Bone and Muscle disorders

  1. Osteoporosis Etiology
    • Oseteopenia: low bone mass precursor to osteoporosis
    • Involoves reduction in bone mass/volume
    • Brittle Bones results in invrease resk of frature
    • Can be primary: presence of risk factors
    • Can be secondary to other metabolic disorders such as DM, hypersthyroidism, RA, cushings disease
  2. Osteoporosis Risk Factors
    • Age: over 50 female,
    • Race: caucasion,
    • Post menopausal
    • Small body frame
    • Family history
    • Long periods of immobility, lack of WB
    • Long term use of heparin, corticosteroids, antacids, laxatives, anticonvulsants
    • Excessive use of alcohol, caffine, tobacco
    • Dietary deficiencies of calcium, vit D
  3. Osteoporosis Diagnosis
    • x-ray
    • CT scan
    • MRI
    • Bone mineral density test: normal >833 mg/cm2 Osteopenia 648-833 Osteoposis <648
    • Blood tests: Blood Ca, Vit D
  4. Osteoporosis S&S
    • may be asymphomatic until well advanced
    • Pain esp. back pain
    • Loss of height, postural changes
    • bone loss in mandible can change appearance
    • suseptible to fracture
  5. Osteoporosis Medical Management
    • Hormone therapy: estrogen, androgens
    • Meds: calcium, Citamin D, Calcitonin, Biphoshonates, Fluoirde
    • Modify risk factors: limit use of alcohol, tabacco, caffine
    • Adequate dietary intake of calcium and Vit D
  6. Osteoporosis Prevention
    • Keep active & stay strong
    • Regular exercise that includes weight bearing activities
    • Flexibility, strengtheing and balance ex.
    • Safety and fall prevention programds
    • Home assessment for hazards
  7. Osteoporosis Rehab Management
    • Joint protection: bracing, splints
    • Weight bearign exercise
    • Fall prevention strategies: use of assistive deives, balance strategies, home assessment
    • Use caution with any assessment or treatment technigue that involves forces being transmitted though bones
  8. Rickets/Osteomalacia
    • Diseases that involve improper ossification of bone: soft bones
    • Causes by vitamin D deficiency and an inability to absorb calcium properly
  9. etiology of Rickets/ Osteomalacia
    • Insufficient intestinal absorption
    • Increased renal phosphorus loss
    • often related to other metabolic disorders of liver, gall bladder, pancreas, small intestine or kidney
    • Incidence is higher in cold regoins
    • Sunlight - vit D - Increases Ca absorb
  10. Rickets/ Osteomalacia S&S, medical menagement and Rehab
    • S&S: diffue, general aching and fatigue. Deformation of WB bones, decreased height
    • Medical Management: Rx of primary metabolic problem, increased calcium. increased Vit D, Increased Sunlight
    • Rehab: maintain strength, WB, Preserve joints
  11. Bone Tumors
    • Etiology: primary or secondary
    • Signs and Symptoms: bone painm, worse at night
    • Medical Management: surgical amputation, chemo, radiation
    • Rehab: same as other cancers, pain limits function and ability to participate
  12. Osteomyelitis
    • Etiology: Inflammation cuase by bacterial infection in the bone, usually related to surgery or Trama
    • S&S: exudate - pressure within bone- pressure on nerves- pain
    • Swelling redness, warmth at site
    • Fever, luekocytosis, malaise, irritablility
  13. Osteomyelitis Medical Management
    • Aggressive antibiotics
    • if chronic may need surgery to remove necrotic bone tissue
    • when inflamed amintain ROM, strength, function of rest of body, protect affected area, limit WB
  14. Paget's Disease Etioloyg and S&S
    • Cause not establish, possibly a slow virus, genetics
    • S&S: excessvie bone destruction and replacement with fibrous tissue and abnormal bone growth
    • Structural abnormalities, bone thickening, can have pathological fratures
    • Sometimes asymptomatic
    • with skull involvement: HA, CN symptoms
  15. Pagets Medical Management
    • reduce risk of fracture & deformity
    • NSAID manage pain
    • Calcitonin
    • Surgery
    • Rehab: fragile Pt may be involved with pain control, stregthening to support abnormal bone
  16. Muscular Dystrophy types
    • Duchennes: most rapidly progressive
    • FSH
    • Myotonic
    • Limb Girdle
  17. Duchennes Muscular Dystrophy Etiology
    • Sex linked recessive inherited
    • Reuslts in a metabolic dfect in the muscle cell that leads to degeneration and necrosis of muscle
    • Muscle cells are replaced by fat or fibrous tissue
  18. Duchennes S&S, Diagnosis, Complications
    • S&S degeneration of skeletal ms proximal first
    • waddling gait, problems climbing stairs gowers sign
    • Diagnosis: eclevated CPK, EMG, muscle biopsy
    • Complications: scoliosis, limb deformites (anke and foot) Cardiac and respirtory problems
  19. Duchennes Medical Management
    • Treatment of symptoms
    • Goal: maintain function as long as possible
    • Rehab: maintain ambulation and fuction
    • moderate ex and supportice divices
    • once WC bout medical complications increase
    • Train Family
  20. Carpal Tunnel Syndrome
    • Formed by carpal bones and transverse carpal ligament
    • Contains 9 flexor tendons and media nerve
  21. Carpal Tunnel Syndrome Management
    • Conservative: resting, splint at night, functional splint at work, adapt environment
    • Corticosteroid injections
    • Surgical: sever the flexor retinaculum (transverse carpal lin) relieve the compression forces, open or endoscopic
  22. Carpal Tunnel Role of Rehab
    • Prevention: ergonomic assesment
    • Conserative: splintin, ROM, strengthening, Fuct activites, Help adapt workplace? schedule
    • Post-op: scar massage, stretching, elbow and schoulder strengthening
    • ergonomic analysis, adapt to work recurrence
  23. Thoracic Outlet Syndrome
    • Condition wiht insidous onset related to compression of bracial plexus and subclavian arterly
    • often related to ms tension, poor postsure, or sleeping witha rms in elevated, ER postion
  24. Thoracic Outlet Syndrome Etiology and S&S
    • muscle tension, poor posture, awkward positions
    • S&S: pain parathesia, vasomotor symptoms weakness,& wasting of small ms of hand
  25. Thoracic Outlet Syndrome Medical Management
    • Discountinue damaging activity, ice anit-inflammatory meds
    • Rehab: correct posture/ positioning
    • stretch/ strenghening as neededd, functional activites
    • modify environment
  26. Dequervains Syndrome
    • Overuse of thumb inflammation of thumb abductor tendons
    • S&S: pain
    • Management: ice, rest, splinting, ROM, strengthening, functional activities
  27. Define Impingement
    • Structures are pinched between bony surfaces- inflammation - pain
    • Treatment: anti-inflammatory meds, phono, ionto, steroid injections
  28. Impingement Examples
    • Rotator cuff: impingement of rotator cuff between its insertion on humerus and ingerior acromion
    • Patella: pinching or lat/ inf. ct soft tissues in knee cause= patellar malalignment
  29. Fibromyalgia
    • a group of disorders characterized by pain and stiffness affecting muscles, tendons, and soft tissue joints.
    • 18 specific trigger points
    • Typical onset= females 20-50 years old with history of trauma or osteoarthritis
  30. Fibromyalgia S&S
    • generalized aching, non-restorative sleep
    • fatigue poor work tolerance, weakness
    • AM stiffness, HA, irritable colon, anxiety depression
  31. Fibromyalgia Medical Management
    • Stress reducaion, Anti-depressand meds, NSAID
    • Rehab: regular exercise, rest, heat, massage, aquatic therapy, modalities, flexibility, strengtheing, posture, functional activites
Card Set
Bone and Muscle disorders