Joint Disorders. Musculoskeletal Disorders (Part B-2) Module 7 -Chapter 10. Overview Disorders of the Muscular System Disorders of the Skeletal System

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1 Musculoskeletal Disorders (Part B-2) Module 7 -Chapter 10 Overview Disorders of the Muscular System Disorders of the Skeletal System Susie Turner, MD 1/9/13 Joint Disorders Arthritis Inflammation of Joint Over 100 different types of inflammatory or degenerative diseases of the joints. Osteoarthritis Rheumatoid Arthritis Gouty Arthritis Ankylosing Spondylitis Septic or Infectious Arthritis Temporomandibular Syndrome 1

2 Osteoarthritis A degenerative disease related to the aging process Wear-and-tear arthritis First Cartilage Degenerates then Bone Not due to an inflammatory process Usually due to old age/trauma/ genetic predisposition Arthritis of the Hip Due to Arthritis. Can you see it? Normal Hip 2

3 Total Hip Replacement Due to Arthritis Rheumatoid Arthritis Autoimmune disease Leads to chronic inflammation of the synovium Involves several organ systems Higher incidence in women Can lead to damage in articular cartilage & bone S/S; joints are red, swollen, painful, warm 3

4 Gout Uric acid crystals cause inflammation Joint is extremely painful, swollen and dusty-red Common in men > 40 Usually affects single joint like big toe uric acid crystals in joint fluid Ankylosing Spondylitis Chronic progressive inflammation of axial skeleton Especially sacroiliac joints & intervertebral spaces Leads to a rigid spine Poker back S/S; Low back pain radiating to legs, and ankylosis Stiffening & immobility of a joint Most common in young men Genetic predisposition 4

5 Infectious (Septic) Arthritis Bacterial Infection of a Joint Infection typically reaches the joint through the bloodstream. Due to trauma, injury, surgery, bacteremia. S/S Local red, swollen, painful joint with decreased ROM. Systemic fever, chills, malaise TMJ Syndrome Pain in the temporomandibular joint Muscle spasm & degenerative changes in joint Can be caused by stress, grinding teeth, misaligned jaw 5

6 Muscle & Tendon Disorders Fibromyalgia Muscular Dystrophy Myasthenia Gravis General Inflammatory Disorders S/S Spasms, cramps (strong, painful spasms), myalgias, stiffness Decrease strength, atrophy (shriveling up), hypotonia ( loss of muscular tone) Fibromyalgia Chronic Pain Illness Widespread MS aches, pain and stiffness Soft tissue tenderness Trigger Points Women more commonly affected Often stress induced General fatigue and sleep disturbances 6

7 Muscular Dystrophy Inherited skeletal muscle disease Muscles atrophy, deteriorate & get progressively weak Sons Inherit disease from mother Most Common MD Duchenne s Muscular Dystrophy Affects boys age 3 to 7 Muscles fibers are structurally abnormal Because lack protein called dystrophin Myasthenia Gravis Immune System attacks muscle tissue Muscle disease causing progressive muscular paralysis. Immune system attacks muscle cell receptors Begins with cranial nerve symptoms Eyelid weakness 7

8 Miscellaneous Bone Disorders Adhesions Fibrous bands May form between the surfaces where bones join Contracture Fibrosis of connective tissue Prevents normal mobility General MS Disorders Bursitis Ex.; Student s Elbow Olecranon bursitis Ex; Housemaid s Knee Prepatellar Bursitis 8

9 Epicondylitis Tendonitis Inflammation of tendons Common in shoulder Epicondylitis Tennis Elbow Inflammation of the epicondyle Overdoing it Doing too much too soon or ignoring the warning signs of muscle or joint pain. Ex; repetitive tears in knee ligament fibrous scar tissue, permanent joint damage leads to early osteoarthritis OVERUSE INJURIES 9

10 Carpal Tunnel Syndrome Inflammation at wrist Due to overuse Repetitive wrist movements Can compress tendons and nerves and produce pain and loss of mobility. Treatment for Overuse Injuries Use ice after workout to prevent or reduce inflammation Taking non-steroidal, antiinflammatory meds to reduce pain NSAIDS Non-steroidal antiinflammatory drugs RICE REST ICE COMPRESSION ELEVATION 10

11 Oncology Connective Tissue Tumors Ganglion Cyst Tumor of the tendon sheath or joint capsule Commonly found in the wrist. Bone Tumors Bone Tumors Most are malignant Benign Type Osteoma Malignant Type Osteosarcoma S/S Bone pain which increases night, and pathologic fractures osteoma 11

12 Osteosarcoma Primary Bone Tumor Usually in children or young adults Metastasize early usually to lung Primary Bone Tumors 12

13 Secondary Bone Tumors Begin somewhere else and metastasize (spread) to bone. Bone is common site of secondary tumors Breast, Lung, & Prostate Cancer Especially tend to spread to spine & pelvis. Muscle Tumors Unusual Rhabdomyosarcoma 13