Analysis of Required Investigations of Work-Related Musculoskeletal Disorders in Spain

Musculoskeletal disorders (MSD) are the most common source of occupational health problems in Western countries. In Spain, musculoskeletal disorders (MSDs) can be reported either as accidents or occupational diseases. When reported as an occupational disease, a full diagnosis is performed, as the compensation system needs the approval of the social security authority and a mandatory investigation has to be performed. Although many methods are available for investigating the causes of occupational accidents, occupational diseases have not been analysed with the same depth, and there is a lack of investigation methods. This paper aims to analyse the role of 43 occupational investigations of causes of musculoskeletal diseases in the prevention cycle. This study is based on the occupational investigations performed by workplaces’ occupational health and safety specialists when musculoskeletal diseases are reported. The analysis of the data involves descriptive statistics and the Φ coeffcient. Based on administrative data, 68 workplaces employing 15,260 workers were surveyed and 41 workplaces with 13,201 workers submitted valid questionnaires to be analysed. The most frequent cause of reported musculoskeletal disease, in terms of primary risk, is repetitive movement. The only proposed measure with a significant association to the exposure by repetitive movements is job rotation (alternating workers between tasks within a job or between activities as a means to vary different levels of exposure). The investigation of occupational diseases has been useful in most of the cases for proposing preventive measures. Most of the workplaces surveyed have performed investigations and adopted preventive measures, but the managers of some workplaces were not aware of any disease notification regarding their workers when surveyed. More research is needed to provide tools for this important task

The primary role of radiological imaging in the diagnosis of rare musculoskeletal diseases. Emphasis on ultrasound

Objective: In July 2017 a multidisciplinary clinical Center specialized in rare diseases was activated. A rare disease can involve the musculoskeletal system. A multimodality musculoskeletal imaging approach allows for a rapid diagnosis. The purpose of this study was to assess when musculoskeletal radiology, ultrasound in particular, plays a primary role in the diagnostic path of a rare disease. Methods and materials: The Center included a list of 621 main rare diseases. Pathologies in which radiology has a primary diagnostic role were extracted from the list. From September 2017 to January 2018 all conditions involving the musculoskeletal system, including the peripheral nervous system, were systematically evaluated by one radiologist. The second radiologist, an official consultant of the Center, verified the list for consistency. Descriptive analysis was performed. Results: A total of 101/621 (16%) rare diseases can be diagnosed for the first time in the diagnostic path of the patient with medical imaging. A total of 36/101 (36%) rare diseases involve the musculoskeletal system. A total of 14/36 (39%) are pediatric diseases, 10/36 (28%) are adult age diseases, while 12/36 (33%) diseases affect all ages. A total of 23/36 (64%) of the selected rare diseases could be diagnosed with MRI, 19/36 (53%) with CT, 23/36 (64%) with X-ray, 9/36 (25%) with an US, and 1/36 (3%) with PET. Conclusions: Musculoskeletal imaging could be important for a non-invasive diagnosis in up to 36/101 (36%) rare diseases, as well as for outcome prediction, especially in pediatrics. Musculoskeletal imaging plays a crucial role in the diagnosis of rare diseases and could strongly influence the clinical pathway. Ultrasound is crucial in up to 25% of patients with rare diseases affecting the musculoskeletal system

MUSCULOSKELETAL DISORDERS IN MIDWIVES IN HOSPITALS

The work of the midwives is highly demanding and responsible, as well as associated with significant load on the musculoskeletal system. The aim of the study was to follow the frequency and localization of musculoskeletal disorders and diagnosed diseases of the musculoskeletal system among midwives working in hospitals. Methods The study included 176 midwives with an average age of 48.9 ± 13.1 years working in hospitals in the city of Sofia. An adapted questionnaire was applied to collect information for musculoskeletal symptoms and physician-diagnosed diseases. Data were processed with the statistical package SPSS 20.0.Results and Discussion The incidence of musculoskeletal complaints was high. The most common complaints were in the lower back (67.7%), followed by the back (61.1%), neck (56.3%) and shoulders (50.3%). Diagnosed diseases of the musculoskeletal system were consistent with the complaints. The analysis of the data showed that poor working conditions, frequent work in uncomfortable working postures with bending, twisting and stretching increased the frequency of musculoskeletal complaints.Conclusion The results point to further study of the ergonomic characteristics of workplaces and work movements and the organization of the work process in order to improve working conditions and protect the health of midwives working in hospitals.

Musculoskeletal dysfunction in dental practice

Shows the comparative statistics of diseases of musculoskeletal system, depending on the type of dental reception. Recommendations on prevention of diseases of joints, ligaments and spin

Skeletal Dysplasias Associated with Mild Myopathy—A Clinical and Molecular Review

Musculoskeletal system is a complex assembly of tissues which acts as scaffold for the body and enables locomotion. It is often overlooked that different components of this system may biomechanically interact and affect each other. Skeletal dysplasias are diseases predominantly affecting the development of the osseous skeleton. However, in some cases skeletal dysplasia patients are referred to neuromuscular clinics prior to the correct skeletal diagnosis. The muscular complications seen in these cases are usually mild and may stem directly from the muscle defect and/or from the altered interactions between the individual components of the musculoskeletal system. A correct early diagnosis may enable better management of the patients and a better quality of life. This paper attempts to summarise the different components of the musculoskeletal system which are affected in skeletal dysplasias and lists several interesting examples of such diseases in order to enable better understanding of the complexity of human musculoskeletal system

Immune Mediated Musculoskeletal Disorders of Dogs: An Overview

Immune mediated musculoskeletal diseases are important diseases of dogs which occur due to failure of immunoregulation or to an abnormal immune response. As clinical signs of these disorders overlap with numerous other syndromes of musculoskeletal system, the confirmative diagnosis is difficult. Glucocorticoids are the basis of therapy with adjunct therapy of cytotoxic drugs, chrysotherapy which require continuous monitoring of patient. Generally there is no curative treatment in most of the disorders due to recurrence of disease after withdrawal of treatment

Physical rehabilitation in traumatology and orthopedics

Дисципліна спрямована на формування сучасного мислення та системи спеціальних знань з основ фізичної реабілітації / фізичної терапії при захворюваннях опорно-рухового апарату і умінь щодо організації та проведення реабілітаційних заходів при різноманітних захворюваннях та травмах опорно-рухового апаратуThe discipline is aimed at the formation of modern thinking and the system of special knowledge on the basics of physical rehabilitation / physical therapy in diseases of the musculoskeletal system and skills in organizing and conducting rehabilitation measures in various diseases and injuries of the musculoskeletal systemДисциплина направлена на формирование современного мышления и системы специальных знаний по основам физической реабилитации / физической терапии при заболеваниях опорно-двигательного аппарата и умений по организации и проведению реабилитационных мероприятий при различных заболеваниях и травмах опорно-двигательного аппарат

THE ROLE OF EXTRAGENITAL DISEASES IN THE STRUCTURE OF MATERNAL MORTALITY

In this paper, was analyzed the data of scientific research on the importance of extragenital diseases in the structure of maternal mortality. In the civilized world’s countries, extragenital diseases occupy the first place among the causes of maternal mortality. According to the WHO and many scientists, among the deceased women in childbirth and puerperas, 37.9% died of extragenital pathology, of which 35.3% were respiratory diseases, 14.1% - diseases of the circulatory system, 7.0% - injuries and poisoning, 3, 5% - neoplasms, 2.4% each - some infectious diseases, congenital anomalies; 1.2% each - diseases of the nervous system, digestive organs, musculoskeletal system. Of extragenital pathologies, chronic conditions etiologically unrelated to pregnancy are often found, such as cardiovascular diseases; systemic diseases of the connective tissue; bronchopulmonary diseases; digestive tract diseases; liver disease kidney disease chronic diseases of the blood system; diseases of the nervous system; diabetes and others

Differential diagnosis in children with musculoskeletal pain in Emergency Department

Objective: The study was aimed to analyze the diagnostic approach to a child with a non-traumatic musculoskeletal pain registered in the pediatric Hospital Emergency Department (HED). Since the pandemic COVID-19 affects patient health and the healthcare system, we also evaluated the impact of pandemic on type of musculoskeletal symptoms. Study design: A retrospective cross-sectional study was conducted by statistical analysis of data of patients with non-traumatic musculoskeletal pain registered in HED between January 2018 and December 2020. Data of patients referred and not referred to hospital ward and admitted to HED before and during COVID-19 pandemic have been compared. Results: Majority of patients presented acute, non-trauma related, single-site pain, usually localized in the hip, the knee and the spine. 21,49% of patients were referred to a hospital ward, usually rheumatological, neurological or orthopedic. Final diagnoses in almost ¾ patients belong to the group of musculoskeletal system and connective tissue disorders. During the pandemic significantly less patients with musculoskeletal pain reported to our HED. The duration of symptoms before admission was not significantly longer than in previous years, but the problem in children and the impact of the pandemic on the musculoskeletal system in children is complex. Conclusions: Our study provides detailed information on patterns of pediatric musculoskeletal consultations in HED. A positive history of trauma preceding musculoskeletal pain in a child may only be accidentally related to the final cause. Musculoskeletal pain can be also a symptom of a lot of various systemic conditions, not only diseases of the musculoskeletal system. The still ongoing COVID-19 pandemic may require changes in the organization of the HED. We believe that the presented results can help in organizing and planning care in pediatric HEDs, develop diagnostic algorithms and training for HED staff

Long-term musculoskeletal morbidity after adult burn injury: a population-based cohort study

Objective - To investigate if adults who are hospitalised for a burn injury have increased long-term hospital use for musculoskeletal diseases. Design - A population-based retrospective cohort study using linked administrative health data from the Western Australian Data Linkage System. Subjects - Records of 17,753 persons aged at least 20 years when hospitalised for a first burn injury in Western Australia during the period 1980–2012, and 70,758 persons who were age and gender-frequency matched with no injury admissions randomly selected from Western Australia's electoral roll. Main outcome measures - Admission rates and cumulative length of stay for musculoskeletal diseases. Negative binomial and Cox proportional hazards regression modelling were used to generate incidence rate ratios (IRR) and HRs with 95% CIs, respectively. Results - After adjustment for pre-existing health status and demographic characteristics, the burn cohort had almost twice the hospitalisation rate for a musculoskeletal condition (IRR, 95% CI 1.98, 1.86 to 2.10), and spent 3.70 times as long in hospital with a musculoskeletal diagnosis (95% CI 3.10 to 4.42) over the 33-year period, than the uninjured comparison cohort. Adjusted survival analyses of incident post-burn musculoskeletal disease admissions found significant increases for the 15-year post burn discharge period (0–6 months: HR, 95% CI 2.51, 2.04 to 3.11; 6 months–2 years: HR, 95% CI 1.77, 1.53 to 2.05; 2–15 years: HR, 95% CI 1.32, 1.23 to 1.42). Incident admission rates were significantly elevated for 20 years post-burn for minor and severe burn injury for a range of musculoskeletal diseases that included arthropathies, dorsopathies, osteopathies and soft tissue disorders. Conclusions - Minor and severe burn injuries were associated with significantly increased post-burn incident admission rates, long-term hospital use and prolonged length of stay for a range of musculoskeletal diseases. Further research is required that facilitates identification of at-risk patients and appropriate treatment pathways, to reduce the long-term morbidity associated with burns