Nurs 623 Maryville Exam 4 Study Guide

Musculoskeletal Think about the following useful approaches to help determine differential diagnoses formusculoskeletal complaints: • Acute or chronic in duration Acute Chronic - Acute musculoskeletal injury impliespain of less than 6 weeks’ duration. - Non-articular condition consider: • Trauma/fracture • Fibromyalgia • Polymyalgia rheumatica • Bursitis • Tendinitis - Articular condition consider: •Acute arthritis Infectious arthritisGout Pseudogout Reactive arthritis •Initial presentation of chronicarthritis - complaint 6 weeks - If the problem is chronic, ask the patientwhy he or she is addressing it at this particular time. -Consider the following to guide yourdifferentials… Is inflammation present? Is there prolonged morning stiffness?Is there soft tissue swelling? Are there systemic symptoms?Is the ESR or CRP elevated? -Examples of chronic conditions include: • Osteoarthritis • Psoriatic arthritis • Reactive arthritis • Rheumatoid arthritis • SLE • Sclerodema • Polymyositis • Articular or nonarticular in origin Articular Non-Articular NURS 623 -Includes structures like the synovium, synovial fluid, articular cartilage, joint capsules, and juxta-articular bone. -Articular disorders may be characterized by deepor diffuse pain, pain or limited ROM on active and passive movement, swelling, crepitus. - Crepitus (joint noises or palpable grindingduring joint motion) may be due to -Supportive structures such as tendons, bursae,muscles, fascia, bone, nerve, overlying skin. -Tend to be painful on active but not passive (assisted) ROM. Seldom demonstrate swelling,crepitus, instability, or deformity by itself. - Nonarticular disorders are classified as eitherfocal or widespread.