, NR577 jFinal jExam jStudy jGuide jfor jWeeks j5-8
If jyou junderstand jthe jconcepts jbelow jand jhow jto jdiagnose, jtreat, jand jmanage, jyou jwill jbe
jsuccessful jon jthe jFinal jexam.
Week j5: jMusculoskeletal jand
jNeurological jDisorders
j Musculoskeletal jDisorders
▪ Scoliosis
▪ Patellofemoral jstress jsyndrome
Patellofemoral j overuse j syndrome j occurs j during j running j and j sports j that
j involve j repetitive j stress j in j the j lower
extremity. jThe jathlete jpresents jwith jactivity-related jpain jin jthe
janterior jknee. jIn jyoung jathletes, jit jis joccasionally jassociated jwith
jswelling jand jcrepitus jof jthe jknee jjoint.
Evaluation jof jthese jinjuries jis jcomprehensive jand jrequires ja j―top-
down‖ jevaluation jof jthe jathlete’s jleg jfrom jthe jhip j to jthe jfoot.
jMost jathletes jwith jthis jcondition, jregardless jof jlevel jor jphysical
jcondition, jtypically jhave jhip/core jweakness jthat jresults jin jaltered
jknee jbiomechanics. jA jcomprehensive jevaluation jof jhip jalignment
jand jrotation, j muscle j development, j tightness j in j the j hamstrings
j and j IT j band, j and j foot j mechanics j is j necessary j to j fully
j understand jand jtreat jthe jcause jof jthis jdisorder. jMost jathletes
jwith jthis jcomplaint joften jhave ja jmultifactorial jcause jfor jtheir
jsymptoms.
Treatment jshould jbe jgeared jtoward jidentifying jthe jcause. jOften,
jathletes jare jovertraining jand jneed jto jmodify jcurrent j activities.
j Cross-training j may j help. j Addressing j hip j and j pelvic j stability j is
j now j a j mainstay j of j treatment j for jthis j disorder. jStretching j and
j strengthening jof jthe jhamstrings j and j quadriceps jare
jrecommended. jThe juse jof jbraces jproviding jproprioceptive
jfeedback jduring jcompetition jis jcontroversial.
▪ Growing jPains
―growing j pains‖ j of j presumed j bone j and jjoint j origin jof j children.
Growing jpains, ja jcommon jcause jof jleg jpain jin jchildhood, jare
jcharacterized jby jpoorly jlocalized jpain jat jnight, jwhich jfrequently
jwakes jthe jchild jfrom jsleep; jno jobjective jsigns jof jinflammation;
jand jno jdaytime jsymptoms. jPatients jwith jgrowing jpains joften jask
jto jbe jmassaged, jwhich jis jnot jtypical jof jthose jwith jarthritis.
▪ Shin jsplints
The jterm jshin jsplints jis jwidely jused jfor jshin jpain, jbut jit jis jnot ja jdiagnosti
jterm. jA j more jspecific j diagnosis jshould jbe
made j if j possible. j Shin j splints j usually j occur j in j the j beginning j of
j training j after j a j relatively j inactive j period. j The j pain jand
j tenderness j are jlocated j over j the j anterior j compartment j and
, jdisappear j in j 1 j to j 2 j weeks j as j the jathlete j becomes jconditioned
jto jthe jexercise. jCare jmust jbe jtaken jto jdifferentiate jshin jsplints
jfrom jstress jfractures jof jthe jtibia, jwhich jcause jmore jlocalized
jpain jand jhave jmany jmore jpotential jcomplications jif jnot jcared jfor
jproperly.
▪ Osgood-Schlatter jdisease j(OSD)
active jadolescents jduring jgrowth jspurts, jages jof j9 jand j15 jwhen jth
jtuberosity jhas jnot jyet jbeen jossified
area jis j not jhard j enough j to jresist jtraction jof jthe jpatellar
jligament, jcommon jin j young j adolescents j who jplay jsports
jrequiring jrepetitive jquadriceps jcontractions, jsuch jas jbasketball,
jsoccer, jor jfigure jskating
overuse jsyndrome jthat jpresents jwith jpain,
j tenderness, jand jedema jto jthe jaffected jknee.
j typically j resolves j by j itself j as j ossification j of j the
j tuberosity j continues j as j the j child j grows. jS ji jg jn js
j a jn jd j S jy jm jp jt jo jm js
• pain jworsened jby jactivity jsuch jas jrunning, jjumping, jsquatting, jusing
jstairs
• palpable jlump j below jthe jknee
• localized jerythema, jswelling, jand jtenderness
• may j be junilateral j or j bilateral
Treatment j for j Osgood-Schlatter j disease j includes:
• anti-inflammatory jmedication j(ibuprofen) jto jreduce jpain jand jswelling
• stretching, jflexibility, jand j physical jtherapy jexercises jfor jthe jthigh jand
jleg j muscles
• surgery jmay jbe jrequired jfor jpersistent jpain jor jprogressive jdisease
• RICE j (rest, j ice, j compression, j elevation) j may j be j helpful j to j manage j pa
j and j inflammation
Neurological jDisorders
▪ EEG
a j patient j with j suspected j epilepsy, j the j presence j of jseizure j activity j duri
j the j EEG j establishes j the j diagnosis.
If jyou junderstand jthe jconcepts jbelow jand jhow jto jdiagnose, jtreat, jand jmanage, jyou jwill jbe
jsuccessful jon jthe jFinal jexam.
Week j5: jMusculoskeletal jand
jNeurological jDisorders
j Musculoskeletal jDisorders
▪ Scoliosis
▪ Patellofemoral jstress jsyndrome
Patellofemoral j overuse j syndrome j occurs j during j running j and j sports j that
j involve j repetitive j stress j in j the j lower
extremity. jThe jathlete jpresents jwith jactivity-related jpain jin jthe
janterior jknee. jIn jyoung jathletes, jit jis joccasionally jassociated jwith
jswelling jand jcrepitus jof jthe jknee jjoint.
Evaluation jof jthese jinjuries jis jcomprehensive jand jrequires ja j―top-
down‖ jevaluation jof jthe jathlete’s jleg jfrom jthe jhip j to jthe jfoot.
jMost jathletes jwith jthis jcondition, jregardless jof jlevel jor jphysical
jcondition, jtypically jhave jhip/core jweakness jthat jresults jin jaltered
jknee jbiomechanics. jA jcomprehensive jevaluation jof jhip jalignment
jand jrotation, j muscle j development, j tightness j in j the j hamstrings
j and j IT j band, j and j foot j mechanics j is j necessary j to j fully
j understand jand jtreat jthe jcause jof jthis jdisorder. jMost jathletes
jwith jthis jcomplaint joften jhave ja jmultifactorial jcause jfor jtheir
jsymptoms.
Treatment jshould jbe jgeared jtoward jidentifying jthe jcause. jOften,
jathletes jare jovertraining jand jneed jto jmodify jcurrent j activities.
j Cross-training j may j help. j Addressing j hip j and j pelvic j stability j is
j now j a j mainstay j of j treatment j for jthis j disorder. jStretching j and
j strengthening jof jthe jhamstrings j and j quadriceps jare
jrecommended. jThe juse jof jbraces jproviding jproprioceptive
jfeedback jduring jcompetition jis jcontroversial.
▪ Growing jPains
―growing j pains‖ j of j presumed j bone j and jjoint j origin jof j children.
Growing jpains, ja jcommon jcause jof jleg jpain jin jchildhood, jare
jcharacterized jby jpoorly jlocalized jpain jat jnight, jwhich jfrequently
jwakes jthe jchild jfrom jsleep; jno jobjective jsigns jof jinflammation;
jand jno jdaytime jsymptoms. jPatients jwith jgrowing jpains joften jask
jto jbe jmassaged, jwhich jis jnot jtypical jof jthose jwith jarthritis.
▪ Shin jsplints
The jterm jshin jsplints jis jwidely jused jfor jshin jpain, jbut jit jis jnot ja jdiagnosti
jterm. jA j more jspecific j diagnosis jshould jbe
made j if j possible. j Shin j splints j usually j occur j in j the j beginning j of
j training j after j a j relatively j inactive j period. j The j pain jand
j tenderness j are jlocated j over j the j anterior j compartment j and
, jdisappear j in j 1 j to j 2 j weeks j as j the jathlete j becomes jconditioned
jto jthe jexercise. jCare jmust jbe jtaken jto jdifferentiate jshin jsplints
jfrom jstress jfractures jof jthe jtibia, jwhich jcause jmore jlocalized
jpain jand jhave jmany jmore jpotential jcomplications jif jnot jcared jfor
jproperly.
▪ Osgood-Schlatter jdisease j(OSD)
active jadolescents jduring jgrowth jspurts, jages jof j9 jand j15 jwhen jth
jtuberosity jhas jnot jyet jbeen jossified
area jis j not jhard j enough j to jresist jtraction jof jthe jpatellar
jligament, jcommon jin j young j adolescents j who jplay jsports
jrequiring jrepetitive jquadriceps jcontractions, jsuch jas jbasketball,
jsoccer, jor jfigure jskating
overuse jsyndrome jthat jpresents jwith jpain,
j tenderness, jand jedema jto jthe jaffected jknee.
j typically j resolves j by j itself j as j ossification j of j the
j tuberosity j continues j as j the j child j grows. jS ji jg jn js
j a jn jd j S jy jm jp jt jo jm js
• pain jworsened jby jactivity jsuch jas jrunning, jjumping, jsquatting, jusing
jstairs
• palpable jlump j below jthe jknee
• localized jerythema, jswelling, jand jtenderness
• may j be junilateral j or j bilateral
Treatment j for j Osgood-Schlatter j disease j includes:
• anti-inflammatory jmedication j(ibuprofen) jto jreduce jpain jand jswelling
• stretching, jflexibility, jand j physical jtherapy jexercises jfor jthe jthigh jand
jleg j muscles
• surgery jmay jbe jrequired jfor jpersistent jpain jor jprogressive jdisease
• RICE j (rest, j ice, j compression, j elevation) j may j be j helpful j to j manage j pa
j and j inflammation
Neurological jDisorders
▪ EEG
a j patient j with j suspected j epilepsy, j the j presence j of jseizure j activity j duri
j the j EEG j establishes j the j diagnosis.
