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nsm 1 notes
questions from notes
| question | answer |
|---|---|
| sexually transmitted ds assoc with Reiter's syndrome: | chlamydia; shigella and rarely salmonella or yersinia with fecal exposure |
| other manifestations of Reiter's besides triad: | circinate balanitis, keratodermia blennorrhagicum and oral lesions |
| Where does Reiter's syndrome arthritis affect? | knees, ankles and feet |
| Is HLA in Reiters? | yes in 75% |
| Osteochondroses ds's: | Legg-Calve-Perthes, Osgood Schlatter, Freiberg's, Kohlers, Kienbochs, preisers, panners, sever's |
| Legg-Calve-Perthes ds sx (AKA juvenile coxa plana) | avasc nec of cap fem epiph; 3-12 yrs, male; bilateral (10%); insidious, traumatic or inflammatory |
| What are Legg sx seen in later stages: | sudden onset, referred knee px, pxful or pxless limp, limited mvmt (esp rot, abd, flx), px worse w/activity, disuse atrophy, appearance of leg deficiency, DJD later in life |
| How does Legg start? | infl for 2wks-2mths, fx of epiphysis (seen as bulging jt capsule on xray) |
| How does stage 2 Legg look on xray? | opacity & flattening, physis widens and irregular (snow cap sign) |
| Tx for Legg: | minimizing discomfort and deformity-slings, braces & crutch devices |
| What is Chandler's ds: | adult onset AVN of the femoral head |
| Causes of Chandlers: | mc related to chronic alcoholism and long-term steriod use; 5 S's=sterno, steroids, scuba divers, sickle cell anemia, SLE |
| Sx of Chandlers | pxful, dec ROM of hip & affected lower ext; abrupt onset |
| Course of Chandlers | heals spontaneously w/ deformity |
| Osgood Schlatter sx | very common, post-traumatic, traction of AVN of ant tib epiphysis; 10-14 yrs |
| Pain findings with Osgood: | can be bilateral, swollen tender area, px upon resisted ext of the leg |
| Osgood on xray: | prox segment fails to unite with tibial shaft and remains mobile |
| Osgood tx | avoid physical stresses; use of compression supports are very effective |
| AKA for scheuermann's ds | juvenile kyphosis dorsalis; juvenile discogenic ds |
| Is scheuermann's an AVN? | no, not a true one |
| What is scheuermann's? | very common; young person's first chiro visit, d/t congenital weakness of cartilaginous endplate complicated by excessive physical stress. Ends with cessation of growth. |
| Sx of scheuermanns: | low grade back px, stiffness and poor posture mc |
| xray of scheuermanns | multi-level vertebral end plate irregularity and sclerosis, dec disc ht, loss of ant vertebral body height creating "trapezoid-shaped segments", schmorl's nodes; hyperkyphosis |
| tx of scheuermann's | manual therapy, ext back exercises and postural training to relieve discomfort and stiffness. Bracing to minimize deformity in severe cases. |
Created by:
pcelvfrdm
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