Quartz 5

MSK (8%)

2 min read

Chest/Rib Disorders

  • Deformities

  • Fractures

  • Compartment syndrome

Degenerative Diseases

  • Osteoarthritis

Infectious Diseases

  • Osteomyelitis

  • Septic arthritis

Lower Extremity Disorders

  • Avascular necrosis

  • Developmental dysplasia

  • Extensor mechanism injuries

  • Fractures / dislocations

  • Osgood-Schlatter disease

  • Slipped capital femoral epiphysis (SCFE)

  • Soft-tissue injuries

Neoplasms

  • Benign

  • Malignant

  • Paget disease of bone

Rheumatologic Disorders

Connective Tissue Diseases

  • Ehlers-Danlos Syndrome (EDS)

    • COLA / TNXB mutations

    • PT referral

    • hEDS = clinical diagnosis

    • Consider TTE

  • Marfan Syndrome

    • FBN1 mutation

    • TTE, genetics, ophthalmology eval

    • Activity restrictions

  • Osteogenesis Imperfecta

    • Blue sclera

Fibromyalgia

  • 3 months diffuse pain + somatic symptoms

  • Associated with anxiety, depression, RLS, OSA

  • Treatment: (multimodal—exercise, CBT, meds)

Crystal Arthropathies (Gout / Pseudogout)

  • Usually monoarticular → arthrocentesis required
FeatureGoutPseudogout
CrystalsNeedle-shapedRhomboid
BirefringenceNegative (blue/purple)Positive (yellow)
Lab↑ Uric acidNormal uric acid
Classic joint1st MTP (podagra)Knee
  • Tophi (gout)

Treatment

  • Acute: NSAIDs, colchicine, steroids

  • Chronic: allopurinol + lifestyle

Juvenile Idiopathic Arthritis (JIA)

  • Age <16, arthritis >6 weeks

  • Scheduled NSAIDs

Osteoporosis

  • DEXA screening:

    • Women ≥65

    • Men ≥70

Polyarteritis Nodosa

  • Medium-vessel vasculitis

  • Palpable purpura (non-blanching), ulcers, livedo reticularis

  • Angiography: “string of pearls / rosary”

Polymyalgia Rheumatica

  • Proximal pain (shoulder/hip girdle) + stiffness

  • ~50% associated with giant cell arteritis

  • ↑ ESR/CRP

  • Treatment: prednisone

Polymyositis

  • Proximal muscle weakness

  • ↑ CK, anti-Jo-1, aldolase, LFTs, LDH

  • Diagnosis: EMG/NCS, biopsy

  • Treatment: steroids, DMARDs/biologics

Dermatomyositis

  • Myositis + skin findings:

    • Gottron papules

    • Heliotrope rash

  • Evaluate for paraneoplastic process

Reactive Arthritis

  • Post-infectious (1 week–1 month later)

  • GI or GU (most commonly Chlamydia)

  • Lower extremity arthritis

  • Uveitis

Rheumatoid Arthritis

  • Persistent joint swelling

  • Ulnar deviation

  • Morning stiffness >1 hour

  • Imaging: periarticular osteopenia, marginal erosions

  • Labs: (RF, anti-CCP, inflammatory markers)

Sjögren Syndrome

  • Middle-aged women

  • Sicca symptoms (dry eyes/mouth), parotitis, dental caries

  • Anti-SSA (Ro), Anti-SSB (La)

Systemic Lupus Erythematosus (SLE)

  • Women of childbearing age

Manifestations

  • Skin: photosensitivity, malar rash

  • Joints: arthritis

  • Kidney: nephritis

  • Hematologic involvement

Labs

  • ANA ≥1:80

  • Anti-dsDNA, anti-Smith

Treatment

  • Hydroxychloroquine

Systemic Sclerosis (Scleroderma)

  • Tight, shiny skin

  • Anti-Scl-70

  • Raynaud phenomenon, ILD, pulmonary HTN

CREST (Limited Scleroderma)

  • Calcinosis

  • Raynaud phenomenon

  • Esophageal dysmotility

  • Sclerodactyly

  • Telangiectasia

  • Anti-centromere antibodies

Spinal Disorders

Ankylosing Spondylitis

  • HLA-B27+

  • Schober test (<21 cm abnormal)

  • “Bamboo spine”, sacroiliitis

Herniated Disc Disease

  • Herniated nucleus pulposus

  • Radiculopathy

Structural Disorders

  • Kyphosis

  • Scoliosis

Spinal Stenosis

  • “Shopping cart sign”

  • Age >60

  • MRI for diagnosis

Cauda Equina Syndrome

  • Emergency

  • Treatment: IV steroids + surgical decompression

Spondylopathies

  • Spondylolisthesis → vertebral slippage

  • Spondylolysis → pars fracture

  • Spondylosis → degenerative arthritis

Other Spinal Conditions

  • Sprain / strain

  • Torticollis

  • Trauma

Thoracic Outlet Syndrome

  • Adson’s test

  • Roos test

Upper Extremity Disorders

  • Fractures / dislocations

  • Soft-tissue injuries

Graph View