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Samenvatting Bewegingsapparaat, Geneeskunde, Leerjaar 3, Maastricht University $3.20
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Samenvatting Bewegingsapparaat, Geneeskunde, Leerjaar 3, Maastricht University

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Het document is een samenvatting van de ziektebeelden van het bewegingsapparaat die behandeld worden in leerjaar 3 geneeskunde. Het omvat epidemiologie, pathofysiologie, symptomen, diagnostiek en behandeling van desbetreffende aandoeningen.

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  • March 4, 2023
  • 68
  • 2021/2022
  • Summary
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Orthopedie..................................................................................................................................4
Schouderproblemen...........................................................................................................4
Frozen shoulder..............................................................................................................4
Subacromiaal pijnsyndroom..........................................................................................4
Cuffdegeneratie en ruptuur............................................................................................5
Bursitis.............................................................................................................................6
Tendinopathie van de bicepspees..................................................................................6
Tendinitis calcarea..........................................................................................................7
Subluxatie/habituele luxatie van de schouder...............................................................7
Elleboog problematiek........................................................................................................8
Bursitis olecrani...............................................................................................................8
Epicondylitis lateralis (tenniselleboog)...........................................................................9
Epicondylitis medialis (golfers elleboog).........................................................................9
Pronator (teres) syndroom...........................................................................................10
Supinator syndroom......................................................................................................10
Cubitaletunnelsyndroom..............................................................................................11
Elleboogluxatie..............................................................................................................11
Subluxatio capitelli radii (Zondagmiddagarmpje).........................................................12
Pols/hand problemen.......................................................................................................12
Polsverstuikingen..........................................................................................................12
Intersection syndrome/Oarsman’s wrist (Roeierspols)................................................13
Tendinitis de Quervain..................................................................................................13
Lunatomalacie (ziekte van Kienböck)...........................................................................14
Ganglion........................................................................................................................14
Ulnair bandletsel van het MCP1- gewricht (Skiduim)...................................................15
Trigger finger (of snapping thumb bij aandoening aan digiti 1)...................................15
Mallet finger..................................................................................................................16
Symptoom van Dupuytren (Koetsiershand).................................................................16
Heupproblemen................................................................................................................16
Congenitale heupdysplasie...........................................................................................16
Heupluxatie...................................................................................................................17
Coxitis fugax..................................................................................................................17
Ziekte van Perthes.........................................................................................................18
Epiphysiolysis capitis femoris........................................................................................18
Avasculaire femurkopnecrose......................................................................................19

, Bursitis trochanterica....................................................................................................19
Snapping hip..................................................................................................................19
Knieproblemen..................................................................................................................20
Meniscusletsel...............................................................................................................20
Kruisbandletsels............................................................................................................20
Collaterale bandletsels..................................................................................................21
Unhappy triad...............................................................................................................22
Haemarthros.................................................................................................................22
Septische artritis...........................................................................................................23
Corpus liberum..............................................................................................................23
Osteochondritis.............................................................................................................23
Patella tendinitis/Jumper’s knee..................................................................................24
Ziekte van Osgood- Schlatter........................................................................................25
Retropatellaire chondropathie/Runner’s knee/patellofemoraal pijnsyndroom..........25
Habituele patellaluxatie................................................................................................26
Pes anserinus bursitis....................................................................................................26
Bursitis prepatellaris en bursitis infrapatellaris............................................................27
Kniekuilcyste (Bakerse cyste)........................................................................................27
Enkelproblemen................................................................................................................28
Instabiel ligamentair letsel/enkelbandletsel/verzwikking............................................28
Tarsale tunnel syndroom..............................................................................................28
Achillespeesruptuur......................................................................................................28
Tendinitis achillespees..................................................................................................29
Tibial stress syndroom (shin splint)..............................................................................29
Pedes plani....................................................................................................................30
Pedes cavus...................................................................................................................31
Fasciitis plantaris/Hielspoor..........................................................................................31
Klauwtenen...................................................................................................................31
Hamertenen..................................................................................................................32
Hallux valgus en bunion................................................................................................32
Hallux rigidus.................................................................................................................33
Trigger toe (Hallux saltans)...........................................................................................33
Neuralgie van Morton...................................................................................................34
Eeltknobbels (callusknobbels).......................................................................................34
Likdoorns.......................................................................................................................34

,Reumatologie............................................................................................................................35
Reumatoïde artritis.......................................................................................................35
Primaire artrose deformans..........................................................................................37
Ziekte van Bechterew (spondylitis ankylopoetica).......................................................38
Reactieve artritis...........................................................................................................39
Artritis psoriatica...........................................................................................................40
Osteoporose..................................................................................................................40
Polymyalgia rheumatica................................................................................................41
Jicht...............................................................................................................................42
Pseudojicht (CPP- artritis, CPPD)...................................................................................43
Fibromyalgie..................................................................................................................44
Neurologie.................................................................................................................................45
Kenmerken centrale versus perifere aandoening........................................................45
Radiculopathie/radiculair syndroom lumbosacraal......................................................46
Radiculopathie/radiculair syndroom cervicaal.............................................................48
Hernia Nucleus Pulposi.................................................................................................49
N. medianus neuropathie/carpale tunnelsyndroom....................................................50
N. ulnaris neuropathie/ulnaropathie/Cubitale tunnelsyndroom................................50
N. radialis neuropathie..................................................................................................51
N. peroneus/fibularis neuropathie...............................................................................52
N. cutaneus femoralis lateralis neuropathie/meralgia paraesthetica..........................52
Syndroom van Guillain- Barré.......................................................................................53
Diabetische polyneuropathie........................................................................................54
Neurogene claudicatio/wervelkanaalstenose..............................................................54
Myelopathie..................................................................................................................55
Plexopathie...................................................................................................................56
Beroerte/CVA................................................................................................................57
Subarachnoïdale bloeding.............................................................................................59
Ziekte van Parkinson.....................................................................................................60
Benigne essentiële tremor............................................................................................62
Cerebellaire tremor.......................................................................................................62
Amyotrofische laterale sclerose (ALS)..........................................................................63
Multiple Sclerose (MS)..................................................................................................64
Brown- Séquard syndroom...........................................................................................65
Gecombineerde strengziekte als gevolg van vitamine B12 deficiëntie........................66

, Cerebellaire ataxie........................................................................................................67
Spierdystrofie van Duchenne........................................................................................67

Orthopedie
Schouderproblemen
Frozen shoulder
Een sterk verminderde passieve en actieve bewegingsomvang van het glenohumerale gewricht ten
gevolge van een verminderde elasticiteit van het kapsel.

Epidemiologie:
- 40-60 jaar
- Diabetes mellitus +
- Opletten dat CVA patiënten geen frozen shoulder krijgen

Pathofysiologie:
- Primair niet duidelijk
- Secundaire oorzaak:
o Immunologisch
o Trauma
o Inflammatoir
o Endocrien
o Borstchirurgie
o Hand in mitella

Symptomen:
- Fase 1: nachtpijn
- Fase 2: progressieve passieve en actieve bewegingsbeperking
- Fase 3: functie neemt weer toe

Diagnostiek:
- LO:
o Beperking van actieve en passieve beweeglijkheid van glenohumerale gewricht
- Röntgenfoto:
o Niet afwijkend, soms geringe ontkalking van humeruskop
- Artrografisch onderzoek toont verkleind gewrichtvolume en recessus axillaris verkleind

Behandeling:
- Conservatief: pijnmedicatie, ontstekingsremmers en fysiotherapie. Na 6-8 weken minder pijn
en meer beweeglijkheid
- Operatief: schouder passief mobiliseren. Ook chirurgisch kan er een ruimte gemaakt worden
tussen subscapularis en supraspinatus pees.

Subacromiaal pijnsyndroom
Een van de meest voorkomende oorzaken van pijn in de schouder. De pijn komt voor uit een
veroudering, overbelasting of beschadiging va de pezen van de rotator cuff rondom de schouder. Dit
kan leiden tot een ontsteking van de slijmbeurs.

Epidemiologie:
- 40-60 jaar

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