Clinical Foundations of Musculoskeletal Medicine: A Manual for Medical Students

412 Pages·2021·16.108 MB·English

by  Robert J. Esther

Clinical Foundations
of Musculoskeletal
Medicine
A Manual for Medical Students
Robert J. Esther
Editor
123
Clinical Foundations of Musculoskeletal
Medicine
Robert J. Esther
Editor
Clinical Foundations
of Musculoskeletal
Medicine
A Manual for Medical Students
Editor
Robert J. Esther
Department of Orthopedics
University of North Carolina at Chapel Hill
Chapel Hill, NC
USA
ISBN 978-3-030-42893-8 ISBN 978-3-030-42894-5 (eBook)
https://doi.org/10.1007/978-3-030-42894-5
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Preface
Musculoskeletal diseases are a significant source of morbidity. Students,
however, often receive scant formal education in musculoskeletal anatomy
and pathology. A foundational knowledge of the musculoskeletal system is
important not only in orthopedic surgery and rheumatology, but also in a wide
range of other specialties. Given the prevalence of musculoskeletal com-
plaints, one can make a compelling case that understanding the pathology of
these conditions is particularly relevant to primary care.
The University of North Carolina School of Medicine has long been a
leader in musculoskeletal education. In the 1970s, Frank Wilson, MD, and
H. Robert Brashear, MD, developed a comprehensive, innovative educational
program that fostered the development of generations of UNC students.
Although they were orthopedists, Drs. Wilson and Brashear ensured that stu-
dents of all disciplines learned the basic science and principles fundamental
to sound musculoskeletal care.
Over time, the school of medicine at UNC has continued to support MSK
education. The contributors to this book represent a wide range of depart-
ments and divisions. This breadth of engagement speaks to the faculty’s com-
mitment to education across a range of disciplines and specialties.
My goal is for this book to serve as an introduction for students to the vari-
ous principles and science underlying musculoskeletal care. I hope that the
material sparks students’ interests to pursue further education in this area
regardless of their chosen medical specialty. I am grateful to my co-authors
and to my colleagues for inspiring me to improve as a teacher and
physician.
Chapel Hill, NC, USA Robert J. Esther
v
Contents
Part I Principles of Musculoskeletal Health and Disease
1 Incidence and Prevalence of Musculoskeletal Disease . . . . . . . . . 3
Joshua A. Shapiro
2 Musculoskeletal Tissues and Anatomy . . . . . . . . . . . . . . . . . . . . . 11
Kurt O. Gilliland and Edward T. Kernick
3 Introduction to Musculoskeletal Imaging . . . . . . . . . . . . . . . . . . . 23
Jordan B. Renner
4 Basic Bone Metabolism . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47
Meghana Bhatta and Morgan S. Jones
5 Principles of Diagnosis and Treatment of Bone Remodeling
Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57
Roger Harty and Morgan S. Jones
6 Principles of Diagnosis and Treatment of Osteomalacia . . . . . . . 67
Roger Harty and Morgan S. Jones
7 Principles of Diagnosis and Treatment of Osteoporosis . . . . . . . 77
Donald M. Caraccio and Morgan S. Jones
Part II R heumatic Diseases
8 Rheumatoid Arthritis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 97
Beth L. Jonas
9 Osteoarthritis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 105
Amanda E. Nelson
10 Seronegative Spondyloarthropathies . . . . . . . . . . . . . . . . . . . . . . 119
Ellen Amanda Snyder
11 Systemic Lupus Erythematosus . . . . . . . . . . . . . . . . . . . . . . . . . . . 133
Jacquelyn Smith
12 Crystalline Arthropathy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 143
Rami ElTaraboulsi
vii
viii Contents
Part III M usculoskeletal Infection, Vascular, and Neoplastic Diseases
13 Microbes in Bone and Joint Infections . . . . . . . . . . . . . . . . . . . . . 153
Nikolaos Mavrogiorgos
14 Principles of Musculoskeletal Infections . . . . . . . . . . . . . . . . . . . . 161
Laurence E. Dahners, and Lukas Keil
15 Vascular Disorders of Bone . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 173
Joshua A. Shapiro
16 Bone Tumors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 187
James Pascal Norris IV
17 Soft Tissue Tumors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 209
James Pascal Norris IV
Part IV M usculoskeletal Trauma and Rehabilitation
18 Systemic Response to Trauma . . . . . . . . . . . . . . . . . . . . . . . . . . . . 229
John J. Yoon, Elizabeth B. Dreesen, and Michelle R. Brownstein
19 Principles of Musculoskeletal Fracture Care . . . . . . . . . . . . . . . . 239
Matthew R. Stillwagon and Robert F. Ostrum
20 Rehabilitation of Musculoskeletal Injuries . . . . . . . . . . . . . . . . . . 255
Deborah L. Givens and Michael McMorris
21 Management of Musculoskeletal Pain. . . . . . . . . . . . . . . . . . . . . . 265
Candy O. Ezimora and Ty L. Bullard
Part V Clinical Conditions of the Musculoskeletal System
22 Common Pediatric Conditions and Evaluation of the Limping
Child . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 279
Pamela J. Lang
23 Common Clinical Conditions of the Spine . . . . . . . . . . . . . . . . . . 305
Daniel L. Robinson
24 Low Back Pain . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 317
Lincoln Pratson and Daniel Cavanaugh
25 Common Clinical Conditions of the Shoulder . . . . . . . . . . . . . . . 329
Robert J. Esther and Colleen B. Balkam
26 Common Clinical Conditions of the Elbow . . . . . . . . . . . . . . . . . 343
Daniel Carpenter and Reid W. Draeger
27 Common Clinical Conditions of the Hand and Wrist . . . . . . . . . 357
Emily E. Jewell and Reid W. Draeger
Contents ix
28 Common Clinical Conditions of the Hip . . . . . . . . . . . . . . . . . . . . 377
Joseph Stone
29 Common Clinical Conditions of the Knee . . . . . . . . . . . . . . . . . . 385
Jeffrey T. Spang and Mark A. Cairns
30 Common Clinical Conditions of the Foot and Ankle . . . . . . . . . . 399
Chinmay Paranjape and Joshua Tennant
Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 413
Contributors
Colleen B. Balkam, MD Department of Orthopedic Surgery, University of
North Carolina at Chapel Hill, Chapel Hill, NC, USA
Meghana Bhatta, MD Department of Endocrinology, University of North
Carolina, Chapel Hill, NC, USA
Michelle R. Brownstein, MD Department of Surgery, University of North
Carolina, Chapel Hill, NC, USA
Ty L. Bullard, MD Department of Anesthesiology, University of North
Carolina School of Medicine, Chapel Hill, NC, USA
Mark A. Cairns, MD Department of Orthopedic Surgery, University of
North Carolina, Chapel Hill, NC, USA
Donald M. Caraccio, MD Department of Endocrinology, University of
North Carolina, Chapel Hill, NC, USA
Daniel Carpenter, MD Department of Orthopedic Surgery, University of
North Carolina, Chapel Hill, NC, USA
Daniel  Cavanaugh University of Maryland Orthopaedic Associates,
Bel Air, MD, USA
Laurence E. Dahners, MD Department of Orthopedic Surgery, University
of North Carolina, UNC Hospitals, Chapel Hill, NC, USA
Reid W. Draeger, MD Department of Orthopedic Surgery, University of
North Carolina, Chapel Hill, NC, USA
Elizabeth B. Dreesen, MD Department of Surgery, University of North
Carolina, Chapel Hill, NC, USA
Rami  ElTaraboulsi, MD Division of Rheumatology, Allergy, and
Immunology, University of North Carolina at Chapel Hill, Chapel Hill, NC,
USA
Robert J. Esther, MD Department of Orthopedics, University of North
Carolina at Chapel Hill, Chapel Hill, NC, USA
Department of Orthopedic Surgery, University of North Carolina at Chapel
Hill, Chapel Hill, NC, USA
xi
xii Contributors
Candy O. Ezimora, MD Department of Anesthesiology, University of
North Carolina School of Medicine, Chapel Hill, NC, USA
Kurt  O.  Gilliland, PhD Department of Cell Biology and Physiology,
University of North Carolina, Chapel Hill, NC, USA
Deborah  L.  Givens, PT, DPT, PhD Division of Physical Therapy,
Department of Allied Health Science, School of Medicine, University of
North Carolina at Chapel Hill, Chapel Hill, NC, USA
Roger Harty, MD Division of Endocrinology and Metabolism, University
of North Carolina, Chapel Hill, NC, USA
Emily E. Jewell, MD Department of Orthopedic Surgery, University of
North Carolina, Chapel Hill, NC, USA
Beth L. Jonas, MD Division of Rheumatology, Allergy, and Immunology,
UNC School of Medicine, University of North Carolina, Chapel Hill, NC,
USA
Morgan  S.  Jones, MD Division of Endocrinology and Metabolism,
University of North Carolina, Chapel Hill, NC, USA
Lukas Keil, MD Department of Orthopedic Surgery, University of North
Carolina, UNC School of Medicine, UNC Hospitals, Durham, NC, USA
Edward T. Kernick, DPM Department of Cell Biology and Physiology,
University of North Carolina, Chapel Hill, NC, USA
Pamela J. Lang, MD Division of Pediatric Orthopedics, Division of Sports
Medicine, Department of Orthopedics and Rehabilitation, University of
Wisconsin School of Medicine and Public Health, Madison, WI, USA
Nikolaos Mavrogiorgos, MD Division of Infectious Diseases, University of
North Carolina, Chapel Hill, NC, USA
Michael McMorris, PT, DPT Division of Physical Therapy, Department of
Allied Health Science, School of Medicine, University of North Carolina at
Chapel Hill, Chapel Hill, NC, USA
Amanda  E.  Nelson, MD Division of Rheumatology, Allergy, and
Immunology, Thurston Arthritis Research Center, University of North
Carolina at Chapel Hill, Chapel Hill, NC, USA
James  Pascal  Norris IV, MD Department of Orthopedic Oncology,
Vanderbilt University Medical Center, Nashville, TN, USA
Robert F. Ostrum, MD Department of Orthopaedics, University of North
Carolina, Chapel Hill, NC, USA
Chinmay Paranjape, MD Department of Orthopedic Surgery, University of
North Carolina, Chapel Hill, NC, USA
Lincoln Pratson, MD Department of Orthopedic Surgery, University of
North Carolina, UNC Hospitals, Chapel Hill, NC, USA