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OA: Articular cartilage loss, osteophytes & narrowing, hypertrophied articular process & lig flava bulging Knee, hand, hip : stiffness, pain, grinding, swelling - Csp: - headaches, radiculopathy (unilateral) - Tsp: - - radiculopathy - Lsp: - Neurogenic claudicat...

OA: Articular cartilage loss, osteophytes & narrowing, hypertrophied articular process & lig flava bulging Knee, hand, hip : stiffness, pain, grinding, swelling - Csp: - headaches, radiculopathy (unilateral) - Tsp: - - radiculopathy - Lsp: - Neurogenic claudication - LBP, numbness, weakness aggravated by standing & walking - SIJ - Hip: - Groin - Tibiofemoral: - walking, stairs, standing, weight bearing - Patellofemoral: - (Bending) - Compression pain, reduced quad strength - Under or around the knee - Ankle - AC - GH - SC - Radioulnar - Radiocarpal - Carpometacarpal Herniation: Spurling + distraction Worse in flexion Central - myelopathy Lateral - radiculopathy - Csp (C5,6,7) - neck & arm pain, paresthesias - Tsp - chest wall, epigastric, arm pain, sometimes groin & lower extremity - Lsp - LBP Stenosis: : OA, Discs, spinal cysts, fractures and tumours - Csp - Neck pain, N/T, weakness, balance, function decrease - alleviation when leaning forward / sit - Tsp - Lsp - Heavy feeling in legs, cramping, worsens standing / walking Facet syndrome: Spurling & distraction, kemps : spondylitis, spondylosis, micro/trauma Worse with extension and side bending/rotation - Csp - Neck pain, stiffness, radiculopathy, headaches - Tsp - Lsp Radiculopathy: Sensory loss, pain and weakness C5 - shoulder, abduction C6 - arm, elbow flexion & wrist extension C7 - down arm, elbow extension & wrist flexion C8 - lower arm, finger grip, thumb extension T1 - medial arm & forearm, thumb abduction T - torso, weak intercostal L1 - groin, flexion L2 - anterior thigh, flexion and adduction L3 - thigh, weak knee extension & dorsiflexion L4 - thigh & medial leg, weak toe extension, medial leg and foot L5 - lateral leg, dorsum of foot S1 - posterior leg, plantar flexion, lateral foot S2 - posterior leg, weak knee flexion, posterior thigh and medial leg S3-5 - perineal, bladder, weak pelvic floor Myelopathy: UMN signs: Spasticity, hyperreflexia, babinski, weakness CAD: - Dizziness, Headaches, chest pain, SOB, jaw/shoulder pain VBI: - Dizziness, dysphagia, diplopia, dysarthria, drop attacks, nausea, nystagmus, numbness, ataxia RA: Autoimmune inflammatory disease where antibodies attack synovium (smaller joints-hands then knees) - Swelling, stiffness, warmth, muscle wasting, bilateral - Csp - Tsp - Lsp - SIJ - Hip - Tibiofemoral - patellofemoral - Ankle  - AC - GH - SC - Radioulnar - Radiocarpal - Carpometacarpal Ankylosing spondylitis: synovitis, fibro-osseous inflammation, annulus fibrosis ossification Spondylolisthesis: Congenital, spondylolysis, degenerative, traumatic, pathological, post-surgical - 5 grades - Pain, radiculopathy, N/W, stiffness, posture - Step off deformity, hamstring tightness, spasms Tendinopathy - overuse, age, diabetes, posture, alignment Tendinitis acute inflammation Tendinosis - degeneration Insertional - local to insertion Non-insertional - diffuse to tendon - Slow onset, Increases with activity, stiffness, swelling, tenderness, crepitus, weakness - EG: patella tendinopathy test knee extension = pain and weakness - If no pain but its weakness - indicative of nerve or muscle Calcific tendinopathy - most often supraspinatus - Sudden onset, constant and severe - Sharp / burning front / top of shoulder, night pain, sporadic patterns Degenerative scoliosis: - standing/walking, radiculopathy, posture - fatigue, pain, muscular imbalance, ROM, migraines LS strain - grade 1-3 - SIJ dysfunction Iliolumbar ligament: trauma, repetitive stress, posture, pelvic instability - Flexion and sidebending T.O.S Vascular - subclavian - swelling, discoloration, coldness, pain / cramping w activity, blood clot Neurogenic (95%) - N/T/W, pain, muscle wasting - Csp rib, posture, trauma, pregnancy, repetitive trauma Intercostal neuralgia - Inhalation ribs compression  - Radiculopathy, N/T, appetite decrease Tietze syndrome - Costochondral junction - inhalation , SOB, rotation and sidebending decreased Precordial catch syndrome - Chest nerves compressed via pleura irritation - 6 - 12, below nipple Herpes zoster - Varicella zoster dormant, maculopapular rash Costovertebral joint syndrome - Costovertebral joint derangement / partial dislocation Post herpetic neuralgia - Shingles pain 3+ months - Hyperalgesia, allodynia, burning, itching, unilateral Pancreatitis - Gallstones + alcohol - Abdo P, vomiting = organ failure Osteitis pubis - Overuse, ant/med groin - Activity aggravates Iliopsoas bursitis - anterior hip, snapping, extending leg pain, sometimes radicular entrapping femoral nerve Ischiogluteal bursitis - prolonged sitting, possible radiation Trochanteric bursitis - greater trochanter, lying on side Merelgia parasthetica - lat femoral cutaneous nerve compressed by inguinal ligament Obesity, diabetes, old age - Dysesthesia, pain, N/T coccydnia - Abnormal mobility = inflammation + degeneration - pregnancy Piriformis syndrome Gluteal tendinopathy - Greater trochanter pain FAI - head pinches socket + labrum - WoPINCER - MeCAM - Groin pain, after activity, stiffness ITB syndrome - hills - Between gerdy tubercle + lateral epicondyle - Varum / valgus - Pain at rest and can result in PFP syndrome Knee Meniscal tear: Bucket handle - true-locking (Lateral) Meniscal cyst (usually) - trauma PFPS - Dull ache, generalised - Cinema sign Osteochondritis dissecans - avascular fragment of bone under cartilage separates - 15 - 20 - Give way, locking, tender condyle, quads wasted - Patella - Talus Chondromalacia - stress, malalignment, trauma, wear & tear, imbalance, obesity - Sharp, localised - Hyaline cartilage of trochlear groove breakdown - Abnormal shape, malalignment, dislocation, vastus medialis - Ant knee pain, quads wasted, up stairs aggravated, cinema sign, crepitus Pes anserinus bursitis - Medial, just below joint line, sharp or ache, worsen with activity, tenderness, swelling - Flexion and extension aggravates, night pain - Less commonly catching Patella maltracking - Imbalance patella + trochlea = cartilage loss + OA - VMO, instability, dislocations, genu valgum, patella alta, anteversion, dysplasia - Anterior knee pain, sharp, worsens with activity Infrapatellar fat pad syndrome: - Inferior patella - Swelling, tenderness, worsen with activity, night pain - HOFFA’s test (seated 90 degrees, pressure infrapatellar, patient extends leg)  - Plantar fat pad syndrome (heel) - Flexion relieves Ligament strain: - Lateral - Medial - Anterior - posterior Anterior: - Prepatellar bursitis - carpet layers - Infrapatellar bursitis Posterior: - Semimembranosus bursa - Popliteal/baker cyst - - Popliteal aneurysm Lateral: - Meniscus cyst Medial: - Calcification MCL Synovial chondromatosis - cartilaginous nodules form within synovium, which detach - Deep, ache, intermittent, progressive - Locking, catching, instability - Swelling, crepitus Ankle Tendinopathy: - Insertional - non-insertional Patella: local inferior patella Tendon rupture: - Achilles - Tibialis posterior - Tibialis anterior ATFL sprain CFL sprain Retrocalcaneal bursitis Calcaneal bursitis Metatarsalgia Plantar fasciitis Interdigital neuritis Gout - diet & alcohol (uric acid) Allopurinol Pseudogout - calcium pyrophosphate dehydrate Tendinitis: - Achilles - Bicep - Supraspinatus - Calcific - more sudden onset, night pain - Tenosynovitis: - Ankle - Wrist Avascular necrosis talus Sesamoiditis Tarsal tunnel - post tibial nerve Freibergs Stress fracture Subacromial impingement: - Bursitis - tendinitis Rotator cuff tear - Sudden sharp onset, resulting dull pain worsening with activity Bicep tear Long head pathology commonly associated with shoulder flexion Short head pathology commonly associated with elbow flexion and supination Adhesive capsulitis - contracted - Diabetes, immobility, thyroid, autoimmune Inflammatory - onset of pain and increasing stiffness (2-9 months) Adhesive - stiffness, pain may decrease (4-12 months) Resolution - slow improvement (5-26 months) Instability - Anterior is most common - Throwing or lifting, instability Capsular tears - Traumatic or degeneration - Instability, weakness, dislocation, pain with specific movements Capsular contracture - Abnormal shortening / tightening - Immobility or after injury - scar tissue - Overhead, external rotation, abduction GH ligament - Superior - anterior instability, external rotation - Middle - anterior dislocation, mid range motion - Inferior - abduction + external rotation, traumatic anterior dislocations - Overhead, throwing - Pain, instability Transverse ligament - decompress ulna SLAP - 4 grades, various involvement of biceps long head - Pain may radiate, clicking, popping, instability, weakness, night pain - Clunks, crank, speeds Epicondylitis - degenerative tendon aponeurosis. Lateral - Extensor carpi radialis brevis Medial - Flexor carpi radialis, pronator teres Olecranon bursitis - repetitive trauma / direct trauma, RA, gout - Flexion P - Swelling dorsal side Carpal tunnel syndrome - Median - Menopause, pregnancy, RA - Night time - Flexor retinaculum, carpals Cubital tunnel syndrome - Ulna - Flexor carpi ulnaris, olecranon, osbourne ligament, medial epicondyle - Guyon's canal TFCC Ulnocarpal impaction Ganglions Dupuytrens: Nodules in the palm, forming cords, contracture - Unable to straighten, difficulty tasks, progressive Diabetes : Glucose leads to formation of AGEs = tendons, ligaments, cartilage = lower elasticity : Microvascular damage reducing blood flow and healing : neuropathy : chronic inflammation - Frequent urination, excess thirst, weight loss, hunger, blurry vision, numbness tingling, fatigue, dry skin, slow sores, frequent infections - Adhesive capsulitis, Carpal tunnel, dupuytrens, OA, osteoporosis, plantar fascitiis, bone spurs, gout, PAD IBS diagnostic: - Related to defecation - Stool frequency change - Stool appearance - 6 months+ - Abdo pain 1/7 last 3 months DVT well criteria: - Previous DVT - Active cancer - Immobilisation - Bedridden 3+ days - Tender - Leg swollen - Calf swelling 3cm+ than other - Non-varicose veins Anaemia: - Iron deficient (GI and NSAIDs) - RA, lupus (Chronic inflammatory) - Neurologic (pernicious) B12 - Infectious - SOB, fatigue, pale hands, brittle+concave nails PVD is the broad term for all peripheral arteries & veins. PAD is narrowing / blockage of arteries, commonly the legs. PAD: pain with activity (intermittent claudication), cold exx, weak pulses, non-healing sores PVD: swelling, varicose veins, skin changes, pain standing, heaviness, ankle ulcers Contracture - permanent shortening / tightening : muscles, ligaments, joint capsule  - Immobility, scars, neurological, trauma - Eg: dupuytrens Fibrosis - excess fibrous tissue - Chronic inflammation, trauma, repetitive stress, immobilisation, systemic conditions Densification - thickened and rigid fascia - Chronic inflammation, repetitive stress, posture, immobility - Heaviness / tightness, muscular tension, discomfort during movement. Synovial membrane - diffuse, deep ache, worsened by movement - Inflammation or synovitis via autoimmune disease / injury - Swelling & pressure Fibrous layer - local, sharp - Trauma / overstretching - Compression via osteophytes Pain above L4: - AAA - pulsatile mass, bruit, abdo/back pain, syncope, radiating to legs - Femoral nerve L2-3 - anterior thigh pain, knee extension weakness, decreased plantar reflex, N/T - Abdo cancer - weight + appetite loss, abdo pain, bowel habit change, fatigue, malaise, jaundice, ascites, - Inguinal hernia - groin bulge, fever, nausea, sharp pain, ache or burn - Pelvic haematoma - bruising, swelling, difficulty hip flexion, rapid pulse, low BP, dizziness, B+B, possible nerve weakness / numbness Pins and Needles: 12VLS. SSSSHMMAGDK Stroke/TIA - facial, speech and visual changes, paralysis, weakness (UEX), H/A MS - Lhermitte's - optic neuritis, P/N, weakness, fatigue, coordination, ataxia, spasms, cramping, urinary urgency, memory, horner's syndrome - Stress, heat, infection, GBS - ascending paresthesia & weakness. 2 - 3 weeks following infection. Leads to respiratory involvement. Spinal cord compression - bilateral, gait changes, B+B PAD/vascular - pulses, coldness, claudication SLE - skin + joint manifestations, butterfly rash Kidney Disease - swelling, appetite loss, urinary frequency (esp night), confusion, nausea Peripheral Neuropathy (alcohol, B12, shingles, diabetes) Diabetes - increased thirst, increased urinary frequency, weight loss, hunger, blurry vision B12 deficiency - fatigue, weakness, appetite loss, dizzy, SOB, memory, confusion, GI issues Alcohol (chronic) - nerve damage Shingles Cervical myelopathy - spinal cord compression - UMN + LMN signs, wasting, P/N, gradual ALS - UMN + LMN signs PLS - UMN signs Untreated hypothyroid Myasthenia Gravis (less likely) - proximal weakness, facial weakness, diplopia, dysphagia, dysarthria