Common Musculoskeletal Problems (eBook)

Common MusculoskeletalProblems 3
Contents 5
Contributors 7
Chapter 1: Introduction 11
A Primary Care Approach to the Patient 11
Layout 13
Chapter 2: The Cervical Spine 14
Functional Anatomy 14
Red Flags 15
Approach to the Patient with Cervical Spine Pathology 16
Common Clinical Presentations 16
“Mechanical” Neck Pain 16
Cervical Radiculopathy 17
Cervical Myelopathy 20
Whiplash Associated Disorder 21
Conclusion 21
Suggested Reading 21
Chapter 3: The Shoulder 23
Functional Anatomy 23
Red Flags 26
General Approach to the Patient 26
Common Clinical Presentations 27
Rotator Cuff Pathology 27
AC Joint Pathology 29
Shoulder Instability 29
References 31
Chapter 4: The Elbow 32
Functional Anatomy 32
Red Flags 34
General Approach to the Patient with Elbow Pain 35
Common Clinical Presentations 35
Lateral Epicondylitis (Lateral Elbow Tendinopathy or Tendinosis) 35
Medial Epicondylitis (Medial Elbow Tendinopathy) 36
Olecranon Bursitis 36
Less Common Presentations 37
References 38
Chapter 5: The Hand and Wrist 39
Anatomy and Function 39
Red Flags 41
General Approach to the Patient with Hand and Wrist Pain 43
Primary Hand and Wrist Examination 43
Common Clinical Presentations 44
Trauma 44
Acute Nontraumatic Hand and Wrist Pain (< 8 Weeks Duration)
Chronic Nontraumatic Hand and Wrist Pain (> 8 Weeks Duration)
References 47
Chapter 6: Lumbosacral Spine 48
Functional Anatomy 48
Red Flags 51
General Approach to the Patient with Back Pain 51
Common Clinical Presentations 53
Mechanical Low Back Pain 53
Disk Herniation 54
Spinal Stenosis 54
References 55
Chapter 7: The Hip 57
Functional Anatomy 57
Red Flags 58
Approach to the Patient with Hip Pain 58
Primary Hip Exam 58
Most Common Clinical Presentations 59
Lateral “Hip” Pain: Trochanteric Bursitis 59
Posterior “Hip Pain” 60
Anterior Hip or Groin Pain 60
References 61
Chapter 8: The Knee 63
Functional Anatomy 63
Red Flags 65
General Approach to the Patient with Knee Pain 65
Common Clinical Presentations 67
Anterior Knee Pain 67
The Acutely Effused Knee (Trauma) 68
Ligament Tears 68
Meniscal Tears 69
Fracture 69
Patellar Dislocation 70
Chronic Atraumatic Pain (Osteoarthritis) 70
References 72
Chapter 9: The Ankle 73
Functional Anatomy 73
Red Flags 76
Common Clinical Conditions 78
Lateral Ankle Sprain 78
Posterior Ankle Pain 79
Tendinopathy 80
Suggested Reading 81
Chapter 10: Pediatric Musculoskeletal Complaints 82
Red Flags 82
Common Clinical Presentations 83
Slipped Capital Femoral Epiphysis 83
Bowlegs and Knock-knees 84
Genu Varum (Bowlegs) 85
Genu Valgum (Knock-Knees) 86
Intoeing 88
Femoral Anteversion 88
Tibial Torsion 89
Metatarsus Adductus 89
Back Pain in Children and Adolescents 90
Suggested Reading 91
Chapter 11: The Acute Swollen/Painful Joint 92
Red Flags 92
Approach to the Patient with an Acutely Swollen, Painful Joint 93
Common Clinical Presentations 93
Infection (Septic Joint) 93
Crystal Deposition Arthritis 95
Trauma 96
References 96
Chapter 12: Musculoskeletal Radiology 98
Ordering X-Rays for Specific Body Areas 99
C-Spine 99
LS Spine 99
Shoulder 99
Humerus 99
Elbow 99
Forearm 100
Wrist 100
The Hand 100
Pelvis and Hip 100
Thigh 100
Knee 101
Leg, Ankle, and Foot 101
Special Testing 101
Summary 103
Reference 103
Chapter 13: Soft Tissue Injuries 104
Acute Management 104
Thumb Spica Splint (See Table 13.1 and Fig. 13.1a–d ) 106
Sugar Tong Splint (See Table 13.2 and Fig. 13.4a–d) 106
Arm Sling (See Table 13.3) 108
Stax Splint (See Table 13.4 and Fig. 13.5a–d) 110
Extension Block Splint (See Table 13.5 and Fig. 13.6a–d) 110
Knee Immobilizer (See Table 13.6) 110
Knee Sleeve (See Table 13.7) 110
Ankle Sugar Tong Splint (See Table 13.8 and Fig. 13.7a–d) 112
Proper Use of Crutches 113
Recommended Reading 115
Chapter 14: The Preparticipation Physical Exam 116
Obtaining the Medical History 117
Performing the Physical Exam 120
Clearance Determination 123
Cardiovascular 124
Neurologic 125
Musculoskeletal 125
Pulmonary 126
Abnormal Vision and Eye Disorders 126
Abnormalities of Abdominal Organs 127
Gender-Specific Issues 127
Diabetes 128
Heat Illness 128
Transmissible Illness 128
References 129
Appendix 130
Index 155