Western+Diagnosis+-+Musculoskeletal+System

Bursitis Tendinitis Sciatica and low back pain Fibromyalgia Sprains & Strains Arthritis: Osteoarthritis & Rheumatoid Arthritis Systemic Lupus Erythematosis (SLE) Progressive Systemic Sclerosis (PSS) Polymyositis / Dermatomyositis Temporal Arteritis Osteoporosis Gout Infections Neoplasms Autoimmune Disorders

Physical Exam A. Observation of the whole body B. Inspection -Appearance, color, deformity, relationship to body C. Palpation-Tenderness, Temperature (back of hand), Swelling, Spasm, Crepitus (audible or tactile) D. ROM -Measured in degrees of a circle - joint at center -Abnorally limited by pain, spasmm inflammation, adhesions, deformity, swelling -Passive -Active - compare both with opposite side E. Joint Position -Position of function -Position of comfort F. Measurement -Atrophy vs. Hypertrophy G. Neurological Exam -Muscle strength -Cutaneous sensation - dermatomes -DTR's

Lab Studies A. ESR (sed rate), C-reactive protein - inflammation B. RF (rheumatoid factor), ANA (anti-nuclear antibody) - autoimmune connective tissue disorders C. CK (creatine-kinase), SGOT (AST) - peripheral muscle disorders

Imaging A. x-rays - always done first in evaluatng musclular disorders B. CT scans C. MRI D. ultrasound - soft-tissue masses E. Arthrography - joints F. Bone and Marrow scans - bony disorders

Other A. Joint aspiration - Synovial fluid evaluation B.Arthroscopy C. Thermography D. Electromyography - electrical change associated with muscle contraction E. Nerve conduction velocity - conduction of impulse along a nerve - for differentiation of muscular disorders F. Muscle and bone biopsy

Emergencies Not many true emergencies in muscular system A. Acute bacterial arthritis -Joint destruction if not promptly treated -Acute joint pain and stiffness -warmth, tenderness, swelling - fever, chills, leukocytosis - with anti-inflammatory meds, no signs or symptoms - Joint aspiration with culture -Antimicrobial therapy -Patient will not move joint spontaneously, or if all at possible B. Urgent -fractures

Wu Wei Zi (also a great liver herb) & Ginseng for endurance, muscles