MSK Final Exam Part 2 PDF

Prepared by : Nihad M.Kher Nazhad F.Ismael Balla K.Hassan Nyan A.Namiq Danya A.Salim Supervised by : Dr.Sarkawt S.Kakai Fibromyalgia is a disorder characterized by widespread musculoskeletal pain accompanied by fatigue, sleep, memory and mood issues. Women are more likely to develop fibromyalgi...

Prepared by : Nihad M.Kher Nazhad F.Ismael Balla K.Hassan Nyan A.Namiq Danya A.Salim Supervised by : Dr.Sarkawt S.Kakai Fibromyalgia is a disorder characterized by widespread musculoskeletal pain accompanied by fatigue, sleep, memory and mood issues. Women are more likely to develop fibromyalgia than are men. Many people who have fibromyalgia also have tension headaches, temporomandibular joint (TMJ) disorders, irritable bowel syndrome, anxiety and depression. While there is no cure for fibromyalgia, a variety of medications can help control symptoms. Exercise, relaxation and stress-reduction measures also may help. • Brain fog • Muscle pain and tenderness • Face and jaw pain • Fatigue • Bladder control issues • Headaches and migraines • Memory problems • Digestive problems • Insomnia • Anxiety and depression • Genetics: Because fibromyalgia tends to run in families, there may be certain genetic mutations that may make you more susceptible to developing the disorder. Infections: Some illnesses appear to trigger or aggravate fibromyalgia. Physical or emotional events: Fibromyalgia can sometimes be triggered by a physical event, such as a car accident. Prolonged psychological stress may also trigger the condition. Your sex: Fibromyalgia is diagnosed more often in women than in men. Family history: You may be more likely to develop fibromyalgia if a parent or sibling also has the condition. Other disorders: If you have osteoarthritis, rheumatoid arthritis or lupus, you may be more likely to develop fibromyalgia. In the past, doctors would check 18 specific points on a person's body to see how many of them were painful when pressed firmly. Newer guidelines from the American College of Rheumatology don't require a tender point exam. Instead, the main factor needed for a fibromyalgia diagnosis is widespread pain throughout your body for at least three months. To meet the criteria, you must have pain in at least four of these five areas: Left upper region, including shoulder, arm or jaw Right upper region, including shoulder, arm or jaw Left lower region, including hip, buttock or leg Right lower region, including hip, buttock or leg Axial region, which includes neck, back, chest or abdomen Tests Your doctor may want to rule out other conditions that may have similar symptoms. Blood tests may include: Complete blood count Erythrocyte sedimentation rate Cyclic citrullinated peptide test Rheumatoid factor Thyroid function tests Anti-nuclear antibody Celiac serology Vitamin D Medications Medications can help reduce the pain of fibromyalgia and improve sleep. Common choices include: • Pain relievers: acetaminophen,ibuprofen,naproxen sodium • Antidepressants: duloxetine,milnacipran • Anti-seizure drugs: Gabapentin Therapies A variety of different therapies can help reduce the effect that fibromyalgia has on your body and your life. Examples include: • Physical therapy: A physical therapist can teach you exercises that will improve your strength, flexibility and stamina. Water-based exercises might be particularly helpful. • Occupational therapy: An occupational therapist can help you make adjustments to your work area or the way you perform certain tasks that will cause less stress on your body. • Counseling: Talking with a counselor can help strengthen your belief in your abilities and teach you strategies for dealing with stressful situations. Anterior knee joint pain Prepared by : Bahar Qadr Marya Badran Zhino Faisal Ahmed Rzgar Sajd mhyadin Abdulla Muhammad Supervisor : Dr Sarkawt Outline Anatomy of anterior knee Introduction Diagnosis Cause Sign and Symptom Medical condition relate with anterior knee joint Treatment prevention Anatomy INTRODACTION Anterior knee joint pain is felt at the front of the knee, typically centered around or behind the patella. This pain can be localized, and individuals may experience discomfort during activities that involve bending the knee, such as walking, running, or going up and down stairs. Physical examination Medical history Blood tests X- rays Arthroscopy SIGN AND SYMPTOMS Pain while walking Painful stairs climbing Painful kneeling or squating Swelling around the knee Weakness in leg muscle Stiffness or tightness causes • Age : incrased with age ( like osteoarthhritis) • Previous injuries : history of knee injurys such as ligament tears or fracture • Excess weight : beingg overweight or obse puts extra stress of knee joint • Muscle imbalance :weakness and imbalance effect joint stability • Overuse and repetitive strian • Poor biomechanics :abnormailtis in the aligment or structure of knee joint can increase the risk of pain. • Genatic • Gender: some condition like patellofemoral pain sendrome are more common in females • Accupation: job or activitis such as(squatting ,heavy lifting) increase Pain • Medical condition MEDICAL CONDITIONS ARE ASSOCIATED WITH ANTERIOR KNEE JOINT PAIN     Patellofemoral pain syndrome: pain around or behind the patella, often aggravated by activities like running or climbing stairs. Patellar tendonitits ( jumper’”s knee):Inflammation of the patellar tendon, causing pain at the base of the patella, typically due to overuse or repetitive stress Chondromalacia:Softening or deterioration of the cartilage on the underside of the patella, leading to anterior knee pain. Quadriceps tendonitis: Inflammation of the quadriceps tendon, resulting in pain and swelling around the top of the patella. MEDICAL CONDITIONS ARE ASSOCIATED WITH ANTERIOR KNEE JOINT PAIN Lliotibial band syndrome:Pain on the outer side of the knee due to friction of the iliotibial band against the lateral femoral condyle.  Osteoarthiritis: Wear and tear of the knee joint cartilage, causing pain and stiffness, often felt in the anterior region.  Meniscal tears: can result in pain, swelling, and sometimes locking of the knee  ACL Injury:often associated with sports, can lead to pain and instability in the knee.  Treatment Rest and activity modification Ice and compression Physical therapy Pain medication Corticosteriod injection Bracing or taping surgical Weight management  To prevent anterior knee joint pain, focus on strengthening the muscles around the knee, maintaining a healthy weight, wearing proper footwear, and using correct form during exercises. Additionally, consider low-impact activities like swimming or cycling and avoid prolonged periods of kneeling or squatting. If pain persists, consult a healthcare professional for personalized advice. Ankle sprain Prepared by G.Smart Razhan Sami Dlvin Muhammad Rayan yousif Summaya Abdulqadr Elaf Farhad Supervisor: Dr Sarkawt Introduction • An ankle sprain occurs when the strong ligaments that support the ankle stretch beyond their limits and tear. • Ankle sprains are common injuries that occur among people of all ages and at all activity levels; in fact, they are the number one reason for missed participation in athletics. • Also known as twist ankle or rolled ankle or ankle ligament injury Anatomy of the Ankle Joint (3) sets of ligaments stabilize the ankle complex: 1/lateral collateral ligaments 2/medial collateral ligaments(deltoid ligaments) 3/Distal tibiofibular syndesmotic complex Causes ankle sprain occurs by twisting or rotation at the ankle joint that cause ligamentas injury,like; -fall -landing awkwardly from jump -walking or exercise on uneven surface -steping on the foot -losing balance Risk factors -Factors that increase your risk of a sprained ankle include : 1/ Sports participation 2/ Uneven surfaces 3/ Prior ankle injury 4/ Poor physical condition 5/ Improper shoes Classification of Ankle sprain by Grades Symptoms Grade-1 Ligament tear Loss of function ability Grade-2 Grade-3 None Partially Complete Minimal Some Great Pain Minimal Swelling Minimal Moderate Severe Usually not Common Yes Ecchymosis Difficulty bearing weight Recovery time None (1-3)weeks Moderate Severe Usual Almost always (3-6)weeks Up to several mons How to diagnose ankle sprain ? •Palpate they will gently press around the ankle to feel for any injured ligaments. •ROM: range of motion by moving your ankle in different directions. However, if the ankle is stiff and swollen, it may not move much. •And CT,ultrasound,MRI,X-ray Doctor recommended for severe case Some test for diagnosis: Anterior drawer test Talar tilt test Dorsiflexion ex.rotation stress Squeeze test (hopkin’s) Treatment : For acute : we use PRICE protocol For chronic Non-Surgical treatment -Physical therapy -Bracing ,crutch -Medication (ex.NSAIDs) Surgical treatment usually involves repair or reconstruction of the damaged ligament(s) Physiotherapy •Reduce pain & Swelling (heat,ice,us,e.stimulation,tape,special exercises,hands-on treatment like soft tissue massage) •Restore Function &ROM •Strengthen weak muscles •Improve mobility & stability & balance •Identify severity of the injury •Improve proprioception(joint position sense) Stop exercising when you detect swelling or feel pain Prevention of ankle sprain: 1.Warm up before exercising. 2.Be careful on uneven surfaces. 3.Use ankle support if needed. 4.Wear proper shoes. 5.Limit high heels. 6.Stick to activities you're conditioned for. 7.Keep your muscles strong and flexible. 8.Practice balance exercises. https://youtu.be/nDMGFyo_eW8?si=T Cz-suWXNThx3Qjr (Vedio-Dr.Sarkawt) https://www.ncbi.nlm.nih.gov/books/NBK4592 12/#:~:text=Acute%20ankle%20sprains%20are %20commonly,the%20likelihood%20of%20the se%20complications (Example of sources)