-IBIS-1.5.0-
tx
musculoskeletal system
sprain/strain
diagnoses

definition and etiology

definition:
• sprain: Wrenching or twisting of a joint with partial rupture of its attaching ligaments.
• strain: Overstretching a muscle.

etiology:
Invariably, both conditions are trauma-induced. Of the two, and the terms are often (incorrectly) used interchangeably, the sprain is the more serious. There are three classifications of a sprain:

• Grade 1: Mild/minimal sprain with no ligamentous tear. There may be pain, swelling and tenderness.

• Grade 2: Moderate sprain with an incomplete or partial rupture of ligaments or tendons. There is marked pain, swelling, bruising, decreased ROM and minor instability of the joint.

• Grade 3: Joint injury with complete tearing of the associated ligament. Presents as severe pain, swelling, hemorrhage, significant joint instability and no ROM.

signs and symptoms

signs and symptoms:
• History of trauma.
• Pain.
• Swelling.
• Tenderness.
• Bruising.
• Decreased joint ROM.
• Degree of instability depends on grade.

lab findings and examination:
• (+) orthopedic tests: e.g. drawer sign.
• (+) X-rays in Grade 3 sprains.
• (+) Arthrography of joint: usually only done when a Grade 3 is suspected and surgical correction of the injury may be necessary.
• May see increased ESR if severe.

course and prognosis

Grades 1 and 2 usually present with no healing complications after proper immobilization, physiotherapy (especially hourly icing), and therapeutic movement. A grade 3 sprain is more serious and may be deemed to require surgery, although surgical benefits are debatable.

differential diagnosis

• Fracture.


footnotes