SPINAL Pathologies Differential Diagnosis - SEPARATE Hip + Spine
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Questions and Answers

What condition is commonly associated with central stenosis and older age group according to the D/D Table?

Ankylosing spondylitis

Identify the spinal pathology linked to sharp, stabbing pain and rib joint dysfunction.

Rib joint dysfunction

Which demographic group is particularly susceptible to osteoporosis as shown in the D/D Table?

Thin and small frame individuals and females

Describe the type of pain associated with vascular TOS as per the D/D Table.

<p>Throbbing, achy pain</p> Signup and view all the answers

What are the two types of pain that are affected by movements and sustained posture?

<p>Sprain and strain</p> Signup and view all the answers

Which pathology relates to weakness and is commonly linked with central stenosis?

<p>Disc pathology</p> Signup and view all the answers

How is aerobic exercise related to ankylosing spondylitis based on the D/D Table?

<p>Exercise alleviates symptoms.</p> Signup and view all the answers

What type of pain is typically experienced during laughing, inhaling, or exhaling according to the table?

<p>Rib joint dysfunction pain</p> Signup and view all the answers

What posture alleviates symptoms associated with disc pathology?

<p>Supine lying alleviates symptoms associated with disc pathology.</p> Signup and view all the answers

Which condition is indicated by morning pain experienced by patients?

<p>Ankylosing spondylitis is indicated by morning pain.</p> Signup and view all the answers

What are some physical signs that suggest the presence of TOS (Thoracic Outlet Syndrome)?

<p>Signs include edema, pallor, cyanosis, distended veins, and muscle atrophy.</p> Signup and view all the answers

How does facet joint dysfunction typically present in terms of motion assessment?

<p>It is likely hypomobile in PPIVMs and may show painful PAIVMs.</p> Signup and view all the answers

What condition is characterized by back pain assessed as painful, excessive, or reduced PROM?

<p>Spondylolysis is characterized by such pain assessments.</p> Signup and view all the answers

Identify a common symptom of central stenosis in patients.

<p>Bilateral symptoms are commonly associated with central stenosis.</p> Signup and view all the answers

What is the relationship between running and stress fractures?

<p>Increased training load and activity aggravate stress fractures, especially in runners.</p> Signup and view all the answers

Which condition presents most painful in movements transitioning from FLEX to EXT in the hip?

<p>FAI (Femoroacetabular Impingement) presents this specific pain pattern.</p> Signup and view all the answers

What are the characteristic symptoms of an avulsion fracture?

<p>Extremely tender upon palpation and possible deformity are symptoms of an avulsion fracture.</p> Signup and view all the answers

What motion assessment limitation is commonly found in patients with stress fractures?

<p>FLEX and EXT motions are equally limited in cases of stress fractures.</p> Signup and view all the answers

How does scoliotic condition present in terms of physical examination?

<p>Unilateral symptoms and abnormal spinal curve alignment suggest a scoliotic condition.</p> Signup and view all the answers

What pain characteristic is associated with osteoarthritis?

<p>Deep, aching pain is commonly associated with osteoarthritis.</p> Signup and view all the answers

What examination finding suggests the presence of rheumatoid arthritis?

<p>Hyperreflexive deep tendon reflexes (DTR) suggest the presence of rheumatoid arthritis.</p> Signup and view all the answers

Identify a potential consequence of prolonged sitting in athletic activities.

<p>Prolonged sitting aggravates Femoroacetabular Impingement (FAI) conditions.</p> Signup and view all the answers

What demographic factor is correlated with a higher prevalence of ankylosing spondylitis according to the D/D Table?

<p>Being male is correlated with a higher prevalence of ankylosing spondylitis.</p> Signup and view all the answers

Which condition is often associated with dull, aching, stiff pain as indicated in the D/D Table?

<p>Sprain is often associated with dull, aching, stiff pain.</p> Signup and view all the answers

What symptom is prevalent in patients with central stenosis, especially when moving from standing to walking?

<p>Walking and standing pain is prevalent in patients with central stenosis.</p> Signup and view all the answers

According to the D/D Table, what pain quality is associated with vascular thoracic outlet syndrome (TOS)?

<p>Throbbing, achy pain is associated with vascular TOS.</p> Signup and view all the answers

Identify a pathology linked to narrowed foramina that may cause radicular pain as per the D/D Table.

<p>Foraminal stenosis is linked to radicular pain.</p> Signup and view all the answers

What condition is identified with pain alleviation through FLEX and is primarily associated with disc pathology?

<p>Disc pathology is associated with pain alleviation through FLEX.</p> Signup and view all the answers

What type of pain is typically described as cramping and is indicative of central stenosis?

<p>Cramping pain is typically described in association with central stenosis.</p> Signup and view all the answers

For individuals with thoracic outlet syndrome, what type of pain is characterized as burning, sharp, and following nerve distribution?

<p>Burning, sharp, electrical pain is characterized in thoracic outlet syndrome.</p> Signup and view all the answers

What type of pain is associated with the transition of flexion to extension in hip conditions?

<p>FAI (Femoroacetabular Impingement) presents most painful when transitioning from FLEX to EXT.</p> Signup and view all the answers

What findings might indicate TOS (Thoracic Outlet Syndrome) based on specific symptoms?

<p>Diminished pulse and edema/pooling of blood can indicate TOS.</p> Signup and view all the answers

Which condition is characterized by an increased lordosis and step deformity?

<p>Spondylolysis is associated with increased lordosis and step deformity.</p> Signup and view all the answers

How do adverse neurodynamics present in physical assessments?

<p>Adverse neurodynamics typically show muscle atrophy in the affected nerve distribution.</p> Signup and view all the answers

What symptom is commonly associated with ankylosing spondylitis in terms of pain timing?

<p>Morning pain is commonly associated with ankylosing spondylitis.</p> Signup and view all the answers

Which condition could lead to bilateral symptoms in patients?

<p>Central stenosis can lead to bilateral symptoms.</p> Signup and view all the answers

What examination finding indicates spinal instability often related to rheumatoid arthritis?

<p>Upper cervical instability is often indicated in cases of rheumatoid arthritis.</p> Signup and view all the answers

Which condition presents with painful excessive motion assessment and reduced PROM?

<p>Spondylolysis presents with painful excessive, reduced PROM.</p> Signup and view all the answers

What characterizes morning and night pain in an older population?

<p>Osteoarthritis is commonly associated with morning pain and night pain.</p> Signup and view all the answers

What is commonly observed in patients experiencing rib joint dysfunction?

<p>Rib motion/breathing issues and chest swelling can indicate rib joint dysfunction.</p> Signup and view all the answers

What abnormal spinal curvature can accompany TOS?

<p>Scoliosis can accompany Thoracic Outlet Syndrome.</p> Signup and view all the answers

How does flexible joint motion appear in patients with strain?

<p>Flexion and extension are equally limited in cases of strain.</p> Signup and view all the answers

What clinical finding is present when performing ISOM tests for osteitis pubis?

<p>Pain and weakness with ISOM hip ADD are indicative of osteitis pubis.</p> Signup and view all the answers

Which condition is identified by history of family traits and is specifically associated with degeneration?

<p>Osteoarthritis shows an association with family history.</p> Signup and view all the answers

What type of pain is associated with vigorous exercise and may be indicative of VBI?

<p>Throbbing or aching pain.</p> Signup and view all the answers

Which spinal pathology is linked to the presence of dull, aching, stiff pain?

<p>Sprain or strain.</p> Signup and view all the answers

Which demographic factors are associated with a higher prevalence of disc pathology?

<p>Smoking and being thin with a small frame.</p> Signup and view all the answers

What motion is commonly assessed with regards to rib joint dysfunction?

<p>Rotation (ROT).</p> Signup and view all the answers

What are the potential effects of prolonged sitting on thoracic outlet syndrome (TOS)?

<p>Increased pain or discomfort in upper limbs.</p> Signup and view all the answers

Which pathology is indicated by the symptom of cramping pain?

<p>Central stenosis.</p> Signup and view all the answers

What is a characteristic pain quality of spondylosis that differs from sprain or strain?

<p>Stiff pain.</p> Signup and view all the answers

How does the quality of pain change during movements for patients with central stenosis?

<p>Pain intensifies during extension (EXT) and improves with flexion (FLEX).</p> Signup and view all the answers

What condition is associated with increased lordosis and step deformity?

<p>Spondylolysis</p> Signup and view all the answers

What are common symptoms indicating thoracic outlet syndrome (TOS)?

<p>Edema, pallor, decreased pulse, and shoulder deviation.</p> Signup and view all the answers

Which condition often presents with a Rust's sign and abnormal spinal curvatures?

<p>Osteoporosis</p> Signup and view all the answers

Identify a condition characterized by painful hip motion predominantly transitioning from flexion to extension.

<p>Femoral Acetabular Impingement (FAI)</p> Signup and view all the answers

What are the findings associated with decreased active range of motion (AROM) in the context of ankylosing spondylitis?

<p>Limited extendability and morning stiffness.</p> Signup and view all the answers

What signs may indicate a labral tear in the hip?

<p>Clicking and catching sensations during movement.</p> Signup and view all the answers

Name the condition that is significantly aggravated by increased training load and often presents in endurance athletes.

<p>Stress fractures</p> Signup and view all the answers

Which pathology is related to muscle atrophy in an affected nerve distribution?

<p>Adverse neurodynamics</p> Signup and view all the answers

Identify one characteristic symptom of spondylosis.

<p>Increased lordosis with pain on movement.</p> Signup and view all the answers

Which condition is characterized by significant pelvic tilt and postural deviation?

<p>Osteoporosis</p> Signup and view all the answers

What clinical sign might indicate a hip condition involving pain during trunk flexion and one-leg stance?

<p>Pain or weakness with ISOM hip adduction.</p> Signup and view all the answers

During a physical examination of a patient with central stenosis, which symptom would likely be present?

<p>Bilateral symptoms and diminished reflexes.</p> Signup and view all the answers

What findings are likely present in conditions affecting rib joint dysfunction during breathing assessments?

<p>Chest swelling, redness, or abnormal rib motion.</p> Signup and view all the answers

What factors are commonly associated with osteoarthritis as per the D/D table?

<p>Older age, increased mass, and a sedentary lifestyle.</p> Signup and view all the answers

What demographic factors contribute to increased susceptibility to osteoporosis according to the D/D Table?

<p>Female gender and a thin, small frame.</p> Signup and view all the answers

What type of pain is typically associated with the active movement of laughing or exhaling?

<p>Rib joint dysfunction pain.</p> Signup and view all the answers

Which condition is indicated by thoracic outlet syndrome (TOS) presenting with 'burning, sharp, electrical pain'?

<p>Vascular TOS.</p> Signup and view all the answers

Describe the type of pain commonly associated with central stenosis based on the D/D Table.

<p>Throbbing, aching pain.</p> Signup and view all the answers

How is 'stiff pain' typically described in the context of spinal pathologies?

<p>Associated with spondylosis and sprain/strain.</p> Signup and view all the answers

What is the characteristic symptom associated with central stenosis that affects walking?

<p>Walking and standing pain.</p> Signup and view all the answers

In the context of spinal pathologies, what condition can be linked to 'cramping' pain?

<p>Central stenosis.</p> Signup and view all the answers

According to the D/D Table, what common symptom is seen in patients with lumbar pain?

<p>Spondylosis and spondylolisthesis.</p> Signup and view all the answers

What condition is indicated by morning pain and restrictive mobility?

<p>Ankylosing spondylitis.</p> Signup and view all the answers

Which condition is commonly linked to increased lordosis and step deformity?

<p>Spondylolysis.</p> Signup and view all the answers

What type of pain is associated with a labral tear in hip conditions?

<p>Pinching sensation with movement.</p> Signup and view all the answers

What examination finding might suggest TOS (Thoracic Outlet Syndrome)?

<p>Edema or pooling of blood in the upper extremities.</p> Signup and view all the answers

Which pathology is characterized by bilateral symptoms and is associated with narrowing of neural foramina?

<p>Central stenosis.</p> Signup and view all the answers

What type of pain is typically experienced due to overuse and is linked to osteoarthritis?

<p>Dull, aching pain.</p> Signup and view all the answers

What indicates a likely diagnosis of a stress fracture in younger athletes?

<p>Increased training load and pain during activity.</p> Signup and view all the answers

Which spinal pathology presents with abnormal spinal curves like scoliosis?

<p>Scoliosis.</p> Signup and view all the answers

What symptom might be indicative of an avulsion fracture through palpation?

<p>Extremely tender upon palpation.</p> Signup and view all the answers

What condition is characterized by painful, excessive motion during ISOM assessment?

<p>Sprain.</p> Signup and view all the answers

What clinical finding is commonly noted in those with adverse neurodynamics?

<p>Muscle atrophy in affected nerve distribution.</p> Signup and view all the answers

What common symptom is associated with facet joint dysfunction?

<p>Painful motion assessment when evaluating the joints.</p> Signup and view all the answers

Which hip condition is associated with pain during running and cutting activities?

<p>FAI (Femoroacetabular Impingement).</p> Signup and view all the answers

What characteristic sign is exhibited in patients with osteoporosis?

<p>Rust's sign.</p> Signup and view all the answers

Which condition is primarily associated with a thin and small frame?

<p>Osteoporosis (D)</p> Signup and view all the answers

Smoking is a factor that can lead to osteoporosis and disc pathology.

<p>True (A)</p> Signup and view all the answers

What type of pain is commonly experienced with central stenosis?

<p>Weakness</p> Signup and view all the answers

Burning, sharp, electrical pain that follows the nerve distribution is associated with __________.

<p>TOS</p> Signup and view all the answers

Match the following pain types with their potential cause:

<p>Dull, aching, stiff pain = Sprain or Strain Sharp, stabbing pain = Rib joint dysfunction Throbbing, achy pain = Vascular TOS Cramping = Central stenosis</p> Signup and view all the answers

Which pathology is characterized by pain alleviation through exercising?

<p>Ankylosing spondylitis (C)</p> Signup and view all the answers

Facet joint dysfunction is noted for being exacerbated in the rotation motion assessment.

<p>True (A)</p> Signup and view all the answers

What demographic group is particularly susceptible to spondylolysis?

<p>Younger individuals</p> Signup and view all the answers

Which condition is commonly linked with morning pain?

<p>Ankylosing spondylitis (B)</p> Signup and view all the answers

Decreased Active Range of Motion (AROM) can occur with conditions like Ankylosing spondylitis and Spondylosis.

<p>True (A)</p> Signup and view all the answers

What condition presents with a pain quality that is sharp and occurs predominantly with movement?

<p>Labral tear</p> Signup and view all the answers

Symptoms associated with _____ include edema, pooling of blood, and distended veins.

<p>Thoracic Outlet Syndrome (TOS)</p> Signup and view all the answers

Match each symptom to the appropriate condition:

<p>Rust's sign = Disc pathology Diminished pulse = Thoracic Outlet Syndrome Increased lordosis = Spondylosis Sharp pain with hip movement = Labral tear</p> Signup and view all the answers

Which condition is associated with decreased pulse during assessment?

<p>Thoracic Outlet Syndrome (A)</p> Signup and view all the answers

Strains and sprains can occur simultaneously in musculoskeletal injuries.

<p>True (A)</p> Signup and view all the answers

What movement is likely to cause pain in patients with FAI?

<p>Transitioning from flexion to extension</p> Signup and view all the answers

_____ is characterized by pain during coughing or sneezing.

<p>Iliac crest contusion</p> Signup and view all the answers

Which condition is likely associated with unfavorable biomechanics in the low back?

<p>Scoliosis (C)</p> Signup and view all the answers

Osteitis pubis is more commonly observed in skeletally mature athletes.

<p>False (B)</p> Signup and view all the answers

Name one condition that can cause bilateral symptoms.

<p>Central stenosis</p> Signup and view all the answers

The common symptom of _____ is pain triggered by prolonged sitting.

<p>Femoroacetabular Impingement (FAI)</p> Signup and view all the answers

Match the findings to their corresponding conditions:

<p>Crepitus = Osteoarthritis Muscle spasm = Strain Catching = Labral tear Forward head posture = Osteoporosis</p> Signup and view all the answers

Which condition is most commonly associated with dull, aching, stiff pain?

<p>Sprain (C)</p> Signup and view all the answers

Scoliosis is primarily associated with cramping pain.

<p>False (B)</p> Signup and view all the answers

What type of pain is linked with rib joint dysfunction?

<p>Sharp, stabbing pain</p> Signup and view all the answers

Individuals with ______ are at a higher risk of osteoporosis.

<p>thin and small frame</p> Signup and view all the answers

Match the following symptoms with their associated conditions:

<p>Throbbing, achy pain = Vascular TOS Burning, sharp pain = TOS Stiff pain = Spondylosis Weakness = Central stenosis</p> Signup and view all the answers

Which demographic is more likely to experience central stenosis?

<p>Older adults (D)</p> Signup and view all the answers

Vigorous exercise can exacerbate symptoms of vascular TOS.

<p>True (A)</p> Signup and view all the answers

What condition is characterized by a loss of bone density and is commonly seen in older populations?

<p>Osteoporosis</p> Signup and view all the answers

Which of the following conditions is often associated with increased lordosis?

<p>Ankylosing spondylitis (D)</p> Signup and view all the answers

Morning pain is a common symptom of both ankylosing spondylitis and osteoarthritis.

<p>True (A)</p> Signup and view all the answers

What type of pain is most painful with transition from FLEX to EXT in hip conditions?

<p>FAI</p> Signup and view all the answers

Increased training load coupled with activity aggravates _______________ symptoms.

<p>stress fractures</p> Signup and view all the answers

Match the following conditions with their associated symptoms:

<p>Osteitis pubis = Pain/weakness with ISOM hip ADD Avulsion fracture = Extremely tender upon palpation Labral tear = Popping and catching Osteoarthritis = Deep, aching pain</p> Signup and view all the answers

Which condition is characterized by rust's sign and decreased AROM?

<p>Disc pathology (A)</p> Signup and view all the answers

Facial expressions are irrelevant when assessing for strains or sprains.

<p>False (B)</p> Signup and view all the answers

Identify a condition associated with muscle atrophy in affected nerve distribution.

<p>Adverse neurodynamics</p> Signup and view all the answers

Diminished pulse is often a sign of ______________.

<p>TOS</p> Signup and view all the answers

Which symptom is correlated with rheumatoid arthritis?

<p>Hyper reflexive DTR (D)</p> Signup and view all the answers

Scoliosis presents with unilateral symptoms.

<p>False (B)</p> Signup and view all the answers

What symptom would indicate a labral tear in hip conditions?

<p>Catching</p> Signup and view all the answers

Increased kyphosis and a protuberant abdomen are commonly observed with ______________.

<p>osteoporosis</p> Signup and view all the answers

Which condition is correlated with increased training load in athletes?

<p>Osteitis pubis (C)</p> Signup and view all the answers

Pain can be alleviated through rest and arm support in cases of TOS.

<p>True (A)</p> Signup and view all the answers

What symptom is commonly associated with osteoporosis, particularly in thinner individuals?

<p>Fractures or bone weakness.</p> Signup and view all the answers

Identify the type of pain that is often described as throbbing and achy in vascular thoracic outlet syndrome.

<p>Throbbing, achy pain.</p> Signup and view all the answers

What is the primary presenting symptom of spondylolysis, especially in younger individuals?

<p>Lower back pain.</p> Signup and view all the answers

Name two conditions associated with disc pathology that can present as pain with movement.

<p>Central stenosis and radicular pain.</p> Signup and view all the answers

Which symptom is indicative of adverse neurodynamics and may be associated with central stenosis?

<p>Weakness.</p> Signup and view all the answers

What demographic factor is often related to increased instances of spondylosis?

<p>Older age.</p> Signup and view all the answers

In patients experiencing rib joint dysfunction, what activity might exacerbate their pain?

<p>Laughing or deep inhaling/exhaling.</p> Signup and view all the answers

What movement is likely to alleviate symptoms associated with central stenosis?

<p>Flexion.</p> Signup and view all the answers

What type of pain is primarily experienced during flexion to extension movement in hip conditions?

<p>FAI</p> Signup and view all the answers

Which condition can lead to reduced pain with isometric contraction and increased pain during motion assessment?

<p>Spondylolysis</p> Signup and view all the answers

What symptoms commonly indicate the presence of vascular thoracic outlet syndrome (TOS)?

<p>Pallor, cyanosis, and distended veins</p> Signup and view all the answers

Which pathology is linked to shoulder deviations and requires special assessments for postural evaluation?

<p>Adverse neurodynamics</p> Signup and view all the answers

What is a common finding associated with increased lordosis and step deformity?

<p>Spondylolysis</p> Signup and view all the answers

What clinical sign is often assessed for thoracic outlet syndrome associated with muscle atrophy?

<p>Adverse neurodynamics</p> Signup and view all the answers

What symptom is characteristic of an avulsion fracture when palpating affected areas?

<p>Extremely tender upon palpation</p> Signup and view all the answers

Which condition typically presents with catching or popping sensations in the hip joint?

<p>Labral tear</p> Signup and view all the answers

In which condition is the painful range of motion often linked with Gower's sign during AROM testing?

<p>Spondylosis</p> Signup and view all the answers

What is a notable presentation of a patient with scoliosis during an examination?

<p>Abnormal spinal curve and shoulder level discrepancies</p> Signup and view all the answers

Which pathology is characterized by diminished pulse assessments commonly observed during examination?

<p>Thoracic Outlet Syndrome (TOS)</p> Signup and view all the answers

What type of pain is primarily associated with morning discomfort linked to osteoarthritis?

<p>Dull, aching pain</p> Signup and view all the answers

Which condition presents with bilateral symptoms and is typically examined for central stenosis?

<p>Central stenosis</p> Signup and view all the answers

What clinical finding suggests an increased risk linked to rheumatoid arthritis?

<p>Hyperreflexive deep tendon reflexes (DTR)</p> Signup and view all the answers

What common activity may aggravate pain associated with iliac crest contusions?

<p>Coughing, sneezing, or bearing down</p> Signup and view all the answers

How do repeated flexion movements affect the symptoms of disc herniation?

<p>They peripheralize symptoms.</p> Signup and view all the answers

What centralizing technique is typically seen in the treatment of disc herniation?

<p>Repeated extension movements.</p> Signup and view all the answers

What term is used to describe ankylosing spondylitis due to its lack of localization?

<p>'Bamboo spine'.</p> Signup and view all the answers

What relationship exists between the severity of disc herniation and nerve root compression?

<p>More severe disc herniation often results in increased nerve root compression.</p> Signup and view all the answers

What is a common hallmark symptom associated with ankylosing spondylitis?

<p>Morning stiffness and pain.</p> Signup and view all the answers

How do repeated flexion movements relate to symptom difference in disc herniation?

<p>Repeated flexion peripheralizes symptoms in disc herniation.</p> Signup and view all the answers

What symptom behavior characterizes the effect of repeated extension on disc herniation?

<p>Repeated extension centralizes symptoms in disc herniation.</p> Signup and view all the answers

In severe cases of disc herniation, what results from increased nerve root compression?

<p>A more severe version of the condition results in greater nerve root compression.</p> Signup and view all the answers

What is the common term used to describe the non-localized pain in ankylosing spondylitis?

<p>It's commonly referred to as 'bamboo spine.'</p> Signup and view all the answers

What demographic group is most commonly affected by ankylosing spondylitis?

<p>Ankylosing spondylitis typically has an onset in younger adults, primarily males.</p> Signup and view all the answers

In the context of disc herniation, what effect does repeated flexion have on patient symptoms?

<p>It peripheralizes symptoms.</p> Signup and view all the answers

What is the relationship between the severity of disc herniation and nerve root compression?

<p>A more severe disc herniation correlates with increased nerve root compression.</p> Signup and view all the answers

What does the term 'bamboo spine' refer to, and which condition is it associated with?

<p>'Bamboo spine' refers to ankylosing spondylitis.</p> Signup and view all the answers

How does the motion of repeated extension affect symptoms in patients with disc herniation?

<p>Repeated extension centralizes symptoms.</p> Signup and view all the answers

What is a significant symptom associated with ankylosing spondylitis regarding pain timing?

<p>Patients typically experience morning pain.</p> Signup and view all the answers

In the context of disc herniation, what is the significance of repeated flexion and extension movements on patient symptoms?

<p>Repeated flexion typically peripheralizes symptoms, while repeated extension centralizes them.</p> Signup and view all the answers

What correlation exists between the severity of disc herniation and nerve root compression?

<p>A more severe disc herniation correlates with increased nerve root compression.</p> Signup and view all the answers

How does ankylosing spondylitis manifest atypically when compared to general spinal pathologies?

<p>Ankylosing spondylitis is characterized by diffuse pain, often referred to as 'bamboo spine', rather than localized symptoms.</p> Signup and view all the answers

Identify the onset demographic commonly associated with ankylosing spondylitis.

<p>Ankylosing spondylitis typically has an onset in young adults, particularly males.</p> Signup and view all the answers

What type of spinal pathology is indicated by a patient experiencing symptoms that are reduced with extension?

<p>Symptoms reduced with extension suggest a disc herniation rather than other spinal pathologies.</p> Signup and view all the answers

What does repeated flexion indicate in relation to disc herniation symptoms?

<p>It peripheralizes the symptoms.</p> Signup and view all the answers

How does the severity of disc herniation relate to nerve root compression?

<p>A more severe disc herniation results in increased nerve root compression.</p> Signup and view all the answers

What condition is often referred to as 'bamboo spine' and what characteristic symptom does it have?

<p>Ankylosing spondylitis; it is not localized.</p> Signup and view all the answers

In the context of disc herniation, what is the significance of repeated extension movements?

<p>Repeated extension centralizes the symptoms.</p> Signup and view all the answers

What is a common onset demographic for ankylosing spondylitis?

<p>It typically begins in younger adults.</p> Signup and view all the answers

What symptom pattern is observed in patients with disc herniation during repeated flexion and extension movements?

<p>Increased symptoms peripheralize with repeated flexion, while symptoms centralize with repeated extension.</p> Signup and view all the answers

Explain the correlation between the severity of disc herniation and nerve root compression.

<p>A more severe version of disc herniation results in increased nerve root compression, leading to more significant symptoms.</p> Signup and view all the answers

Describe the characteristic spinal appearance associated with ankylosing spondylitis and its symptom localization.

<p>Ankylosing spondylitis is often referred to as 'bamboo spine' due to its rigid appearance and is not localized, affecting multiple spinal levels.</p> Signup and view all the answers

What specific demographic factors should be considered when assessing risk for ankylosing spondylitis?

<p>Ankylosing spondylitis is more prevalent in younger males, particularly those with a family history of the condition.</p> Signup and view all the answers

How does the presentation of symptoms differ between disc herniation and ankylosing spondylitis?

<p>Disc herniation typically presents with localized pain and mobility issues, while ankylosing spondylitis presents with systemic stiffness and a 'bamboo spine' appearance.</p> Signup and view all the answers

Which condition is described as 'bamboo spine' and is not localized?

<p>Ankylosing spondylitis (A)</p> Signup and view all the answers

Repeated flexion of the spine centralizes symptoms in disc herniation.

<p>False (B)</p> Signup and view all the answers

What type of symptom severity is correlated with more nerve root compression?

<p>more severe version of disc herniation</p> Signup and view all the answers

In cases of disc herniation, repeated _______ centralizes symptoms.

<p>extension</p> Signup and view all the answers

Match the spinal conditions with their characteristics:

<p>Disc herniation = Peripheralization of symptoms with flexion Ankylosing spondylitis = Non-localized with rigid spine appearance Osteoarthritis = Characterized by degenerative changes Rheumatoid arthritis = Associated with systemic inflammation</p> Signup and view all the answers

Which of the following statements is true regarding disc herniation?

<p>A more severe version can result in increased nerve root compression. (C)</p> Signup and view all the answers

Disc herniation results in symptoms that are commonly centralized by repeated extension.

<p>True (A)</p> Signup and view all the answers

What condition is often referred to as 'bamboo spine' due to its non-localized nature?

<p>Ankylosing spondylitis</p> Signup and view all the answers

A more severe version of disc herniation may lead to increased __________ compression.

<p>nerve root</p> Signup and view all the answers

Match the following conditions with their characteristics:

<p>Disc herniation = Symptoms peripheralize with flexion Ankylosing spondylitis = Referred to as 'bamboo spine' Extensive nerve root compression = Correlates with severe disc herniation</p> Signup and view all the answers

Quale indicia un reflexo hyperreflexive indica in le sistema nervose?

<p>Involvement del neuronio superior del motor.</p> Signup and view all the answers

Quais son le diferencias inter le reflexos hyperreflexive e hyporeflexive?

<p>Le hyperreflexive indica involvement superieur, mentre le hyporeflexive indica involvement inferior.</p> Signup and view all the answers

Como le reflexos del corpo pote adjutar in le evaluation clinico del dolore neurologic?

<p>Reflexos denote le fonction del sistema nervose e pote indicar le location del problema.</p> Signup and view all the answers

Quale implicante cognitive es associabile con le reflexos del motor superior e inferior?

<p>Reflexos del motor superior implica proprioceptive e coordinato, mentre inferior es plus immediate.</p> Signup and view all the answers

Quales indicios clinicales poterea suggerer un involvemento del neuron superior?

<p>L'hyperreflexia indica un involvemento del neuron superior.</p> Signup and view all the answers

Quale condition indica hyporeflexia?

<p>Hyporeflexia indica un involvemento del neuron inferior o del sistema nervoso peripheric.</p> Signup and view all the answers

Como se differencia inter hyperreflexia e hyporeflexia in relation al tipo de neuron involvado?

<p>Hyperreflexia se relacione con neuron superior, enquanto hyporeflexia se relacione con neuron inferior.</p> Signup and view all the answers

Quai es le significato de reflexos in relation a la dysfunction del sistema nervoso?

<p>Reflexos abnormal indica involvamento del systema nervoso, specificamente del neuron qui es implicate.</p> Signup and view all the answers

Quai es le utilitate clinical de observar hyperreflexia e hyporeflexia?

<p>L'observation de hyperreflexia e hyporeflexia ayuda a diagnosticare el tipo de dysfunction neuronal.</p> Signup and view all the answers

Quale condition indica involvement del neuronio motor superior?

<p>Hyperreflexia (B)</p> Signup and view all the answers

Hyporeflexia indica involvement del sistema nervoso centrale.

<p>False (B)</p> Signup and view all the answers

Che cosa indica la hyperreflexia?

<p>Involvement del neuronio motor superior.</p> Signup and view all the answers

Hyporeflexia indica involvement del ______ o del sistema nervoso periferico.

<p>neuronio motor inferior</p> Signup and view all the answers

Associa le seguenti definizioni con i termini appropriati:

<p>Hyperreflexia = Involvement del neuronio motor superior Hyporeflexia = Involvement del neuronio motor inferior Upper motor neuron = Sistema nervoso centrale Lower motor neuron = Sistema nervoso periferico</p> Signup and view all the answers

Flashcards

Spinal stenosis

A narrowing of the spinal canal, a space around the spinal cord and nerves.

Ankylosing spondylitis

A type of arthritis that affects the spine, causing stiffness and inflammation.

Spondylosis

Degeneration of the spine, often involving the joints.

Disc pathology

Problems with the spinal discs (intervertebral discs) - like herniation or bulging of the disc.

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Spondylolysis

A fracture or weakness in the pars interarticularis of the vertebra.

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Scoliosis

A sideways curvature of the spine.

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Vascular TOS (Thoracic Outlet Syndrome)

Nerve or blood vessel compression in the upper chest.

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Osteoporosis

A condition where bones become weak and brittle.

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Sprain

Injury to ligaments, often causing pain, limited movement, and swelling.

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Strain

Injury to a muscle or tendon, often causing pain, limited movement, and swelling.

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TOS (Thoracic Outlet Syndrome)

Nerve and/or vessel compression in the space between collarbones and first rib, causing pain, numbness, and/or tingling in the arm and hand.

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Facet Joint Dysfunction

Pain caused by problems with the joints connecting vertebrae.

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Adverse Neurodynamics

Nerve irritation or damage during movement/motion.

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Central stenosis

Narrowing of the spinal canal, potentially affecting the spinal cord or nerves.

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Foraminal stenosis

Narrowing of the openings between vertebrae that contain nerves

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Hip impingement (FAI)

Condition where the bones in the hip joint rub together, causing pain and stiffness

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Age-related spinal issues

Spinal conditions common in individuals over 50 often include Ankylosing spondylitis, Central stenosis, Osteoporosis, and Vertebrobasilar insufficiency (VBI).

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Younger spinal issues

Spinal conditions more prevalent in younger individuals include Spondylolysis and Thoracic Outlet Syndrome (TOS) with vascular involvement. Scoliosis is also more common in younger patients, especially structural scoliosis.

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Gender and spinal issues

Spondylolysis, Osteoporosis, and TOS are more prevalent in women. Structural scoliosis is also more common in women.

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Smoking and spinal issues

Smoking increases the risk of Osteoporosis, Disc pathology, and Vertebrobasilar insufficiency (VBI). It may also contribute to pain and stiffness.

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Caucasian/Asian and spinal issues

Osteoporosis is more common in Caucasian and Asian individuals.

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Radicular pain

Pain radiating along a nerve often indicates Central stenosis, Foraminal stenosis, Spondylosis, or Thoracic Outlet Syndrome (TOS).

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Dull and Stiff Pain

Dull and stiff pain can suggest Sprain, Strain, or Facet joint dysfunction.

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Sharp, Stabbing Pain

Sharp, stabbing pain is often associated with Rib joint dysfunction.

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What is a key finding for a hip impingement?

Painful hip rotation with a bone-to-bone end feel.

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What is a sign of a hip labral tear?

A popping sensation with hip movement.

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What finding is common in both osteitis pubis and stress fractures?

Pain that is worse after prolonged sitting.

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What is a key difference between FAI and OA?

FAI pain is most intense going from flex to ext, while OA pain is worse going from ext to flex.

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What hip condition presents with morning pain?

OA

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What hip condition is more prevalent in females?

Stress fractures

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What condition is often associated with a sedentary lifestyle?

OA

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What hip finding can be asymptomatic?

Apophysitis

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What condition is most painful when going from flexion to extension?

FAI

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What condition is associated with sharp, aching pain?

Avulsion fracture

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What condition is characterized by a deep, aching pain?

Stress fracture

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What condition is often associated with coughing, sneezing, or bearing down?

Iliac crest contusion

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What hip condition presents with possible deformity?

Avulsion fracture

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What hip condition is associated with tightness in the lower adductors?

Osteitis pubis

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What hip condition is associated with meralgia paraesthetica?

Iliac crest contusion

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Finding: >50 years old

This age range is associated with conditions like Ankylosing spondylitis, central stenosis, osteoporosis, and Vertebrobasilar Insufficiency (VBI).

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Finding: 20-40 years old

Conditions like spondylosis and disc pathology frequently occur in this age group, reflecting the impact of time and activity on spinal health.

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Finding: Younger (under 20)

Spondylolysis, vascular Thoracic Outlet Syndrome (TOS), and structural scoliosis are more prevalent in young individuals.

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Finding: Female

Women are more prone to spondylolysis, osteoporosis, TOS, and structural scoliosis.

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Finding: Thin and small frame

Individuals with a slender build are more susceptible to osteoporosis, especially those with a history of smoking.

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Finding: Male

Males are more likely to experience ankylosing spondylitis, disc pathology, and VBI.

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Finding: Smoking

Smoking increases the risk of osteoporosis, disc pathology, and VBI.

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Finding: Caucasian/Asian

These ethnicities have a higher incidence of osteoporosis compared to other populations.

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What pain pattern suggests a possible Disc Pathology?

Pain that is worse at the end and beginning of the day.

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What condition is associated with morning pain?

Ankylosing spondylitis, Spondylosis and Sprain.

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What condition is associated with pain that is worse at night?

Disc pathology and Thoracic Outlet Syndrome (TOS).

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What condition is associated with pain that is worse with repeated movement?

Disc pathology and Spondylosis.

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What condition is associated with pain that improves with isometric (ISOM) exercises?

Spondylolysis.

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What condition is associated with painful, excessive, and reduced PROM?

Sprain.

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What condition is associated with pain that is worse going from Flexion to Extension?

Hip impingement (FAI).

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What condition is associated with pain that is worse going from Extension to Flexion?

Osteoarthritis (OA).

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What condition is associated with pain that is worse with prolonged sitting?

Osteitis pubis and stress fractures.

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What condition is associated with pain that is worse with running and cutting?

Hip impingement (FAI) and Sprain.

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What condition is associated with pain that is worse with coughing, sneezing, and bearing down?

Iliac crest contusion.

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What condition is associated with pain that is worse with hip rotation and a bone-to-bone end feel?

Hip impingement (FAI).

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What condition is associated with a popping sensation with hip movement?

Labral tear.

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What condition is associated with a clicking sensation with hip movement?

Osteoarthritis (OA) and Labral tear.

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What condition is associated with possible deformity around the hip?

Avulsion fracture.

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Age and spinal issues

People over 50 are more likely to experience conditions like ankylosing spondylitis, central stenosis, osteoporosis, and VBI. These are often associated with age-related wear and tear.

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Younger and spinal issues

Spondylolysis, vascular thoracic outlet syndrome (TOS), and structural scoliosis are more common in younger individuals. These often involve growth, development, or repetitive movements.

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Dull, aching, stiff pain

This type of pain can signal a sprain, strain, or facet joint dysfunction. It's like a dull ache from overuse or injury.

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What kind of pain is associated with a disc pathology?

Pain at the end and beginning of the day, or pain that is worse at night.

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What pain pattern is commonly associated with Ankylosing Spondylitis?

Morning pain.

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What are the symptoms of a sprain?

Pain, swelling, limited range of motion, and hypermobile ISOM.

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What is a sign of spondylolysis?

Pain that improves with isometric (ISOM) exercises, but worsens with motion assessment.

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What condition is associated with excessive PROM and hypomobile ISOM?

A sprain.

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What are the characteristics of facet joint dysfunction?

Painful hypomobile passive physiological intervertebral motions (PPIVMs), painful passive accessory intervertebral motions (PAIVMs), and reduced range of motion (ROM).

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What does ‘hip impingement’ or FAI stand for?

Femoroacetabular impingement

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What is a key sign of hip impingement (FAI)?

Painful hip rotation with a bone-to-bone end feel.

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What condition is associated with pain that gets worse going from flexion to extension of the hip?

Hip impingement (FAI)

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What is the pain pattern associated with hip osteoarthritis (OA)?

Pain that is worse going from extension to flexion of the hip.

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What is a common symptom of both osteitis pubis and stress fractures in the hip?

Pain that is worse after prolonged sitting.

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What hip condition is associated with pain that is worse with running and cutting?

Hip impingement (FAI) and a sprain

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What hip condition often makes coughing, sneezing, or bearing down worse?

Iliac crest contusion.

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What condition is associated with a possible deformity near the hip?

Avulsion fracture.

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What hip condition presents with tightness in the lower adductors?

Osteitis pubis.

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Age & Spinal Issues: >50

Individuals over 50 are more likely to experience conditions like ankylosing spondylitis, central stenosis, osteoporosis, and VBI.

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Age & Spinal Issues: 20-40

This age group is susceptible to spondylosis and disc pathology, reflecting natural changes in the spine.

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Age & Spinal Issues: Younger

Conditions like spondylolysis, vascular TOS, and structural scoliosis are frequent in younger individuals.

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Gender & Spinal Issues: Female

Women are more prone to experiencing spondylolysis, osteoporosis, TOS, and structural scoliosis.

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Body Type & Spinal Issues: Thin & Small Frame

Individuals with slender builds are more susceptible to osteoporosis, especially smokers.

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Gender & Spinal Issues: Male

Men are more likely to experience ankylosing spondylitis, disc pathology, and VBI.

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Lifestyle & Spinal Issues: Smoking

Cigarette smoking is linked to an increased risk of osteoporosis, disc pathology, and VBI

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Ethnicity & Spinal Issues: Caucasian/Asian

Individuals of Caucasian or Asian ethnicity have a higher incidence of osteoporosis.

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What conditions are associated with pain that is worse at the end and beginning of the day?

Disc pathology and Spondylosis are associated with pain that is worse at the end and beginning of the day, suggesting potential disc issues or spinal degeneration.

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What conditions present with morning pain?

Ankylosing spondylitis, Spondylosis, and Sprain can all present with morning pain. Ankylosing spondylitis specifically involves inflammation of the spine. Spondylosis refers to degeneration of the spine. Sprain is a ligament injury, often causing morning stiffness.

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What conditions are associated with pain that is worse at night?

Disc pathology and Thoracic Outlet Syndrome (TOS) are associated with pain that is worse at night. Disc pathology suggests potential pressure on nerves. TOS involves compression of nerves or blood vessels in the shoulder and neck region.

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What condition is associated with pain that improves with isometric (ISOM) exercises but worsens with motion assessment?

Spondylolysis is associated with pain that improves with isometric exercises but worsens with motion assessment. This suggests a weakness or fracture in the pars interarticularis of a vertebra.

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What are the characteristics of a sprain?

A sprain involves an injury to a ligament, often resulting in pain, swelling, limited range of motion, and sometimes hypermobile ISOM. Hypomobile PPIVMs and painful PAIVMs are common findings.

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What are the key findings of Facet Joint Dysfunction?

Facet Joint Dysfunction is characterized by painful hypomobile passive physiological intervertebral motions (PPIVMs), painful passive accessory intervertebral motions (PAIVMs), and reduced range of motion (ROM).

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Hip Impingement (FAI): What does it stand for?

Hip Impingement (FAI) stands for “Femoroacetabular Impingement”. This condition involves a narrowing of the hip joint space, often causing pain and stiffness.

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Hip Impingement (FAI): What is a key sign?

A key sign of hip impingement is painful hip rotation with a bone-to-bone end feel. This indicates a restricted range of motion and potential impinging between bony surfaces.

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What condition presents with pain that is worse going from flexion to extension of the hip?

Hip impingement (FAI) presents with pain that is worse going from flexion to extension of the hip. This is because as the hip moves from bent to straight, the bony surfaces are more likely to come into contact.

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Hip Osteoarthritis (OA): What is a key characteristic?

Hip Osteoarthritis (OA) is characterized by pain that is worse going from extension to flexion of the hip. This is because the weight-bearing surfaces of the joint are more likely to rub together in this movement.

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Osteitis Pubis and Stress Fractures: A common presenting symptom?

Both Osteitis Pubis and Stress Fractures in the hip can present with pain that is worse after prolonged sitting. Prolonged sitting puts pressure on the pubic symphysis (osteitis pubis) or the affected bone (stress fracture).

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Hip pain: Possible deformities?

Avulsion fractures can lead to possible deformities around the hip. These are injuries that occur when a ligament or tendon pulls a piece of bone away from the main bone.

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What are the symptoms of an avulsion fracture?

An avulsion fracture can present with sharp, aching pain, extreme tenderness upon palpation, possible deformity, and crepitus around the hip area.

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Morning pain

Pain experienced right after waking up, often worse at the beginning of the day. This can be a sign of several conditions, like Ankylosing spondylitis, Spondylosis, or a Sprain.

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Night pain

Pain that disturbs sleep, often worse at night. This is commonly associated with Disc pathology or Thoracic Outlet Syndrome (TOS).

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End and beginning of day pain

Pain that is worse at the start and end of the day, potentially indicating Disc pathology or Spondylosis.

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Pain improves with ISOM

Pain lessens when doing isometric exercises, but worsens with movement. This is a strong indicator of Spondylolysis.

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Painful, excessive, reduced PROM

Pain, limited range of motion (ROM), and a hypermobile ISOM (isometric) are common signs of a Sprain.

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Hypomobile PPIVMs, painful PAIVMs

Limited passive physiological intervertebral motions (PPIVMs) and painful passive accessory intervertebral motions (PAIVMs) suggest Facet Joint Dysfunction.

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Hip Osteoarthritis (OA)

Degeneration of the cartilage in the hip joint leading to pain and stiffness. Pain is often worse going from extension to flexion of the hip.

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Osteitis Pubis

Inflammation of the joint between the left and right pubic bones, often leading to pain that worsens with prolonged sitting.

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Stress Fracture

A small crack in a bone, often caused by overuse or repetitive stress. Pain is frequently worse after prolonged sitting.

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Avulsion Fracture

A fracture where a piece of bone is pulled away from the main bone, often caused by a strong muscle contraction. It might present with a deformity around the hip.

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Iliac Crest Contusion

A bruise of the iliac crest, the bony ridge at the top of the hip. Pain is often worse with coughing, sneezing, or bearing down.

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Pain worse with running and cutting

Pain that intensifies while running or performing sudden changes in direction. This could point to a hip Impingement (FAI) or a Sprain.

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Possible hip deformity

A noticeable abnormality or change in the shape of the hip region. This could suggest an Avulsion Fracture, where a piece of bone has been pulled away from the main bone.

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Pain at the end and beginning of the day

Pain that is worse at the end and beginning of the day, often associated with Disc pathology and Spondylosis. This pattern suggests potential disc issues or spinal degeneration.

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What improves with ISOM?

Pain that improves with isometric (ISOM) exercises, often associated with Spondylolysis. This suggests a weakness or fracture in the pars interarticularis of a vertebra.

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What worsens with motion assessment?

Pain that worsens with motion assessment, often associated with Spondylolysis. This suggests a weakness or fracture in the pars interarticularis of a vertebra.

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Hypomobile PPIVMs

Hypomobile passive physiological intervertebral motions (PPIVMs), usually accompanied by painful PAIVMs, are often associated with Facet Joint Dysfunction. This suggests stiffness and limited movement in the facet joints.

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Painful PAIVMs

Painful passive accessory intervertebral motions (PAIVMs), usually accompanying hypomobile PPIVMs, are often associated with Facet Joint Dysfunction. This suggests stiffness and limited movement in the facet joints.

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What is FAI?

FAI stands for Femoroacetabular Impingement. This condition involves a narrowing of the hip joint space, often causing pain and stiffness.

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Painful hip rotation, bone-to-bone end feel

Painful hip rotation with a bone-to-bone end feel is a key sign of hip impingement (FAI). It indicates a restricted range of motion and potential impinging between bony surfaces.

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Pain worse going from flexion to extension

Pain that is worse going from flexion to extension of the hip is often associated with Hip impingement (FAI). The hip's movement from bent to straight can cause more contact between bony surfaces.

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Pain worse going from extension to flexion

Pain that is worse going from extension to flexion of the hip is often associated with Hip Osteoarthritis (OA). This movement causes more pressure and friction on the weight-bearing joint surfaces.

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Prolonged sitting aggravates

Pain that is worse after prolonged sitting is often associated with Osteitis Pubis and Stress Fractures in the hip. Prolonged sitting puts pressure on the pubic symphysis (osteitis pubis) or the affected bone (stress fracture).

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Repeated flexion

Repeated flexion of the spine peripheralizes symptoms, meaning pain moves further away from the source, in a patient with a disc herniation. This suggests the disc is pressing on the nerve root.

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Repeated extension

Repeated extension of the spine centralizes symptoms, meaning pain moves closer to the source, in a patient with a disc herniation. This indicates improvement in nerve root compression.

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Bamboo spine

The term 'bamboo spine' is used to describe the stiffening of the spine in ankylosing spondylitis, a type of inflammatory arthritis.

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Disc herniation

A disc herniation occurs when a portion of the intervertebral disc, which acts as a shock absorber between vertebrae, pushes out of its normal position. This can compress the nerve root, leading to pain, numbness, or weakness.

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Repeated flexion peripheralizes symptoms

This pattern is often seen in disc herniation, where repeated bending forward worsens pain and numbness radiating away from the spine.

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Repeated EXT centralizes symptoms

This indicates a disc herniation, as repeated extension movements bring the pain closer to the spine.

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What is a key sign of disc herniation?

A more severe disc herniation often results in increased nerve root compression, leading to more pronounced symptoms like weakness, numbness, or tingling.

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What does 'centralize' mean in spinal assessment?

Centralizing symptoms means the pain moves towards the center of the body with specific movements, suggesting a possible disc herniation.

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What does 'peripheralize' mean in spinal assessment?

Peripheralizing symptoms means the pain moves away from the center of the body with specific movements, suggesting a possible disc herniation.

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What is the 'bamboo spine' and what condition is it associated with?

The 'bamboo spine' is a term used to describe the stiff, fused spine characteristic of Ankylosing Spondylitis. This condition causes inflammation in the spine, leading to bone fusion over time.

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What is the most likely condition if someone has pain that is worse with repeated movement?

Pain that worsens with repeated movement is a common symptom of disc pathology and spondylosis. Disc pathology involves damage to the spinal discs, while spondylosis refers to degeneration of the spine.

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What is the relationship between age and spinal conditions?

Different spinal conditions commonly occur at different ages. Conditions like ankylosing spondylitis, central stenosis, osteoporosis, and VBI are more likely in individuals over 50. Spondylosis and disc pathology are more prevalent between 20-40. Spondylolysis, vascular TOS, and structural scoliosis are more frequent in younger individuals.

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What are the symptoms of Ankylosing Spondylitis?

Ankylosing spondylitis is a type of arthritis that affects the spine causing stiffness and inflammation. It's often associated with morning stiffness, back pain, and limited motion.

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What is a sign of a disc herniation?

A disc herniation occurs when a disc in the spine bulges or ruptures, putting pressure on the nerves. It's often characterized by pain that is worse at the end and beginning of the day, or pain that is worse at night.

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How do you recognize Spondylolysis?

Spondylolysis is a fracture or weakness in the pars interarticularis of the vertebra. It's often associated with pain that improves with isometric (ISOM) exercises but worsens with motion assessment.

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What is a key characteristic of TOS?

Thoracic Outlet Syndrome (TOS) involves compression of nerves or blood vessels between the clavicle and first rib. It's often associated with pain that is worse at night and can be accompanied by numbness and tingling in the arm and hand.

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What is a key finding for hip impingement (FAI)?

Hip impingement, also known as femoroacetabular impingement (FAI), occurs when the bones in the hip joint rub together, causing pain and stiffness. A key finding is painful hip rotation with a bone-to-bone end feel.

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When is ankylosing spondylitis more common?

Ankylosing spondylitis is more prevalent in males, and has a peak onset between ages 15 to 40.

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What is a key finding for disc herniation?

A more severe version of a disc herniation is correlated with more nerve root compression.

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What is Ankylosing Spondylitis?

Ankylosing Spondylitis is a type of arthritis that affects the spine, causing stiffness and inflammation. It is not localized, as it's commonly called "bamboo spine" because the entire spine becomes stiff.

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Repeated flexion centralizes symptoms

This pattern suggests a possible disc herniation, where bending forward relieves pressure on the affected nerve.

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Repeated extension peripheralizes symptoms

This pattern also indicates a potential disc herniation. Extending the spine puts more pressure on the affected nerve, increasing pain.

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What age group is most commonly affected by disc pathology?

People in the age range of 20-40 years old frequently experience disc pathology due to wear and tear on the spine.

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What condition is associated with pain that is worse after prolonged sitting?

Pain that worsens after prolonged sitting is a common symptom of both osteitis pubis and stress fractures in the hip.

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What centralizes with repeated extension?

A disc herniation is indicated by a centralization of symptoms (pain decreases) with repeated extension movements.

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What peripheralizes with repeated flexion?

A disc herniation is suggested by peripheralizing symptoms (pain increases) with repeated flexion movements.

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What kind of pain is associated with facet joint dysfunction?

Facet joint dysfunction is typically associated with dull, aching, and stiff pain.

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What does repeated extension do for a disc herniation?

Repeated extension movements often lead to centralization of symptoms (pain reduction) in a disc herniation, indicating that the pressure on the nerve root is being relieved.

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Hyperreflexia

Hyperreflexia significa que le nervos in le cerebro o medulla spinal (systema nervose central) non functiona correctemente.

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Hyporeflexia

Hyporeflexia significa que le nervos in le medulla spinal o le nervos peripheral (systema nervose peripheral) non functiona correctemente.

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Nervos Central

Le nervos central include le cerebro e le medulla spinal.

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Nervos Peripheral

Le nervos peripheral es le nervos que se extende del cerebro e le medulla spinal al resto del corpore.

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Que es le differentia inter hyperreflexia e hyporeflexia?

Hyperreflexia indica un problema in le systema nervose central, mentre hyporeflexia indica un problema in le systema nervose peripheral o in le nervos peripheral.

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Que indica le presentia de hyperreflexia?

Hyperreflexia indica un involvement del neuron superior (system nervous central).

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Que indica le presentia de hyporeflexia?

Hyporeflexia indica un involvement del neuron inferior o del system nervous periferic.

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Como differentia se le involvement de neuron superior del involvement de neuron inferior?

Le involvement del neuron superior se manifesta con hyperreflexia, mentre le involvement del neuron inferior se manifesta con hyporeflexia o un absentia de reflexo.

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Involvement del neuron superior

Involvement del neuron superior significa que le problema es in le system nervous central, como le cerebro o le spina dorsal.

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Involvement del neuron inferior

Involvement del neuron inferior significa que le problema es in le nervos que connectan le spina dorsal al musculos.

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System nervous peripheral

Le system nervous peripheral include le nervos que connectan le cerebro e le spina dorsal al resto del corpore.

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Study Notes

Spinal Pathologies - Differential Diagnosis (D/D) Table

  • Severity (Age) Correlations:

    • Symptoms in individuals older than 50 often point towards Ankylosing Spondylitis, Central Stenosis, Osteoporosis, and Vertebral Body Instability (VBI).
    • Ages 20-40 often present with Spondylosis, Disc Pathology.
    • Younger patients frequently present with Spondylolysis, Thoracic Outlet Syndrome (TOS) – vascular, and Scoliosis – structural.
    • Females are more likely to exhibit Spondylolysis, Osteoporosis, and TOS.
    • Thin, small frames frequently demonstrate Osteoporosis.
    • Males are more susceptible to Ankylosing Spondylitis, Disc Pathology, and VBI.
    • Smokers are at a higher risk for Osteoporosis, Disc Pathology and VBI. They may also possibly experience sprains, strains, or rib joint dysfunction. Increased incidence of facet joint and TOS pathology has also been observed in smokers.
    • Caucasians and Asians often exhibit higher incidences of Osteoporosis.
  • Pain Descriptors and Associated Conditions:

    • Dull, aching, stiff pain: Commonly associated with sprains, strains and facet joint dysfunction.
    • Sharp, stabbing pain: More likely associated with rib joint dysfunction.
    • Cramping: Suggests central stenosis.
    • Weakness: May indicate central stenosis, disc pathology, and adverse neurodynamics or spondylolysis.
    • Throbbing, achy pain: Could signal vascular TOS.
    • Burning, sharp, electrical pain: Suggests possible TOS affecting nerve distribution
    • Walking/standing pain: Spondylosis and central stenosis are potential causes.
    • Sustained postural pain: Movements affecting posture could indicate sprains or strains
    • Pain with specific movements (e.g., laughter, inhaling, exhaling): Could indicate rib joint dysfunction.
    • Orthostatic hypertension: Points toward VBI.
    • Vigorous exercise pain: VBI may be a possible cause
    • Exercise alleviates pain: Ankylosing spondylitis is a possible diagnosis.
    • Morning pain: Could be related to Ankylosing Spondylitis, strains, disc pathology, or TOS.
    • Night pain: Disc pathology and TOS often involve night pain.
    • Pain at start/end of day: Spondylosis is a possible reason.
    • Pain affected by Movement/position: Several possible conditions: Spinal movement affectation could suggest spondylolysis. Forward head posture, increased kyphosis, and scoliosis are possible diagnoses.
    • Muscle spasm and posture deviation: Strain
  • Diagnostic imaging and physical findings:

    • Decreased ROM/AROM (Active ROM): Associated conditions include Ankylosing Spondylitis, Spondylosis, Sprains, strains, facet joint dysfunction, adverse neurodynamics, TOS.
    • Decreased PROM (Passive ROM), ISOM (IsoMETRIC): Further suggests Ankylosing Spondylitis, Spondylosis, Strains, Facet joint dysfunction, adverse neurodynamics, and TOS.
    • Hypomobile/ hypermobile PPIVMs/ PAIVMs: Indicates possible Ankylosing Spondylitis, Spondylosis, strain, facet joint dysfunction, and adverse neurodynamics issues in the spine.
    • Reduced pain/ increase in pain with changes in movement positions: Could suggest Spondylolysis, in which pain increases with movement, but reduced with isometric exercises
    • Gower's sign with AROM: Spondylosis is a possibility.
    • Reduced pain with ISOM, increased with motion: Indicative of spondylolysis
    • Painful, excessive, reduced PROM, hypomobile or hypermobile ISOM, hypermobile motion assessment: Sprains and facet joint dysfunction are likely
    • Hypo/ hyper reflexive DTR (Deep Tendon Reflex): Potential for foraminal or central stenosis conditions.
    • Abnormal spinal curve/ posture alignment: Possible scoliosis or structural issues.
    • Diminished pulse: Possible indication of TOS
    • Swelling, pallor/cyanosis, distended veins, atrophy: Possible TOS
  • Other factors affecting spinal pathologies:

    • Radicular pain: Central stenosis, foraminal stenosis, and spondylosis are potential diagnoses.
    • Bilateral/ unilateral symptoms: Bilateral often points towards central stenosis issues, while unilateral could suggest disc pathology.
      • Upper cervical instability in people with rheumatoid arthritis, hyperlidipemia, atherosclerosis, or sickle cell disease: Increased risk of VBI in these patients.

Hip Conditions - Differential Diagnosis (D/D) Table

  • Age Correlations:

    • Younger patients: Apophysitis, osteitis pubis.
    • Older patients: OA (Osteoarthritis)
  • Activity & Lifestyle:

    • Ice sports, endurance athletes: osteitis pubis.
    • Increased training load, high-impact activities: Stress fractures.
    • Females and lean people: Stress fractures.
    • Sedentary lifestyle: OA
  • Pain Descriptors and Associated Conditions:

    • Dull, aching pain: Apophysitis
    • Deep, aching pain: Stress fractures
    • Achy, sharp pain: Possible OA
    • Sharp, aching pain: Avulsion fracture
    • Extremely tender on palpation: Avulsion fracture
    • Coughing, sneezing, bearing down aggravates: Iliac crest contusion.
    • Pain going from FLEX to EXT, EXT to FLEX, with EXT and rotation: Possible FAI (Femoroacetabular Impingement), sprain
    • Pain equally limited with Flex and Extension: Possible stress fracture
    • Morning pain: Associated with OA
    • Night pain: Possible avulsion fracture or stress fracture or OA
  • Physical Findings:

    • Crepitus: Iliac crest contusion, fracture, OA
    • Clicking, grinding, catching, popping: Possible OA, labral tear.
    • Instability: OA, FAI, labral tear.
    • Localized pain: FAI
    • Generalized pain around joint: OA
    • Pain/weakness with hip add, trunk flexion, COD, single-leg stance: Osteitis pubis
    • Pinching sensation with hip movement: FAI
    • Tenderness at lower adductors, lower RA: Possible pathologies
    • Bone to bone end feel: FAI
  • Additional Considerations:

    • Apophysitis can be asymptomatic
    • Symptoms can vary based on the specific hip condition

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Description

Explore the differential diagnosis of spinal pathologies based on age, gender, and risk factors. This quiz covers conditions like Ankylosing Spondylitis, Spondylolysis, and Osteoporosis, providing insights into symptom correlations for various demographic groups. Test your knowledge on this vital topic in spinal health.

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