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MusculoskeletalDiseases & Disorders
Chapter 15
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Musculoskeletal System
Function Provides the body with a supportive
framework
Protects the internal organs
Gives shape to the body
Acts as a storage & supply area for minerals
Serves as a site for blood cell production
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Deformities of the Spine
Lordosis
Kyphosis
Scoliosis
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Lordosis
Inward curvature of aportion of spine
Swayback
Caused by pregnancy,obesity or largeabdominal tumors
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Kyphosis
Outward curvative of
spine
Humpback
Associated withosteoporosis and a
degenerative deformity
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Scoliosis
Sideways curvature
Associated with Congenital defects
Poor posture
Discrepancy in leg
lengths
Growth retardation
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Which type of spinedeformities do these picturesdepict?
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Herniated Disk
Ruptured or bulging disk
Caused by fall, straining or heavy lifting
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Osteoporosis
Metabolic bone disease – loss of calcium from bone
Progressive loss of bone density
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Osteoporosis Signs and symptoms
Asymptomatic
Pain from fractures of vertebrae, hips, wrists or
other bones
Loss of height
Diagnosis dual energy x-ray absorptometry (DEXA) scan.
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Osteoporosis Risk Factors
Age
Race
Family History
Frame size Tobacco use
Estrogen Levels
Nutrition
Chemotherapy Drugs
Thyroid/Parathryoid
Disorders
Sedentary Lifestyle Excess soda consumption
Chronic alcoholism
Corticosteroid Medications
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Osteomyelitis
Infection in the bone Staphylococcus aureus – 90%
Fungus
Prominent in those with
Diabetes Prosthesis
Strep throat
Sickle cell
Cancer Open wounds
DX: Culture of infections
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Paget’s Disease/Osteitis
Deformans Metabolic skeletal disorder where breakdown of
bone is faster than new bone formation
Symptoms Bone/hip pain
Headaches & hearing loss Bowed limbs, curvature of spine
Joint pain
DX ↑Alkaline phosphatase
X-rays & bone scan
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Fractures Greenstick – only one side is broke or bent Displaced – totally broken; compound fracture
Incomplete – partial break
Comminuted – fragmented bone Segmental – broken in two or three places
Butterfly – circular break
Spiral – elongated break from twisting Hairline – very small fracture
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Osteoarthritis Degenerative joint disease
breakdown & eventual loss of the cartilage due towear and tear on joints
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Osteoarthritis
Signs and symptoms Aching stiffness Joint soreness Dull pain Clicking or crackling in joints
Decreased range of motion Bouchard’s/Heberden Nodes on
extremities
DX X-rays/MRI/CAT scan
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Rheumatoid Arthritis
Chronic, systemic, inflammatory diseaseaffecting the synovial membranes of the
joints.
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Rheumatoid Arthritis
Autoimmune disease Symptoms
Joint pain & stiffness
Swelling Malaise, fatigue, low-grade fever
Diagnosis Positive RF and Anti-CCP test
Elevated ESR(indicates inflammation)
X-rays
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Gout
Chronic disorder of uricacid metabolism Urate crystals
accumulate in synovialfluid of the joints.
Symptoms: Severe excruciating pain Swelling & redness
Risk Factors DX
Joint Fluid Analysis Uric acid blood test
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Bursitis & Tendonitis
Inflammation in bursae Inflammation of tendons Bursitis caused by
Excessive frictional forces
i.e. tennis elbow Tendonitis caused by
Overuse, Rheumatoid Arthritis
Postural misalignment
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Strains and Sprains Strain
overstretching a muscle Sprain
A partial tear of a muscle or tendon around a joint
that may also involve blood vessel and nervedamage Caused by trauma or injury
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Carpal Tunnel Syndrome
Median nerve in the wrist iscompressed Overuse or incorrect use of
hands and fingers Inflammation or fibrosis of
the tendon sheaths that pass
through the carpal tunnel.
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Myasthenia Gravis Autoimmune disease - antibodies destroys
acetylcholine (Ach) receptors sites in
muscles Acetylcholine is a neurotransmitter to muscles
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Myasthenia Gravis Symptoms
Weakness & fatigability Dropping eyelids and double vision Difficulty swallowing & Bobbing head DX: Neurological exam Blood test for AChR-binding antibodies Positive Tensilon Test
Nerve Conduction Studies & Single-Fiber Electromyography
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Muscular Dystrophy Degeneration of the skeletal muscles that control
movement X-linked Signs and Symptoms
Progressive weakening of skeletal muscles Difficulty climbing stairs, walking & running Eventually is crippling
DX Made from physical characteristics Muscle biopsy showing atrophy EMG Elevated Serum Creatine Kinase
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Polymyositis
Chronic, inflammation of connective tissue withdegeneration of skeletal muscles Idiopathic disease associated with virus or
autoimmune etiologies.
Muscle weakness in hips & thighs Difficulty going up & down stains and/or rising from a sittingor kneeling position
Difficulty swallowing (dysphagis) Mild joint or muscle tenderness
Fatigue DX
Muscle biopsy showing inflammation & degeneration
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Systemic Lupus
Erythematosis Chronic, inflammatory connective-tissue
disorders Autoimmune disease with antibodies to DNA.
Symptoms Butterfly rash on face
Weight loss, fatigue, & fever
Photosensitivity of skin
Joint & muscle pain Diagnosed by antinuclear antibodies tests.
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Fibromyalgia
Chronic debilitating syndrome causingwidespread pain in fibrous tissues,
muscles, tendons, and other connective
tissues
Characterized by restless sleep,
depression, fatigue, anxiety and bowel
dysfunction
Etiology is unknown- maybe stress,trauma to CNS, chemical imbalances
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Fibromyalgia Diagnosis
HX & PE Ruling out other disorders
Tenderness in specific
tender points at a minimumof 11 location
Pain must persist for at least
3 months
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Bone Tumors
Malignant tumors are either primary or
secondary
Osteosarcoma - most common type in
children (bone pain, fever, swelling) Secondary tumors - metastasize to bone from
breast, lung, thyroid, kidney, prostate.