552 Exam 1: Joint Disorders

Front 1

what is facet joint impingement/locking

Back 1

sudden locking of the posterior joint "theoretically" due to the capsule (or meniscoid) of the post. joint getting impinged between the facets

Front 2

what causes facet joint impingement/locking

Back 2

sudden movement inovloving backward bending, side bending, and/or rotation

Front 3

what position is the joint "locked in" in facet joint impingement

Back 3

(in lumbar spine) a protective position of SB and contralateral rotation

Front 4

what are the S and S for facet joint impingement

Back 4

1) protective position:SB and contralateral rotation
2) rest decreases pain
3) mov't restricted and painful in opposite direction of locked position
4) passive assessment of joint mobility (+) for locked segment
5) possible rotational positional fault
6) pain possibly in corresponding dermatomal distribution

Front 5

if a patient with facet impingement is locked in L SB and R rotation, what movements will be restricted/painful

Back 5

pain and restrcition of movement with
- R SB
- L rotation
- flexion

Front 6

what is the treatment for facet joint impingement

Back 6

*mobilization therapy and traction*
- preceded by modalities and soft tissue work to relieve soft tissue guarding and spasms
- gentle rotation and SB in painfree direction 1st then toward restriction
- ROM exercises if done progressively

Front 7

what is the appropriate way to encorporate rotation and SB in the treatment of facet impingement

Back 7

gentle rotation and SB in PAINFREE direction 1st then toward the restriction

Front 8

what is a facet joint sprain

Back 8

sprain of the capsule of the posterior joint and surrounding ligaments

Front 9

what is the cause of facet joint sprain

Back 9

sudden movement/trauma

Front 10

what are the S and S for facet joint sprain

Back 10

*history of moderate to severe trauma*
- rest relieves pain
- pain with movement, especially at end range
- no firm restriction of mobility, movement PAIN limited
- no positional fault
- pain with testing of joint mobility

Front 11

what is the treatment for facet joint sprain

Back 11

treat as an acute injury with relative rest, ice, pain modalities, and protection against further injury also, gentle progressive ROM

Front 12

is joint mobilization an appropriate tx for facet joint sprain

Back 12

NO- time to heal is needed

Front 13

what is the consequence of hypo or hyper mobility with a facet joint sprain

Back 13

if excessive mov't allowed, hypermobility may ensue.... if patient is treated conservgatively with rest/immobilization, hypomobility with subsequent dysfunctions occur!

Front 14

when would lumbar support be appropriate for a facet joint sprain

Back 14

only in the acute stage if needed

Front 15

what is joint inflammation

Back 15

irritation of the posterior articular structures

Front 16

what is the cause of joint inflammation

Back 16

- chronic loading of the joint ... secondary to poor posture and/or poor working habit (extension)
- insidious onset
- can also be secondary to degenerative joint disease

Front 17

what are the S and S for joint inflammation

Back 17

1) movement increases pain (especially movements loading posterior joints)
2) possibly some pain at rest (but reduced) due to chem. irritation
3) typically better in AM
4) (+) pain when joint stressed
5) slight/mod. restriction of motion due to pain

Front 18

what movements would you expect to increase pain the most with joint inflammation

Back 18

those loading the post. joints .... extension and ipsilateral SB

Front 19

what is the treatment for joint inflammation

Back 19

1) ID causative factors and eliminate cause of injury
2) decrease pain and inflammation (treat as subacute) with modalities use of ice and gentle exercises
3) restore mobility
4) restore strength
5) return to normal posture

Front 20

what disorders are included under the definition of chronic and progressive degeneration of the disc and facet joints

Back 20

- osteoarthritis
- spondylosis
- DDD
- DJD

Front 21

what causes DJD

Back 21

1) wearing away of hyaline cartilage
2) thickening of the synovial lining and joint capsule
3) proliferation of calcific deposits in, and especially around the periphery of the joint (osteophytes)
4) thickening of the subchondral bone

Front 22

what causes DDD

Back 22

1) dehydration of the nucleus pulposus
2) narrowing of the intervertebral space, leading to decrease foraminal opening
3) weakening and degeneration of the annular rings
4) approximatino of the facet joints
5) creation of osteophytes at the margin of the vertebral body

Front 23

what is the common cause for OA/ Spondy/ DDD/ and DJD

Back 23

- develops secondary to the excessive wear and tear process
- segmental hypomobility or hypermobility may promote the process

Front 24

joint hypomobility may lead to ...

Back 24

decreased nutrition of the structures

Front 25

joint hypermobility may lead to

Back 25

increased shear forces

Front 26

what are the S and S for OA/ Spondy/ DDD/ and DJD

Back 26

1) hx of jt. pain and/or stiffness
2) (+) radiographs
3) if irritation present, palpation or stress on spinal segment will cause pain
4) hyper or hypo mobiliry may be present
5) possible referred pain and/or neuro findings
6) pain may come from facet joints or the disc

Front 27

what does it tell you if irritation is present for a patient suffering from OA/ Spondy/ DDD/ and DJD

Back 27

they are in the acute stage

Front 28

what is the belief about hypermobility and hypomobility regarding development in OA/ Spondy/ DDD/ and DJD

Back 28

hypermobility develops first due to the decreased height of the disc.... followed by hypomobility through decreased use due to pain

Front 29

what pain patterns are more indicative of a disc disorder

Back 29

increased pain with activities that inclued high loading on the spine (sitting, FB) and pain with FB

Front 30

what pain patterns are more indicative of a facet joint irritation

Back 30

increased pain with standing and BB of the spine

Front 31

what is the treatment for OA/ Spondy/ DDD/ and DJD

Back 31

*must be adapted to the signs and complaints*
- if hypermobility present provide stability (possibly with external support)
- hypermobility present improve mobility (with caution and monitor tx results!)
- correction of posture, working habits, etc
- use of modalities to address pain

Front 32

the treatment for OA/ Spondy/ DDD/ and DJD is concidered a process of ......

Back 32

long term management promoing healthy back habits and identifying and eliminating aggravating factors

Front 33

what approach is the method of choice when tx OA/ Spondy/ DDD/ and DJD

Back 33

problem-oriented approach