Musculoskeletal
Disorders
HLTH-208 STUDY OF HUMAN DISEASES
PROFESSOR SHEFCHIK
Bones
•Provide the body with a sturdy framework
•Protect internal organs and the central nervous system
•Depend on calcium and phosphate (minerals)
•Can be long, flat, or irregularly shaped
•Red-colored bone-marrow is the site of blood cell formation
•Types of bone cells:
• Osteocytes (mature cells)
• Osteoblasts (bone-forming cells)
• Osteoclasts (bone-resorbing cells)
Joints
The articulating sites between bones
Degree of movement is referred to as Range of Motion (ROM), varies by joint
Consists of:
ligaments made of dense strands of collagen
synovial membrane which secretes synovial fluid to lubricate the joint
cartilage to reduce friction
and sometimes bursae which are sacs of synovial fluid to reduce friction
Muscles
Consists of bundles of muscle fibers held together by connective tissue
Types of muscles:
◦ Skeletal or voluntary muscles are attached to bones with tendons *
◦ Smooth muscles or involuntary muscles are found in internal organs and blood vessels
◦ Cardiac muscle is involuntary and only found in the heart
Diagnostic Tests & Procedures
•X-rays
•CT
•MRI
•Arthroscopy
•Electromyography (EMG)
•Biopsy
Infectious Disorders
Osteomyelitis
Bacterial infection of the bone
Risk factors: Recent injury or surgery, circulation disorders, impaired immune
system, invasive procedures and treatments (like dialysis, IV, catheters), IV drug
use
Signs & Symptoms: pain, redness, heat, chills, fever, elevate leukocytes
Diagnosis: Bone biopsy, CT/MRI, WBC count
Treatment: antibiotics, surgery to remove dead bone tissue
Prevention: Treat infections and compound fractures promptly
Three phases of bone infection
Disorders Associated
with Vitamin & Mineral
Deficiencies
Osteoporosis
Disease characterized by porous bone, that is fragile and susceptible to fracture
Pre-cursor is osteopenia (when bone marrow density is lower than normal)
Risk factors: FEMALE, > age, low calcium and vitamin D intake, small frame, sedentary
lifestyle, smoking, postmenopausal, excessive alcohol, hysterectomy, Caucasian/Asian
Signs & Symptoms: asymptomatic
Complications: fractures, accumulated compression fractures, decreased height,
compression of nerves
Diagnosis: Bone Mineral Density (DEXA scan)
Treatment: Oral medications that promote calcium uptake
Prevention: D & Calcium, weight-bearing exercises, not smoking, ↓ alcohol and caffeine
Spinal changes caused by osteoporosis
Rickets
Rare disease of infancy or early childhood in which bones do
not properly ossify or harden
Bones are soft, bend easily, become deformed
Signs & Symptoms: soft spots are slow to close, curved
bones, lumpy joints, bowed legs
Risk factors: dark skin, northern latitudes, ages 3-36 months,
certain medications
Prevention & Treatment: Vitamin D fortified foods or
supplements, sunlight exposure
Other Bone Deformities
•Paget’s Disease—overproduction of bone
•Scoliosis—abnormal lateral curvature of the spine
•Kyphosis (hunchback)—abnormal posterior curve of the thoracic spine
•Lordosis (swayback)—inward curvature of the lumbar spine
Scoliosis and Kyphosis
Fractures
Signs & Symptoms: Visible out of place limb or joint, swelling/bleeding/bruising,
intense pain, numbness or tingling, broken skin with bone protruding, limited
mobility or inability to move a limb
Treatment: immobilization with a splint or cast, surgery with pins and plates
Complications: fat emboli (long bone fractures), compartment syndrome (with
casts)
Disorders of the Joints
Osteoarthritis
Most common form of arthritis, degenerative
Risk factors: advanced age, trauma or injury to the joint, obesity
Signs & Symptoms: pain and stiffness in the joint, loss of range of motion,
weakened muscles
Diagnosis: x-ray
Treatment: pain and anti-inflammatory medications, steroids, mild exercise,
heat application, surgical replacement of joint
Rheumatoid Arthritis
Chronic, autoimmune disease affecting joints, and surrounding tissues
Risk factors: family history, female, age (usually 30-60 at onset), smoking
Signs & Symptoms: joint pain and stiffness particularly on waking,
swollen/warm/red joints, fatigue, weakness, weight loss. Ankylosis—scaring and
fusion of joints
Diagnosis: often very difficult, x-ray to show joint changes, positive rheumatoid
factor, synovial fluid analysis
Treatment: anti-rheumatic, anti-inflammatory, immunosuppressant
medications, exercise, rest, cold application to joint during flare-up
RICE for Joint Trauma (Strains, Sprains, etc.)
Rest
Ice
Compression
Elevation