infarction |
"Tension" "Sitting on chest" feeling in the chest/between the shoulder blades. May radiate to the Left arm, neck, torso or jaw. Pain may be slightly eased by flexing shoulders Worsened by deep inspiration Diaphoresis, dyspnea, loss of consciousness, pallor, tachycardia |
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TMJ Dysfunction |
Characterised by headache radiating from the muscles of mastication, periauricular region, or the temporomandibular joint associated with abnormal jaw function, asymmetrical chewing, bruxism, neck pain, tinnitis, and vertigo.
Management: Combination of rehabilitative and pharmacological interventions for headaches relatex to TMJ dysfunction. |
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Cervical Myelopathy |
Neck +/- shoulder pain and stiffness. Wide-based clumsy, incoordinated gait Loss of hand dexterity Paraesthesias - one or both arms/hands Visible change in handwriting Difficulty manipulating buttons or handling coins LBP
Examination: Hyper-reflexia + babinski + hoffman Lhermittes sign Urinary retention followed by overflow incontinence (severe)
Management: Imaging, REFER |
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Facet Joint Dysfunction |
Well localised pain Decreased ROM Preceeding abnormal movement or prolonged sustained position
Lumbar facet referral: general lumbar (L1-5) gluteal region (L3-S1) Lateral thigh (L2-S1) posterior thigh (L2-S1)
Management plan: NSAIDS for inflammation Manipulations Exercises/stretches Modalities |
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Costovertebral/Costotransverse Joint Dysfunction |
Posterior thoracic pain which can radiate to the shoulder/arm/chest. Associated paraspinal muscle spasm
Management: Activity modification Inflammation control (if required) Once inflammation decreased, address any restrictions |
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Disc Disruption |
Diffuse dull ache Deep seated stabbing pain in the back Guarded, restricted and slow lumbar spine movement Sensations of a "weak unstable" back, pain can be referred to hip and lower limb. Most common presentation - nondescript pain and a negative physical examination in a severely apprehensive patient.
Management: NSAIDS for inflammation Manipulations, McKenzie exercise, Exercises/stretches, Modalities, Dynamic lumbar stabilisation (spinal bracing in neutral)
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Spondylolisthesis |
Hip and LBP May radiate into lower extremities Limited ROM Positive SLR Tenderness of the lumbar spinous process with or without a palpable step Significant hamstring tightness or spasm which may result in an abnormal gait - short stride length, |
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Pericarditis |
Substernal pain that may radiate to the neck, upper back, upper trap, left supraclavicular area, left arm, costal margin. Pain relieved by leaning forward/sitting upright Pain reduced while holding breath Pain aggravated by movement of deep breathing (cough, laugh, deep inspiration and laying down) Lower extremity oedema |
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T4 Syndrome |
Upper back stiffness and achiness Associated upper extremity numbness and/or paraesthesias (glove distribution) May have associated headache Symptoms usually occur at night or wake the patient up early in the morning.
Examination: Tenderness and restrictions in involved segments (usually T2-T7) Palpation may reproduce the symptoms Neuro exam is normal
Management plan: NSAIDS, Manipulations, Exercises/Stretches, Modalities |
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Angina |
Stable: Chronic coronary artery disease (clinical syndrome), transient myocardial ischemia. Caused by exertion, emotional change Relieved by rest
Unstable: Acute coronary syndrome Occurs at rest (or with minimal exertion), usually lasting >10minutes Severe and of new onset (within 4-6 weeks) Occurs with a crescendo pattern (distinctly more severe, prolonged, or frequent than previously). |
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Aortic Aneurysm |
Dyspnea upon exertion Pulsatile abdominal mass, abdominal pain, and abdominal rigidity.
Thoracic - hoarsness, wheezing, coughing, hemoptysis, chest pain, back pain, or abdominal pain.
Many are asymptomatic.
Patients suspected of AA - refer immediately |
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Osteoid Osteoma |
10-25 yrs Any bone - most commonly femur and tibia IF in the spine, posterior arch (sclerotic pedicle) Highly vascularised and innervated = pain Sharp pain, worse at night, classically relieved by aspirin. Can present as painful scoliosis
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Multiple Myeloma |
50-70yrs TL spine most common, marror rich bones frequently affected. mc primary malignant bone tumor affects ST as well IgG myeloma most common
Diffues back pain, usually worse during the day. Weight loss, cachexia, anemia. Lab findings: Normochromic, normocytic anemia, reversed A/G ratio, bence jones proteinuria and an M spike with serum protein electrophoresis (Definitive) |
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DISH |
Can be asymptomatic 50-60yrs Morning stiffness and low grade MSK pain Dysphagia (20%) Hoarsness of the voice, stridor, and dyspnea have been reported.
Extraspinal symptoms: localised pain, occasional swelling, ossific masses, especially of the achilles and quads tendons. |
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Complex regional pain syndrome |
New onset of unexplained or persistent or recurrent physical or mental fatigue the substantially reduces activity level. Post-exertional malaise, which requires an extended recovery period. At least one symptom from the following: Autonomic manifestations, neuroendocrine manifestations, and immune manifestations.
Joint and muscle pain, difficulty concentrating, tender lymph nodes, headaches, and sleep dysfunction. Significant diagnostic overlap with depression, fibromyalgia, and SLE.
Management: Optimal treatment includes activity modification and stress management, anaerobic reconditioning, and medication fo relief of associated symptoms. |
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Systemic Lupus Erythematosus |
Neck pain associated with fatigue and joint pain/swelling affecting the hands, feet, knees, and shoulders.
MC Females of child bearing age. Chronic Autoimmune disorder - can affect any organ system.
Confirm diagnosis by the presence of skin lesions, heart, lung, or kidney involvement and lab abnormalitites including low platelet counts, or positive antinuclear antibody and anti-DNA antibody tests.
Treatment: medication, physical therapy, and management of associated complications of the skin, lungs, kidneys, joints, and nervous system. |
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Subarachnoid haemorrhage |
Sever headache and/or neck pain with nuchal rigidity. Passive and active flexion of the neck increases pain. Additional symptoms: nausea, vomiting, photophobia, drowsiness, confusion, dizziness, transient loss of consciousness, and enlarged pupils.
Head trauma and intracranial aneurysms are the mc causes. Can be non-traumatic (incidence increases with age) HTN and DM two major risk factors (+ pregnancy).
Previous history of an atypical headache 2 days prior.
Management: Lumbar puncture and CT confirm the diagnosis.
Medical emergency. |
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Subdural hematoma |
Neck pain and unilateral/occipital headache (depends on location) associated with a decline in the level of consciousness and focal neurological deficits. Secondary symptoms - autonomic signs, vomiting, drowsines, or signs of personality change.
Symptoms develop within hours to weeks after the precipitating event. May be caused by sneezing, coughing, strain from heavy lifting, and whiplash injury.
Predisposing factors - old, alcoholism, coagulation disorders.
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Pleurisy |
Sharp, stabbing pain in the anterior/lateral chest Constant or intermittent Aggrivated by deep inspiration/ movements May be tender to palpate chest wall. +/- fever
Management - refer for medical evaluation |
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Pagets disease |
Usually >55 mc in northern parts of counrty, UK and US More commonly monostotic, Polyostotic more clinically significant/deforming
Usually asymptomatic, especially monostotic form dull, boring, constant pain not exacerbated by activity bowing deformities, increased head and foot size hearing loss, other signs of neurological compression |
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Leukemia |
mc malignant childhood disease peak 2-5 years
Joint pain, weakness, lethargy, lymphadenopathy, splenomegaly. Aches and pains in the back, extremities and joints. Fatigue and anorexia.
May also be intermittent low grade fever, enlarged lymph nodes, weight loss, petechiae, lethargy, shortness of breath, bruises, and excessive bleeding.
Labs - elevated ESR, very high or very low white blood cell count.
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Ectopic pregnancy |
Sudden unexplained lower abdominal and pelvic cramp. Usually unilateral (especially following first missed menstrual period) Low back (uni or bilateral) or shoulder pain (unilateral) which may be mild and progress to severs over a matter of hours to days Hypotension |
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Pelvic Inflammatory Disease |
Moderate - severe lower abdominal and/or pelvic pain Back pain possible Abnormal vaginal discharge Burning on urination Dyspareuria Painful menstruation (dysmenorrhea) Constitutional signs |
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Cauda Equina Syndrome |
LBP Uni/Bilateral sciatica Saddle Anaesthesia Change in bowel/bladder function Sexual dysfunction Lower extremity motor weakness and sensory deficits Gait disturbances Diminished or absent lower extremity DTR's |
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Oncogenic Spine Pain |
Sever weakness without pain Weakness with full range Pain does not vary with activity or position Skin temperature differences from side to side Positive neuro deficits Positive percussion tap test Cervical pain or symptoms and urinary incontinence. Look for signs and symptoms associated with other visceral systems. |
