Musculoskeletal Pathologies

Musculoskeletal Pathologies

By Tiffany Morris

​Paget Disease

​Paget's disease of bone is a chronic bone disorder. Normally, there is a process in which your bones break down and then regrow. In Paget's disease, this process is abnormal. There is excessive breakdown and regrowth of bone. Because the bones regrow too quickly, they are bigger and softer than normal. They may be misshapen and prone to breaking. Paget's usually affects just one or a few bones. The pelvis, skull, spine and legs are most commonly affected. The risk of Paget's increases with age (over 50), male, and if family members have the disorder. There is no cure.

Paget ​disease of the breast is a rare form of breast cancer that starts on the nipple. 

​Depending on the location ,Paget's can cause kidney stones due to extra calcium, nervous system problems from pressure on the brain and spinal cord, bone cancer, joint disorders vision, hearing and tooth loss if facial bones are affected. It can also lead to a condition called lions face (leontiasis ossea)

Multiple Choice

This German Composer popular in the 18th century for Piano Sonata 29 & Symphony No. 9 was rumored to have Paget's ,which resulted in his loss of hearing.

• Leonard Bernstein

• Wolfgang Amadeus

• Ludwig Van Beethoven

​Osteomalacia (adults)

Rickets (Children)​

​Osteomalacia means "soft bones." It is a disease that weakens bones and can cause them to break more easily due to decreased mineralization, which results in bone breaking down faster than it can re-form making them rubbery. Osteomalacia develops most commonly due to a vitamin D deficiency (often from not getting enough sunlight), or less frequently, due to a digestive or kidney disorder.

​

​

Osteomyelitis

​

 is an infection in the bone. Bacteria or fungi may reach a bone by traveling through the bloodstream or spreadable from a surface wound that gets infected. Infections might also begin in the bone itself if an injury or surgery exposes the bone to germs. AKA Staph

Smokers and people with other chronic health conditions, like diabetes or kidney failure are more prone to get this (ulcers causing infection)

​

This usually goes away if treated early with antibiotics. If not, it can cause permanent damage even loss of body part affected.

Multiple Choice

Osteomyelitis affects about 2 to 5 out of every 10,000 people. It’s one of the oldest diseases on record. Scientists have traced it back more than 250 million years

• True

• False

​Spondylolysis & Spondylolisthesis

​Spondylolysis is a stress fracture through the pars interarticularis of the lumbar vertebrae which is a thin bone segment joining two vertebrae. It is the most likely area to be affected by repetitive stress. This condition is fairly common and is found in one out of every 20 people including kids and teens causing low back pain . Most times his will heal with rest and physical therapy. Surgery usually isn't needed.

​Spondylolysis and spondylolisthesis are related but not the same. Spondylolisthesis is when one vertebra slips out of place over the vertebra below. Spondylolysis is a common cause of spondylolisthesis, because the crack in the vertebra may cause the bone to slip.

​Patellofemoral syndrome

​Patellofemoral syndrome is a condition that describes pain in the front of the knee and around the kneecap. Also called “jumper’s knee” or “runner’s knee.” It is the general cover all term for knee pain. Common causes of the condition are overuse of the knee joint and hitting the kneecap or falling on it. Although the condition occurs more commonly in athletes, anyone can have the symptoms. Some people have a kneecap that abnormally moves in the groove at the end of the femur. This can cause extra pressure on the cartilage covering the kneecap or on the femur where it rubs, called the trochlear surface. Common symptoms are cracking or popping sounds in the knee when climbing stairs or after sitting for an extended time. Sports related -Cyclists and runners

​

​Massage Tip: Work Hamstring group for patellofemoral syndrome.

Multiple Choice

Women are twice as likely as men to develop patellofemoral pain. This may be because a woman's wider pelvis increases the angle at which the bones in the knee joint meet but female and male ,what age group is mostly affected?

• newborn to 1 year

• 16-25

• 50-60

​Babies do not start forming knee caps until around the age of 2. While the 50 to 60 age group starts showing degenerated signs of wear on their knees it's the age group most active in sports 16-25.

​Ganglion Cyst

A noncancerous lump, firm but move slightly if pressed on (movable lumps are usually not cancer) often on the tendons or joints of wrists and hands but can develop anywhere.

The cause of ganglion cysts is unknown but it's believed joint stress may play a role, as the cysts often develop in sites of overuse or trauma. They may develop following a leak of synovial fluid from a joint into the surrounding area

A ganglion cyst is round and usually painless. Although rare, it can be painful if it presses a nerve. In a few cases, the cyst can interfere with joint movement.

A ganglion cyst often clears on its own. If its interfering with activities, it can be drained or removed.

​

​

Multiple Choice

Ganglion cysts use to be called Bible cysts. Why?

• People would use the heavy bible to hit and break them.

• It was believed preachers got them from holding the bible all day.

• You could pray them away.

• The church would do cyst removals for local towns people.

Bakers Cyst

. A Baker's cyst is a fluid-filled cyst that causes a bulge and a feeling of tightness behind your knee. The pain can get worse when you fully flex or extend your knee or when you're active. Baker's cysts aren't dangerous and they may go away on their own. But occasionally they burst, and if that happens, synovial fluid can leak into the calf below, causing pain, swelling, and reddening.

​Ruptured cyst

​Gout and pseudogout, while both joint problems caused by crystals, are caused by different kinds of crystals. Gout is caused by sodium urate crystals and pseudogout is caused by calcium pyrophosphate crystals

​Gout is a common and complex form of arthritis that can affect anyone. It's characterized by sudden, severe attacks of pain, swelling, redness and tenderness in one or more joints, most often in the big toe is a starting point for gout. Gout is caused by a condition known as hyperuricemia, where there is too much uric acid in the body. The body makes uric acid when it breaks down purines, which are found in your body and the foods you eat.

​We girls finally win one...sort of

​Estrogen protects women form developing gout prior to menopause when estrogen levels decline.

​Gout & Pseudogout

Multiple Choice

Two of the most common arthritis types are rheumatoid arthritis (RA) and osteoarthritis (OA). OA is more common than RA. Both involve inflammation in the joints, but RA causes much more inflammation. What is another difference?

• Osteoarthritis affects people over 50 while rheumatoid arthritis hits later in life around the age of 70.

• Osteoarthritis is wearing away of the cartilage while Rheumatoid arthritis is a disease of the immune system that attacks the joints.

• Athletes and active people get osteoarthritis while the elderly are more prone to get rheumatoid arthritis.

​Lyme disease is caused by the bacterium Borrelia burgdorferi . It is transmitted to humans through the bite of infected blacklegged tick. Typical symptoms include fever, headache, fatigue, and a characteristic bullseye skin rash .Although most cases of Lyme disease can be cured with a 2- to 4-week course of antibiotics ,untreated Lyme disease can cause: Chronic joint inflammation (Lyme arthritis), particularly of the knee. Neurological symptoms, such as facial palsy and neuropathy. Cognitive defects, such as impaired memory.

Multiple Choice

According to the 2019 CDC report, which state had the highest number of reported cases of Lyme's?

• Pennsylvania

• Oklahoma

• New Jersey

• Texas

​Pennsylvania- 6763 with an additional 2235 probable

Oklahoma- ​ 0

New York- 2847 with an additional 1396 probable

Texas- 15 with an additional 26 probable​

​Cases of Lyme's disease in 2019

​Fun Fact- The disease takes its name from Lyme, Connecticut. This is where the illness was first identified in the United States in 1975. (795 cases in 2019)

​The bull's-eye rash is the commonly known Lyme disease symptom, but up to 30% of sufferers never get the rash at all. Many infected people have no idea there's a problem until they've had symptoms for weeks

​Muscular Atrophy

Muscle atrophy is the wasting or thinning of muscle mass. It can be caused by disuse of your muscles or neurogenic conditions. Symptoms include a decrease in muscle mass, one limb being smaller than the other, and numbness, weakness and tingling in your limbs.

​ erity can vary among individuals

Multiple Choice

What percent decrease in muscle strength happens after a simple 3 day illness such as the flu?

• 5%

• 15%

• 25%

​

Studies have shown a 25 percent decrease in isometric muscle strength after a simple febrile illness such as the flu. Replenishing muscle mass lost during a three-day febrile illness may take up to two weeks.

Contracture and Dupuytren Contracture

​A contracture is a permanent tightening of the muscles, tendons, skin, and nearby tissues that causes the joints to shorten and become very stiff.

 Dupuytren contracture is bent fingers from Dupuytren disease. Dupuytren contracture is treated with procedures by a hand surgeon, but this does not cure the underlying disease, and so contractures often return or involve other fingers.

​Not Trigger finger

​

Muscular dystrophy is actually a group of diseases that cause progressive weakness and loss of muscle mass

In most cases, muscular dystrophy (MD) runs in families. It usually develops after inheriting a faulty gene from one or both parents. Themutations in the genes responsible for muscle structure and function.. the abnormal genes interfere with the production of proteins needed to form healthy muscle.

​Myositis ossificans is a condition stemming from an injury. In this condition, bone tissue forms within a muscle. When a bruise, repetitive trauma, or strain occurs to a muscle, myositis ossificans can develop. It is most common in the thigh muscles,  but can also occur in other muscles. Bony tissue formation can occur 2-4 weeks after the muscle injury or bruise. Athletes are prone to this type of injury and will often complain of pain in the muscle associated with exercise. Range of motion and strength of the limb may be compromised. A hard bump may also be felt in the muscle.

​De Quervain's tenosynovitis is a painful condition affecting the tendons on the thumb side of your wrist.(it will probably hurt when you turn your wrist, grasp anything or make a fist.) This is usually caused by repetitive movement. irritating the sheath around the two tendons.

Multiple Choice

De Quervain's tenosynovitis is named after the doctor who discovered it but has been around for a long time and called other names. It's also been called "washerwoman's sprain" and "mommy thumb," due to the job action associated with it at the time. In todays world what action is the leading cause ?

• Excessive texting

• Carrying plastic handled shopping bags for too long

• Wrist rolling from hair and makeup applications.

​This condition develops when the tissue in your shoulder joint tightens and restricts movement. This occurs when you are not active because of another injury, such as a rotator cuff injury, broken arm, or recovering from a surgery.

​Adhesive Capsulitis aka Frozen Shoulder

Multiple Choice

What is frozen shoulder called in Japan?

• The icy joint

• The 50 year old shoulder

• The big ouchy

​

Compartment syndrome is a painful condition that occurs when pressure within the muscles builds to dangerous levels. This pressure can decrease blood flow, which prevents oxygen from reaching nerve and muscle cells.

Compartment syndrome can be either acute or chronic.

Acute compartment syndrome is a medical emergency. It is usually caused by a severe injury. Without treatment, it can lead to permanent muscle damage.(Acute injury can occur when a motorcycle falls on the leg of the rider, or a football player is hit in the leg with another player's helmet. Its a crush injury) Chronic is non life threating and is usually from intense, repetitive exercise and usually stops with rest or changes in routine

​fasciotomy