Musculoskeletal Injury

Aka: Musculoskeletal Injury, Soft Tissue Injury

1. See Also
   1. Musculoskeletal Injury Management
   2. Fracture
   3. Ligament Sprain
   4. Tendon Strain
   5. Contusion
   6. Apophyseal Injury
2. Types: Soft Tissue Injury
   1. Ligament Sprain
      1. Injury to ligament or capsule
   2. Tendon Strain (Tendinopathy)
      1. Injury translated at musculotendinous junctions
   3. Contusion
      1. Blunt injury disrupts soft tissue (skin, muscle) capillaries and venules, resulting in Hemorrhage into local interstitial tissue
   4. Apophyseal Injury (children)
      1. Secondary ossification sites for tendon insertions, which may be injured with overuse prior to Growth Plate closure
      2. Examples
         1. Little Leaguer's Elbow
         2. Osgood-Schlatter Disease (knee)
         3. Sever's Disease (heel)
3. Types: Fractures
   1. See Fracture
   2. See Stress Fracture
   3. See Epiphyseal Fracture (children)
4. Types: Nerve Injuries
   1. General
      1. Peripheral Nerve Injury
      2. Compartment Syndrome
   2. Shoulder and Brachial Plexus
      1. Brachial Plexus Injury
      2. Axillary Nerve Injury
      3. Long Thoracic Nerve Injury
      4. Suprascapular Nerve Injury
      5. Spinal Accessory Nerve Injury
   3. Elbow and wrist
      1. Median Nerve Injury at the Elbow
      2. Median Nerve Injury at the Wrist (Carpal Tunnel)
      3. Radial Nerve Injury at the Elbow
      4. Radial Nerve Injury at the Wrist
      5. Ulnar Neuropathy at the Elbow (Cubital Tunnel)
      6. Ulnar Nerve Injury at the Wrist (Ulnar Tunnel)
   4. Spine
      1. Cervical Radiculopathy
      2. Lumbar Radiculopathy
   5. Buttock and legs
      1. Sciatica
      2. Piriformis Syndrome
      3. Meralgia Paresthetica
      4. Tarsal Tunnel
5. Types: Regions
   1. Spine
      1. Cervical Spine Injury
      2. Lumbar Spine Injury
   2. Upper extremity
      1. Shoulder Pain
      2. Rotator Cuff Injury
      3. Hand Injury
      4. Wrist Injury
   3. Lower extremity
      1. Hip Pain
      2. Knee Injury
      3. Leg Pain
      4. Foot Pain
6. Types: Mechanism
   1. Falls
      1. Fall on Outstretched Hand
      2. Fall on Shoulder
   2. Work and chores
      1. Occupational Injury
      2. Lawn Mower Injury
   3. Sports
      1. Bicycling
      2. Cross Country Skiing
      3. Golf Injuries
      4. Running Injury
      5. In-line Skating
      6. Scuba Diving
      7. Surfing
7. History
   1. Hand dominance (for upper extremity injuries)
   2. Profession or sports
8. Exam
   1. See Brief Musculoskeletal Exam
   2. See Neurologic Exam
   3. See Trauma Secondary Survey
   4. Approach: Every extremity injury
      1. Include examination of joint above and below the involved joint
      2. Include sensory, motor and vascular exam
      3. Include skin and compartment exam
      4. Mallon (2013) Shoulder Disorders, EM Bootcamp, Las Vegas
   5. Upper extremity
      1. Shoulder Exam
      2. Elbow Exam
      3. Hand Exam
      4. Wrist Exam
   6. Lower extremity
      1. Hip Exam
      2. Knee Exam
      3. Low Back Exam
9. Precautions: Assess for Fracture (Especially in children)
   1. Ligaments and Tendons are stronger than Growth Plate
   2. Bone Fractures less often after Growth Plate fusion
10. Management
    1. See Musculoskeletal Injury Management