1. Musculoskeletal Pathology and injuries 1. pain after specific use 2. pain at start of activity resolving with warm-up 3. Pain during and after specific activity which does not affect performance 4. Pain during and after specific activity which does affect performance 5. Pain with activities of daily living 6. Dull or aching pain at rest which does not disturb sleep 7. Dull aching pain that disturb sleep

2. Systemic and musculoskeletal pain Systemic pain Systemic pain Disturb sleep Disturb sleep Deep aching or throbbing pain reduced by pressure Deep aching or throbbing pain reduced by pressure Constant or waves of pain and spasm associated with low grade fever, jaundice, skin rash, generalized weakness, history of infection Constant or waves of pain and spasm associated with low grade fever, jaundice, skin rash, generalized weakness, history of infection Cyclic and progressive symptoms Cyclic and progressive symptoms

3. Musculoskeletal pain Generally lessens at night Generally lessens at night Sharp or superficial ache decreased with cessation of activity Sharp or superficial ache decreased with cessation of activity Continuous or intermittent Continuous or intermittent Aggravated by mechanical stress Aggravated by mechanical stress Usually no specific cause Usually no specific cause

4. Red flags that indicates need medical consultation 1. Sever unremitting pain 2. Pain not affected by medication or position 3. Sever pain with no history of injury 4. Sever spasm not relieved by resting and modalities

5. Muscle strains (contractile tissues)

6. Tendon sprain

7. Bone injuries different types of fractures Transverse fracture Transverse fracture Oblique fracture Oblique fracture Spiral fracture Spiral fracture Comminuted fracture Comminuted fracture Segmental fracture Segmental fracture Butterfly fracture Butterfly fracture Epiphysial fracture Epiphysial fracture Pathological fracture Pathological fracture

10. Singes and symptoms of fractures Pain and tenderness Pain and tenderness Abnormal movement in the limb Abnormal movement in the limb Deformity Deformity Edema Edema Ecchymosis (Bruising) around the fracture Ecchymosis (Bruising) around the fracture Loss of general functions Loss of general functions Loss of normal mobility Loss of normal mobility

11. Bone pathology (Diseases) 1. Congenital hip dysplasia (CHD) or Developmental Dysplasia of the Hip(DDH) Can be unilateral or bilateral, It may come in three levels Can be unilateral or bilateral, It may come in three levels unstable hip dysplasia unstable hip dysplasia Subluxation or incomplete dislocation Subluxation or incomplete dislocation Complete dislocation Complete dislocation

12. Osgod-Schlatter Disease (OS) fibers of patellar tendon pulling small bits of immature bone from the tibia tubersity. fibers of patellar tendon pulling small bits of immature bone from the tibia tubersity. This case is seen more in active adolescent boys (10-15 Y). It is as a result of repeated micro injuries to the base of tibia tubersity which results in building new calcification at the insertion of patella band. This case is seen more in active adolescent boys (10-15 Y). It is as a result of repeated micro injuries to the base of tibia tubersity which results in building new calcification at the insertion of patella band.

13. Osteogenesis Imperficta (OI) some times called brittle bones some times called brittle bones It is a rare congenital disorder of collagen synthesis affecting bones and connective tissue. It is a rare congenital disorder of collagen synthesis affecting bones and connective tissue.

14. Legg-calve-Perthes disease Also known as Coxa plana Also known as Coxa plana It is a vascular necrosis of the proximal femoral epiphysis with flattening of femur head and decreased in size. It is a vascular necrosis of the proximal femoral epiphysis with flattening of femur head and decreased in size. leg shortening, and hip displacement may occur with this case. leg shortening, and hip displacement may occur with this case.

15. Metabolic disorders in the bone Osteoporosis It is a group of disorders which have as their common dominator a reduction of bone mass per unit of bone volume, the clinical manifestation appears in back pain, joints pain, and fractures. It is a group of disorders which have as their common dominator a reduction of bone mass per unit of bone volume, the clinical manifestation appears in back pain, joints pain, and fractures.

16. Osteoporosis It classified into two groups It classified into two groups 1. Primary osteoporosis: it is idiopathic, which occur in children with normal gonadal function and old like postmonoposal and senile patients. 2. Secondary osteoporosis: this occur secondary to other disease like hyperthyroidism

17. Osteomalacia It is a softening of the bone without loss of bone matrix. It is a softening of the bone without loss of bone matrix. Generalized bone condition, in which insufficient mineralization of the bone matrix. Generalized bone condition, in which insufficient mineralization of the bone matrix. Bone fracture is the main manifestation, special care need to be given during bone surgeries, and post surgery rehabilitation. Bone fracture is the main manifestation, special care need to be given during bone surgeries, and post surgery rehabilitation.

18. paget's disease or Osteitis deformans It is a progressive disorder of the adult skeletal system marked by abnormal bone remodeling. It is a progressive disorder of the adult skeletal system marked by abnormal bone remodeling. It cause abnormal joint degeneration and modeling and cause joints pain. It cause abnormal joint degeneration and modeling and cause joints pain.

19. Infectious disease of the musculoskeletal system Osteomyelitis It is an inflammation of bone caused by an infectious organism (bacteria, viruses, fungus. Acute or chronic, it may related to injuries, fractures, and post surgeries. It is an inflammation of bone caused by an infectious organism (bacteria, viruses, fungus. Acute or chronic, it may related to injuries, fractures, and post surgeries. It results in destruction of the infected bone and malunion of fractures.like tuberculosis It results in destruction of the infected bone and malunion of fractures.like tuberculosis

20. Septic arthritis Infection of joints surface by microbial organs cause joint destruction, like diplococus bacteria. Infection of joints surface by microbial organs cause joint destruction, like diplococus bacteria.