Regional Rheumatic Disorders
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Questions and Answers

What is the main characteristic of regional rheumatic disorders?

  • Generalized pain throughout the body
  • Pain only in the muscles
  • Pain only in the joints
  • Localized pain related to tendons, ligaments, fascia, and bursae (correct)

    • What is the function of bursae?

  • To facilitate movement of tendons and muscles and protect bony prominences from repetitive trauma (correct)
  • To regulate body temperature
  • To produce synovial fluid
  • To absorb shock

    • What is tendinitis?

  • Inflammation of the synovial membrane
  • Inflammation of the tendon itself or the sheath that surrounds it (correct)
  • Inflammation of the ligaments
  • Inflammation of the tendon sheath

    • Which bursa is the most common cause of lateral hip pain?

    <p>Trochanteric bursa</p> Signup and view all the answers

    What is a popliteal cyst?

    <p>A posterior extension of the synovial membranes into the popliteal area</p> Signup and view all the answers

    Which condition is often associated with a popliteal cyst?

    <p>Both A and B</p> Signup and view all the answers

    What is the common name for inflammation of the prepatellar bursa?

    <p>Housemaid's knee</p> Signup and view all the answers

    What can be a symptom of a ruptured popliteal cyst?

    <p>Sudden pain and swelling</p> Signup and view all the answers

    What is a common etiology of bursitis?

    <p>All of the above</p> Signup and view all the answers

    What is a characteristic of septic bursitis?

    <p>All of the above</p> Signup and view all the answers

    What is the impingement sign indicative of?

    <p>Inflamed subacromial bursa</p> Signup and view all the answers

    What is the purpose of X-rays in the diagnosis of bursitis?

    <p>To reveal calcific deposits</p> Signup and view all the answers

    What is the initial treatment for bursitis?

    <p>Rest, immobilization, and cold compresses</p> Signup and view all the answers

    What is tendinitis characterized by?

    <p>All of the above</p> Signup and view all the answers

    What is De Quervain's tenosynovitis?

    <p>Inflammation of the tendon sheaths over the distal radial head</p> Signup and view all the answers

    What is the drop arm test indicative of?

    <p>Complete tear of the rotator cuff</p> Signup and view all the answers

    Study Notes

    Regional Rheumatic Disorders

    • Present with localized pain related to tendons, ligaments, fascia, and bursae, in addition to arthritis, bone disease, and neurological problems.

    Bursitis

    • Inflammation of a closed sac lined with synovial cells and containing synovial fluid.
    • Located in areas of friction, facilitating movement of tendons and muscles and protecting bony prominences from repetitive trauma.
    • Important bursae include:
    • Subacromial/Subdeltoid bursa: between the acromion and rotator cuff, common cause of shoulder pain.
    • Olecranon bursa: over the olecrannon process, also known as "student's elbow".
    • Trochanteric bursa: between the hip capsule and iliopsoas muscle and tendon, common cause of lateral hip pain.
    • Prepatellar bursa: between the skin and patella, also known as "housemaid knee".
    • Achilles bursa: between the calcaneus and Achilles tendon.

    Popliteal Cyst

    • Posterior extension of synovial membranes into the popliteal area due to persistent fluid production in the knee, commonly seen with osteoarthritis and rheumatoid arthritis.

    Etiology of Bursitis

    • Trauma: acute or chronic
    • Overuse: leading to microtrauma
    • Systemic disease: inflammatory processes affecting tendon sheaths and bursae
    • Septic: direct involvement from local injury or as part of a septic process

    Diagnosis

    • Localized pain
    • Swelling: only in certain sites (e.g., olecranon)
    • Erythema: gouty or septic
    • Tenderness to palpation
    • Pain on specific maneuvers for shoulder ROM
    • Impingement sign: pain on abduction of the arm above 90 degrees suggests an inflamed subacromial bursa
    • Drop arm test: suggests a complete tear of the rotator cuff

    Imaging Studies

    • X-rays: may reveal calcific deposits from previous inflammatory episodes
    • US and MRI: helpful in detecting inflammation

    Treatment

    • Rest: discontinue aggravating activities, immobilization for 7-10 days
    • Cold compresses: for acutely inflamed areas
    • Analgesic medication: acetaminophen
    • Anti-inflammatory medication: NSAIDs, corticosteroids
    • Aspiration and corticosteroid injection of inflamed bursa
    • Surgery: failure of conservative management

    Tendinitis

    • Intra-tendinous lesions: associated with microtrauma, commonly in supraspinatus and gluteus medius/minor tendons
    • Peritendinous inflammation or tenosynovitis: susceptible to inflammation and pain
    • Examples: De Quervain disease (inflammation of tendon sheaths over the distal radial head) and "trigger finger" (inflammatory thickening of the fibrous sheath of flexor tendons)

    Diagnosis of Tendinitis

    • Pain on motion
    • De Quervain's tenosynovitis: stretching of tendons is particularly sensitive

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    Description

    Learn about regional rheumatic disorders, including bursitis, tendinitis, and other conditions affecting tendons, ligaments, fascia, and bursae. Understand the causes and symptoms of these disorders.

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