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Common orthopaedic symptoms. Commonly body parts encountered . Low back Neck Knee Elbow Shoulder. Common symptoms in orthopaedic. Pain: muscle spasm,strain,overuse injury,degeneration,referred pain,past injury,malignancy Joint stiffness Neurological: numbness,weakness

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Presentation Transcript
commonly body parts encountered
Commonly body parts encountered
  • Low back
  • Neck
  • Knee
  • Elbow
  • Shoulder
common symptoms in orthopaedic
Common symptoms in orthopaedic
  • Pain: muscle spasm,strain,overuse injury,degeneration,referred pain,past injury,malignancy
  • Joint stiffness
  • Neurological: numbness,weakness
  • Others:e.g.deformity,locking,instability,giving way
low back pain lbp
Low back pain(LBP)
  • Acute? Chronic?
  • Localized? Diffuse?
  • Other regions associated?
  • Reliving factors?
  • Occupation? Daily activity?
  • Age?
slide5
LBP
  • Common causes or Dx
  • Degeneration
  • Sprain or incorrect posture
  • Overuse injury
  • PID,spinal stenosis
  • Other systems:e.g. renal colic,leaking AAA
slide6
LBP
  • In P/E
  • Point or level of tenderness
  • Deformity
  • Bone or muscle?
  • Range of movement
  • Neurological deficit
  • Straight leg raising test
management of lbp
Management of LBP
  • For simple LBP: Rest,correct posture,Ex or physiotherapy,Analgesics(topical or oral)
  • Imaging if specific problem suspected e.g.XR,MRI
  • Conservative or operative management
neck pain
Neck pain
  • Approach and management similar to LBP
  • Note symptoms and signs of radiculopathy or myelopathy
slide9
Knee
  • Post-injury? Chronic?
  • Aggravating factors?
  • Instability?
  • Locking?
  • Giving way?
  • Swelling? Signs of inflammation?
  • How daily life is affected?
slide10
Knee
  • Common causes or Dx
  • OA knee
  • Soft tissue injury e.g. ligament,meniscus
  • Loose body
  • Gouty attack(more common in MTP joint of big toe)
slide11
Knee
  • In P/E
  • Deformity: Bow knee ,Knock knee,Fixed flexion contracture
  • Swelling ,Effusion
  • ROM
  • Crepitus
  • Instability
management of knee problem
Management of Knee problem
  • Imaging: XR,MRI
  • To delay speed of degeneration e.g. weight reduction,avoiding frequent squatting or prolonged walking slopes or stairs
  • To strengthen muscle for protecting the joint e.g. quadricep ex,swimming
  • Analgesics
  • Specific measures e.g. Arthroscopy,Surgery
tennis elbow
Tennis Elbow
  • Pain and tenderness at origin of the extensor muscles of the forearm,often radiating down to the back of forearm
  • Caused by strain of the forearm extensor muscle at the point of their origin from the bone
  • P/E : tenderness localized to the front of the lateral epicondyle of the humerus,pain elicited by passively stretching the extensor muscle
  • Mx: Pain relive and NSAID ,avoid overuse,tennis elbow band,ex,steroid injection
shoulder
Shoulder
  • Pain (from local tissue,or referred pain e.g. cervical spine,heart,diaphragm)
  • Stiffness
shoulder15
Shoulder
  • Frozen shoulder(adhesive capsulitis)
  • Severe pain + limitation of shoulder movement in all direction
  • No radiographic abnormality
  • Natural course:spontaneous recovery within 6 to 12 months; with pain subsides first, then stiffness improved with active mobilization
  • Mx: in acute painful stage,rest the shoulder with gentle assisted shoulder ex, NSAID,when pain lessens,active ex for regaining full ROM
shoulder16
Shoulder
  • Pain arc syndrome
  • Pain in shoulder during mid-range(45-160 degree) of shoulder abduction
  • DDX: with Hx of injury—incomplete tear of supraspinatus,crack fracture of greater tuberosity of humerus; with spontaneous onset—supraspinatus tendinitis,calcified deposit in supraspinatus,subacromial bursitis
shoulder painful arc syndrome
ShoulderPainful arc syndrome
  • Dx: by Hx,XR
  • Mx:
  • for crack # --analgesic,active mobilization
  • for tendinits,bursitis,supraspinatus tear—analgesic,physiotherpy e.g. short-wave diathermy,mobilization ex
  • In resistant case ,may need surgery
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