Musculoskeletal System

used to see acute or chronic tears of the joint capsule or ligaments of the knee, shoulder, ankle, or wrist

• radioplaque injected to joint cavity
• joint put to ROM to distribute agent
• x-rays are taken

*note - contrast agent will leak from joint cavity if tear is present for 1-2 days

• normal to hear clicking/cracking in joint for 1-2 days
• joint rested for 12 hrs
• compression elastic bandage applied
• assess for allergies to contrast agent if used

• pregnancy
• claustrophobia
• inability to tolerate position due to age
• debility or disability
• metal implants

used to estimate bone mineral density (BMD)

used to estimate extent of osteoporosis and monitor pt's response to osteoporosis tx

to detect metastatic & primary bone tumors, osteomyelitis, fractures, & aseptic necrosis

*radioisotope injected IV - scan done 2-3 hrs after injection

• possible allergies to radioisotope
• contraindicated to pregnant women
• drink lots of fluids to distribute & eliminate the isotope
• empty bladder bec a full bladder interferes w/ accurate scanning of pelvic bones

• direct visualization of a joint (joint structures, synovium, articular surfaces)
• used to diagnose joint disorders

repair/treat tears, defects, and disease process through arthroscope

• infection
• hemarthrosis
• neurovascular compromise
• thrombophlebitis
• stiffness
• effusion
• adhesions
• delayed wound healing

• joint wrapped w/ compression dressing to control swelling
• ice to control edema & promote comfort
• joint extended/elevated to reduce swelling
• adm analgesics

• swelling
• numbness
• cool skin

joint aspiration to obtain synovial fld for examination or relieve pain d/t effusion

• (synovial fluid)
• septic arthritis
• inflammatory arthopathies
• bleeding
• pain from effusion

• clear
• pale
• straw colored
• scanty in volume

• sterile dressing applied
• risk for infection

• used to
• immobilize reduced fracture
• correct deformity
• apply uniform pressure on soft tissue
• support and stabilize weakend joints

• let pt know to expect increasing warmth
• don't put on hard/sharp edges while drying

• less costly
• better mold than fiberglass
• will also produce heat
• crystallization process takes 15-20 mins
• 24-72 hrs to completely dry

may be used after cast

• do not require rigid immobilization
• used when swelling is anticipated or require special skin care

• used to provide support, control movement, prevent addtl injury
• for longer use than splints

• assess neurovascular status
• consider swelling, bruising, skin abrasions
• let pt know what to expect with procedure
• assess pain (character & intensity)
• most pain can be relieved by elevation, cold packs, analgesics

compartment syndrome: vascular insufficiency & nerve compression d/t unrelieved swelling can result in compartment syndrome. it occurs when there is increased tissue pressure w/in a limited space that compromises circulation and fn of tissue

• call md
• bivalve cast while extremity elevated no highter than the heart
• if pressure not relieved - fasciotomy required

• pressure or inappropriate application may cause tissue anoxia or pressure ulcers.
• lower extremities are more susceptible - heel, malleoli, dorsum of foot, head of fibulla, and anterior surface of patella

• pain
• tightness in area

• a warm area suggests erythema
• may give foul odor

• used to manage open fractures w/ soft tissue damage
• provides stable support for severe comminuted fractures while permitting active tx
• fracture is reduced, aligned, immobilized by pins in bone (humerus, forearm, femur, tibia & pelvis)
• facilitates pt comfort, early mobility, active exercise of adjacent uninvolved joints

• *disturbed body image and risk for infection
• neurovascular status q 2-4 hrs
• assess pin site q 2-4 hrs for redness, drainage, tenderness, pain and loosening of pins
• clean each pin 1-2x a day w/ cotton w/ chlorhexidine

application of pulling force to part of body

• minimize muscle spasms
• reduce, align, and immobilize fractures
• reduce deformity
• increase space between opposing surfaces

• may need to use more than one to achieve desired line of pull (vector force)
• used until external/internal fixation are possible (-> short term)

• counter-traction must be used
• must be continuous
• never interrupted (skeletal)
• weights not removed unless intermittent
• good body alignment
• ropes unobstructed
• weights freely hanging

• is a type of skin traction (non-invasive)
• controls spasms
• immobilizes area before sx

• avoid wrinkling, slipping of traction bandage
• maintain counter traction & positioning (don't turn side2side)

• remove boot & inspect skin 3x daily
• palpate area to detect tenderness
• provide back care q2 hrs
• use air-filled mattress

• avoid pressure on peroneal nerve --> foot drop
• assess toe & foot movement, sensation, pallor, temp, cap refill

• assess circulation w/in 15-30 min after traction is first applied then q 1-2 hrs
• assess peripheral pulses, color, cap refill, temp,
• **assess for DVT - calf tenderness, warmth, redness, swelling