Selected Musculoskeletal Syndromes



Selected Musculoskeletal Syndromes


Brian F. Mandell



RAPID BOARD REVIEW—KEY POINTS TO REMEMBER:



  • Eliciting tenderness that does not mimic the patient’s pain syndrome is not diagnostic.


HIP GIRDLE



  • Hip Joint Pathology—pain deep to the inguinal crease, elicited by passive motion of the hip, but not reproduced by palpation.


  • Trochanteric Bursitis—pain reproduced by palpation of the superficial trochanteric bursa, over the trochanteric prominence, or deep trochanteric bursa, in a deep groove, proximal and slightly posterior.


  • Ischial Bursitis—tenderness along the ischial prominence.


  • Gluteal Bursitis—pain elicited by deep palpation along the gluteal muscles.


  • Piriform Syndrome—pain by deep palpation of the piriformis muscle in the lateral upper quadrant of the buttock area, or, more specifically, by rectal wall examination.


  • Meralgia Paresthetica—area of intense dysesthesia, often with numbness on careful pinprick examination in a patch of skin on the anterior thigh.


KNEE



  • Pain surrounding the knee is frequently attributed to osteoarthritis of the knee, especially in the elderly. However, pain in the knee area can be referred from the hip joint, the lumbar spine, and (rarely) from the foot in patients with significant pes planus and tightened calf muscles.


  • Pes-Anserine Bursitis—pain elicited by gentle palpation approximately 1 cm below the joint line on the medial aspect of the leg.


  • Prepatellar Bursitis—area of swelling immediately anterior to the patella.


ELBOW

Jul 5, 2016 | Posted by in GASTROENTEROLOGY | Comments Off on Selected Musculoskeletal Syndromes

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