Clinical Conditions Flashcards
How does a patient with medial elbow tendinopathy present?
Aching pain over the medial elbow, often associated with the acceleration phase of throwing. Pain is produced on resisted flexion or pronation of the wrist.
Ulnar nerve symptoms are present in up to 20% of cases die to the proximity of the ulnar nerve to the medial epicondyle.
What is psoriatic arthropathy?
Arthritis developed as a result of psoriasis. This is an asymmetrical oligoarthritis,
How does a patient with a pulled elbow present?
Reduced movement of the elbow, pain over the lateral aspect of the proximal forearm. Parents often say that their child is “not using their arm.”
If the radial nerve gets injured in the spinal groove of the humerus, what is the likely distribution of sensory impairment?
The parasthesia is in the distribution of the superficial branch of the radial nerve. (Thumb and two fingers (not tips) and back of hand)
The posterior cutaneous nerve of the arm branches above the spiral groove so it unaffected.
The posterior cutaneous nerve of the forearm branches in the spiral groove so is also usually unaffected.
What is marginal osteophytosis?
This is when the nucleus pulpous dehydrates with age so leads to a decrease in the height of the disc. It also leads to alterations of the load stresses on the joint. Osteophytes therefore develop adjacent to the end plates of the disc.
What is hallux rigidus?
Osteoarthritis of the 1st MTPJ resulting in stiffness. It can also be caused by gout and previous septic arthritis.
How does an elbow dislocation usually occur?
It usually occurs when a young child falls onto an outstretched hand with the elbow partially flexed. This is because, in this position, it is more reliant upon ligaments.
What joints in the hand are most commonly affected by osteoarthritis?
1st CMC joint (between trapezium and 1st metacarpal).
More common in women.
How are most clavicle fractures treated?
Conservatively using a shoulder sling
What is sciatica?
This is the name given to pain caused by irritation or compression of one or more of the nerve roots that contribute to the sciatic nerve (L4, L5, S1, S2).
What is Osgood-Schlatter disease?
This is inflammation of the patellar ligament at the tibial tuberosity.
How do patients with Osgood-Schlatter’s disease present?
Localised pain and swelling.
Patients complain of intense knee pain during running, jumping, squatting, ascending and descending stairs and during kneeling.
Why do most young children appear to be flat footed?
Their arches have not developed fully and there is also a large amount of subcutaneous adipose tissue in the sole of the foot (the medial fat pad). It is only of the deformity persists into adolescence or after recurs during or after adolescence. that it is considered abnormal.
What population develop rheumatoid nodules?
Sufferers of RA who are smokers and have more joint disease. They are also prone to other extra-articular manifestations of RA including vasculitis and lung disease.
What shoulder joint does osteoarthritis most commonly affect?
Acromioclavicular joint (not glenohumeral)
What could cause sciatica?
Marginal osteophytosis
slipped disc
What three ways can pathogens reach the bones and tissues of the spine?
Haematogenous (most common)
Direct inoculation during spinal procedures (e.g. lumbar puncture, epidural or spinal anaesthesia)
Spread from adjacent soft tissue infection.
If a prolapsed intervertebral disc causes a patient to compress the L5 nerve root, what actions and sensory regions will be compromised?
Weakness of dorsiflexion of great toe
Parasthesia of L5 dermatome (lateral leg and dorsum of foot)
What are the most common places to be affected by Duputren’s contracture?
Ring and little finger. But 1st webspace and thumb can also be involved.
What is the most common mechanism of injury of the odontoid process of the axis?
An elderly patient with osteoporosis falling forward and impacting their forehead on the pavement. This hyperextension injury of the cervical spine can result in a fracture of the odontoid peg.
Alternatively, they can be caused by a blow to the back of the head resulting in a hyeprflexion injury e.g. falling against a wall when balance is compromised.
How does a patient with a posterior shoulder dislocation present?
Arm internally rotated and adducted.
They demonstrate flattening / squaring of the shoulder with a prominent coracoid process.
The arm cannot be externally rotated into the anatomical position.
What is the mechanism if injury of a Jefferson’s fracture?
Axial loading.
e.g. diving into shallow water, impacting the head against the roof of a vehicle, falling from playground equipment.
90% of hip dislocations go in which direction?
Posterior. The affected limb will be in a position of flexion, adduction and internal rotation.
How does an upper brachial plexus injury usually occur?
An excessive increase in the angle between the neck and the shoulder:
Trauma
Birth of a baby if the shoulders become impacted in the pelvis and excessive traction is applied to the babies neck.
What are the symptoms of myelopathy?
Global muscle weakness. gait dysfunction, loss of balance and/or loss of bowel and bladder control. They arise due to compression and dysfunction of the ascending and descending tracts within the spinal cord.
What is gouty tophi?
Nodular masses of monosodium urate crystals deposited in the soft tissues.
They are a late complication of hyperuricaemia and develop in over 50% of patients with untreated gout.
They are usually painless.
What are the short term consequences of compartment syndrome?
Increase in intracompartmental pressure
Decreased perfusion of muscle
Ischaemic muscle releases mediators which further increase capillary permeability and exacerbate the rise in pressure.
If severe, rhabdomyolysis (muscle necrosis) and acute kidney injury can occur.
In what population are supracondylar fractures most common?
5-7 year old boys.
90% of supracondylar fractures occur in children under 10
What is a Swan neck deformity?
This the PIPJ hyperextends and MCPJ and DIPJ are flexed. It is thought to resemble the neck of a swan. (opposite to Boutonniere)
The tissue on the solar (palmar) aspect of PIPJ becomes lax (synovitis).
At DIPJ - rupture or elongation of insertion of extensor digitorum into base of proximal phalanx. This causes a mallet deformity.
What is it called when the nucleus pulposus herniates posteriolaterally?
Paracentral prolapse.
It occurs in 96% of cases of prolapse.
How could the superficial peroneal nerve be damaged?
Fractures of the proximal fibula or penetrating injury to the lateral leg.
Ankle arthroscopy or during a lateral approach to surgery on the ankle joint.
How does a patient with Heberden’s nodes present?
Start - chronic swelling or sudden pain, swelling and loss of manual dexterity.
Then - cystic swelling containing gelatinous hyaluronic acid on dorsolateral DIPJ.
Initial inflammation and pain subside and patient is left with an osteophyte
How do ankle sprains occur?
They usually occur through excessive stress on the ligaments of the ankle. e.g. through excessive external rotation, inversion or eversion of the foot caused by an external force.
When the foot is moved past its range of motion, the excess stress puts a strain on the ligaments. If the strain is great enough to the ligaments pass the yield point, then the ligament becomes damaged or sprained.
What is the only ‘cure’ for osteoarthritis of the hip?
A Total Hip Replacement.
This operation replaces the damaged surfaces with implants and helps to relieve pain and restore mobility.
What is a Smith fracture?
Fractures of the distal radius with solar (palmar) angulation of the distal fracture fragment(s).
What is a peg fracture?
This is a fracture of the odontoid process.
How do you treat an intracapsular #NOF?
Surgical replacement of the femoral head. This is due to the high risk of avascular necrosis - especially in displaced fractures.
In what part of the clavicle do most fractures occur?
80% of the fractures occur in the middle third of the clavicle
What is the pain distribution of S1 sciatica?
Posterior thigh, posterior calf, heel, sole of foot
What parts of the scaphoid are most commonly fractured?
Waist of scaphoid (70-80%)
Proximal pole (20%)
Distal pole / scaphoid tubercle (10%)
If you paralyse the median nerve at the elbow (e.g. with a supracondylar fracture), what actions will no longer be possible or be weak?
Flexion of the wrist Pronation Flexion of the thumb Opposition Palmar abduction Flexion of index and middle finger. (Hand of Benediction)
Also sensory loss in whole region supplied by the median nerve.
What causes the ACL to tear?
The ACL is usually torn as a result of a quick deceleration, hyperextension or rotational injury that does not involve contact with another individual. This injury often occurs with a sudden change of direction.
It can also be torn by the application of a large force to the back of the knee with the joint partly flexed.
How does a patent with septic arthritis present?
Symptoms of triad:
-Fever
-Pain
-Reduced range of motion
Symtoms evolve over few weeks-days. The fever is low grade with riggers present sometimes.
Joint examined for erythema (redness), swelling, warmth tenderness, limitations of active and passive range of movement.
What is the most common cause sciatic nerve entrapment in piriformis syndrome?
Spasm of the piriformis muscle, usually due to overuse or direct trauma.
But, anatomical variations between nerve and muscle can also lead to nerve compression and piriformis syndrome.
What muscle waste in long standing carpal tunnel syndrome?
Thenar muscles.
Where exactly does medial elbow tendinopathy most commonly occur?
In the interface between the pronator trees and the flexor carpi radialis origins,
Where does gouty trophi most commonly occur?
Fingers and ears.
But, can also occur in the olecranon bursa and the subcutaneous tissues of the elbow.
How do patients with a femoral shaft fracture present?
The patient will have a tense, swollen thigh.
The blood loss in closed femoral shaft fractures is 1000-1500ml and the patient may have hypovolaemic shock. The blood loss in an open femoral fracture may be double this amount.
What is the ulnar paradox?
The ulnar claw is less pronounced if you have a low ulnar nerve injury compared to one at the elbow.
This is because FDP is paralysed so there is no flexion at the DIPJs of the ring and little finger so the ulnar claw will only consist of hyperextension a the MCPJs and flexion at the PIPJs.
How would a patient paralyse the ulnar nerve at the elbow?
Medial epicondyle fracture or compression in the cubital tunnel.
What are the main complications of supracondylar fractures?
Malunion - causes cubitus varus (gunstock deformity)
Nerve damage - Ulnar (most common), medial or radial.
Ischaemic contracture
How can an injury to the median nerve at the wrist occur?
Penetrating injury
Compression of the carpal tunnel
How does cervical spondylosis lead to myelopathy?
If the degenerative process leads to narrowing of the spinal canal, this may instead put pressure on the spinal cord.
This is less common than radiculopathy.
What causes cervical myelopathy?
Caused by degenerative stenosis of the spinal canal caused by spondylosis (degenerative arthritis).
Or, congenital stenosis of the spinal canal (which is often asymptomatic until adulthood when age-related secondary degeneration starts to occur),
cervical disc herniation,
spondytolosthesis (anterior slippage of a vertebral body on the vertebra below),
trauma,
tumour and
RA affecting the cervical spine.
What is the usual mechanism of injury of a patella dislocation?
Internal rotation of the femur on a planted foot whilst flexing the knee (e.g. in a sudden change of direction in sports)
Why can whiplash lead to injury to the cervical cord?
The cervical spine is highly mobile and ligaments and capsule of the joints are weak and loose. Hence, there may be significant movement of the vertebrae (e.g. subluxation or dislocation)at the time of impact, with return to the normal anatomical position afterwards.
What is cervical spondylosis?
A chronic degenerative osteoarthritis affecting the intervertebral joints in the cervical spine.
What is Horner’s syndrome?
Damage to the sympathetic trunk leading to miosis (decreased pupil size), partial ptosis (drooping eyelid) and anyhydrosis (decreased sweating on the affected side of the face)
What is a frozen shoulder>
This is adhesive capsulitis. This is a painful and disabling disorder in which the capsule of the glenohumeral joint becomes inflamed and stiff, greatly restricting movement and causing chronic pain.
What causes femoral shaft fractures in the elderly?
In the elderly with osteoporotic bones or in patients with metastases or other bone lesions (cysts), femoral shaft fractures can occur following a low velocity injury such as falling over from the standing position.
In what direction do patella dislocations most commonly occur?
Laterally.
How does a patient with carpal tunnel syndrome present?
Paraesthesia in median nerve distribution.
Symptoms worse at night (wrist in flexion so make carpal tunnel even smaller), this often wakes the patient up.
As gets worse, daily activities such as driving and brushing hair can aggravate paraesthesia.
Explain ischamic contracture than can be caused by a distal supracondylar fracture of the humerus.
The brachial artery is occasionally damaged or occluded by a displaced fracture. If the reflex spasm of the collateral circulation around the elbow also occurs then there will be ischaemia of the muscles in the anterior compartment of the forearm.
This results in oedema and compartment syndrome which makes the ischaemia worse because it stops the arterial inflow.
If untreated, the muscle bellies will undergo infarction.
During the repair phase, dead muscle tissue becomes replaced by scar tissue through fibrosis, the fibrotic tissue contracts (Myofibroblast activity) eventually resulting in a flexion contracture known as Volkmann’s ischaemic contracture.
What is the classic presentation of a patient with cervical myelopathy?
loss of balance with poor coordination, decreased dexterity, weakness, numbness and in severe cases, paralysis,
Pain is a symptom in many patients, but it may be absent which can lead to a delay in diagnosis.
How will a patient with a dislocated shoulder present?
The patients shoulder will be visibly deformed and there may be swelling and / or bruising around the shoulder. Movements of the shoulder will be severely restricted.
What rotator cuff tendon is most frequently torn?
Supraspinatus tendon where it passes beneath the coracoaromial arch, tearing at the site of its insertion into the greater tubercle of the humerus.
If you paralyse the median nerve at the elbow (e.g. with a supracondylar fracture), what muscles will be paralysed?
Pronator teres Flexor carpi Radialis Palmaris Longus Flexor digitorum And allotter muscles supplied by median nerve in the forearm and hand.
When is the saphenous vein vulnerable to injury?
During its subcutaneous course int he medial leg.
Saphenous vein cutdown (for emergency venous access) or orthopaedic surgery to the distal tibia or medial malleolus can damage the nerve.
Other than age related degeneration, what are some other risk factors for rotator cuff tears?
Lifting
Repetitive overhead activity
Sports that involve repeated overhead motion eg. swimming, volleyball, tennis..)
What does the hyeprflexion-hyperextension injury of whiplash lead to?
It leads to tearing of cervical muscles and ligaments. Secondary oedema, haemorrhage and inflammation may occur. The muscles respond to injury by contraction (spasm) with surrounding muscles being recruited in an attempt to splint the injured muscle.
How does a patient with osteoarthritis in the hand present?
Pain at the base of their thumb.
Worse when moving and relieved by rest.
Stiffness increases after rest (e.g. morning)
Some swelling around base of thumb
What is the pathology of cervical spondylosis?
Age-related disc degeneration followed by marginal osteophytosis (osteophyte formation adjacent to the end plates of the intervertebral disc).
What direction does the nucleus pulpous commonly herniate?
Posteriolaterally (lateral to the posterior longitudinal ligament). This causes compression of a spinal nerve root within the intervertebral foramen.
What is a Colles’ fracture?
An extra-articular fracture of the distal radial metaphysis, with dorsal angulation and impaction.
What is the mechanism of injury of a tibial plateau fracture?
A varus or valgus load (abnormal medial or lateral flexion load) to the knee, with or without an accompanying axial load (top to bottom load).
What causes cervical spondylotic myelopathy?
Degenerative changes which develop with age, including ligamentous flavum hypertrophy or buckling, facet joint hypertrophy, disc protrusion and osteophyte formation.
What is the most common type of knee injury?
Meniscal injuries
What are the long term consequences of compartment syndrome?
Rhabdomyolysis can result in acute kidney injury which may become chronic.
The necrotic muscle may also undergo fibrosis leading to Volkmann’s ischaemic contracture.
If a patient damages the superficial peroneal nerve, what will be absent?
Loss of active eversion of the midfoot
Loss of sensation over distal anterolateral leg and dorsum of the foot, excluding first webspace.
What is the most common cause of a patella dislocation?
Trauma. Often a twisting injury or a direct blow to the knee.
What can cause an oblique fracture of the medial malleolus?
AN injury that results in adduction or inversion of the foot can push the medial malleolus off the tibia (an oblique fracture) and pull on the lateral structures, leading to ruptured lateral ligaments or a transverse fracture of the lateral malleolus.
What is a Jefferson’s fracture?
A Jefferson’s fracture is a fracture of the anterior and posterior arches of the C1 vertebrae (atlas).
What is the mechanism of injury of the cervical intervertebral disc prolapse?
A tear develops in the annulus fibrosus of the disc, and the nucleus pulposus protrudes from the disc, when the impingement onto adjacent nerve root or the spinal cord.
What are the three common causes of swelling around the elbow?
Olecranon bursitis
Rheumatoid nodules
Gouty trophi
What is the most common form of impingement syndrome? What are the symptoms of this?
Impingement of the supraspinatus tendon under the acromion, during abduction of the shoulder.
This creates a painful arc of abduction, especially between 60 and 120 degrees of abduction. E.g. pain when reaching up to brush hair or living a food can from an overhead shelf.
What are some complications of gouty trophi?
Pain Soft tissue damage Deformity Joint destruction Nerve compression
What is septic arthritis?
This is the invasion of joint space my miscro-organisms, usually bacteria (but occasionally viruses, mycobacteria and fungi). It differs from reactive arthritis which is a sterile inflammatory process that can result from an extra-articular infection e.g. gastroenteritis.
What are the symptoms of radiculopathy?
Dermatomal sensory symptoms (parasthesia, pain) and myotomal motor weakness.
In what population does osteoarthritis most commonly occur?
It more commonly occurs in men than women (4:1) and is most common in manual workers and athletes who engage in sports that involve throwing.
What is the most common mechanism of a supracondylar fracture?
Falling from a moderate height onto an outstretched hand with the elbow hyperextended. e.g. child falling off monkey bars.
How does a patient with pre-patellar bursitis present?
Knee pain and swelling. Also some erythema overlying the inflamed bursa. The patent will find it difficult to walk due to the pain, and will not be able to kneel on the affected side.
How does a patient with a meniscal injury present?
Intermittent pain, localised to the joint line, alongside reports of the knee clicking, catching, locking or a sensation of giving way.
Swelling usually occurs as a delayed symptom or not at all as the menisci are largely avascular.
What is Dupuytren’s contracture?
It is a common condition in which there is localised thickening and contracture of the palmar aponeurosis leading to a flexion deformity of the adjacent fingers.
In what circumstances does OA of the ankle joint usually occur?
70%-80% of cases -a joint that has previously suffered trauma (e.g. fracture of severe sprain). This is known as post-traumatic arthritis.
12% cases 0 underlying medical condition e.g. RA
10% - no underlying precipitating cause. Known as primary ankle arthritis.
When will an X-ray show a schaphoid fracture?
Not always immediately.
Repeat x-ray 10-14 days later
If still not shown use CT or MRI
Delayed diagnosis is common
What does varus mean?
Medial angulation of the distal segment.
What is Osgood-Schlatter’s disease?
OSD is inflammation of the patellar ligament at its insertion into the tibial tuberosity.
When is calcific supraspinatus tendonitis most painful?
During the stage when they are resorbed by phagocytes. In this stage, they appear macroscopically like toothpaste and often appear cloudy on X-Rays.
What is the most common joint affected by septic arthritis?
Knee joint (50% of cases)
What factors can predispose to a patella dislocation?
Weakness of the quadriceps muscle, especially vests medals obliquus.
Shallow patella groove (in the femur).
Patellofemoral joint hypermobility or maltracking.
What is the most common cause of rotator cuff tears?
Age-related degeneration.
With are the blood supply to the rotator cuff tendons decreases, imparting the bodies ability to repair minor injuries.
This is the degenerative-mocrotrauma model.
How does a patient with common fibular nerve injury present?
Foot drop - paralysis of tibias anterior and long extensors of the toes
Inversion of the anke - paralysis of peroneus longs and brevis
Loss of sensation on lateral side of leg and dorsally not
What are the root values of the common peroneal nerve?
L4-S2
What is cervical myelopathy?
This is a condition caused by narrowing of the spinal nerve (vertebral) canal leading to cord dysfunction due to compression of the cord.
How do clavicle fractures occur?
From falls onto the affected shoulder or onto the outstretched hand.
What can cause an oblique fracture of the lateral malleolus?
An injury that results in either eversion or external rotation of the foot can push the lateral malleolus - potentially leading to an oblique fracture.
How does supra patellar bursitis present?
This is an extension of the synovial cavity of the knee joint. A knee effusion therefore often presents with swelling in the supra patellar pouch.
What percentage of people with diabetes suffer from foot diseases?
15% This includes, infection, ulceration or destruction of the tissue of the foot. Also loss of sensation due to peripheral neuropathy, ischaemia due to peripheral arterial disease or a combination of these may lead to foot ulcers and other complications.
What are the most common causes of deep peroneal mononeuropathy?
Motor neurone disease Diabetes Ischaemia Vasculitis Injured during total knee displacement
If the sciatic nerve were completely transected (divided) in the buttock, what effect would this have on the movement and sensation of the lower limb?
Movements of the hip normal
Hamstrings paralysed but patient could still extend the hip though strong action go gluteus maximus.
Knee extension unaffected
Active knee flexion would be absent as almost all are supplied by the sciatic nerve
Dorsiflexion and plantar flexion of the ankle and inversion and eversion of the mid foot would be paralysed as would all movements of the toes.
What are the risk factors for septic arthritis?
Extremes of age Diabetes Mellitus Rheumatoid Arthritis Immunosuppression IV drug use Prosthetic joints due to operation contamination.
Where does the lateral cutaneous nerve of the thigh originate from?
Lumbar plexus - dorsal divisions L2,L3.
It emerges from the lateral border of posts major on the posterior abdominal wall and travels across the iliac fossa, on the surface if the iliacus muscle, it piece the lateral aspect of the inguinal ligament.
Why does a pulled elbow commonly occur in young children?
Because as children age, the annular ligament strengthens.
How does a patient with Duputren’s contracture present?
Thickening or nodule in their palm - painful or painless.
Later, myofibroblasts within the nodule contract leading to the formation of tight bands called ‘cords’ on the palmar fascia.
The overlying skin is tightly adherent to palmar aponeurosis and becomes involves int he disease, which also progresses to the proximal fascia and skin of the fingers.
The fingers become stuck in a flexed position and cannot be passively straightened.
What is piriformis syndrome?
Sciatica like symptoms that do not originate fro compression of the spinal nerve roots, but instead are due to compression of the sciatic nerve by piriformis muscle.
Does a Jefferson’s fracture cause neurological symptoms?
No, the fracture bursts open like a polo. This ‘bursting open’ reduces the likely hood of impingement on the spinal cord. This fracture therefore typically causes pain but no neurological symptoms.
What artery may become involved if there is severe displacement of a distal femoral fracture?
Popliteal artery
What is the unhappy triad?
This is an injury to the anterior cruciate ligament, medial collateral ligament and medial meniscus.
How does a lower brachial plexus injury usually occur?
This usually occurs due to forced hyperextension ir hyperabduction such as when someone falls from a height and grasps a tree branch on the way down.
It can also occur if a babies arm is delivered first and traction is applied.
How does cervical spondylosis lead to radiculopathy?
Narrowing of the intervertebral foramina can put pressure in the spinal nerves leading to radiculopathy
What can cause injury to the common fibular nerve?
Prolonged bed rest
Pressure from a tight plaster cast
Poorly placed stirrups in the operating theatre
Fracture of the neck of the fibula. (Most commonly injured when it wraps around the head of the fibula)
What collateral ligament is more common injured?
Medial collateral ligament.
What does subluxation mean?
Partial disruption of a joint with some remaining but abnormal position of the articular surfaces.
What is student’s elbow?
Olecranon bursitis
What injuries are associated with inferior shoulder dislocations?
Damage to nerves
Rotator cuff tears
Injury to blood vessels
When does a posterior shoulder dislocation occur?
They occur when there is a violent muscle contraction due to an epileptic seizure, electrocution or a lightning strike; when there is a blow to the anterior shoulder or when the arm is flexed across the body and pushed posteriorly.
In what direction will the proximal bone fragment go in a femoral shaft fracture?
The proximal fragment is abducted due to the pull of gluteus medius and minimus on the greater trochanter, and flexed due to the action of iliopsoas on the lesser trochanter.
What will happen to the position of the arm and clavicular fragments in a displaced mid-clavicular fracture (fracture at the mid-point of the clavicle)?
The sternocleiodomastoid muscle elevates the medial segment
Because the trapezius muscle is unable to hold the lateral segment up,
and also because of the weight of the upper limb, the shoulder drops
The arm is pulled medially by pectoralis major (adduction).
What is Erb’s Palsy?
Injury to the superior nerve roots of the brachial plexus. It leads to the arm being in a waiters tip position.
What causes femoral shaft fractures in children and young adults?
High velocity trauma - falls from a height, road traffic collisions.
Child abuse should also be considered in young children.
How is the sciatic nerve in the buttock most commonly damaged?
Stab wounds
Misplaced intramuscular injections
When do you loose peripheral pulses in compartment syndrome?
When the compartment pressure exceeds the systolic arterial pressure. This will also lead to increased capillary refills time.
What is a pulled elbow?
Subluxation of the radial head.
How does a patient with psoriatic arthritis present?
The patient presents with fusiform (sausage shaped) swelling of the digits (dactylitis). The affected joints stiffen and if can progress to widespread joint destruction known as arthritis mutilans.
How does spread of infection into the spinal canal lead to neurological damage?
- Septic thrombosis leading to ischaemia
- Compression of neural elements by abscess / inflammatory tissue
- Direct invasion of neural elements by inflammatory tissue
- Mechanical collapse of bone leading to instability, particularly in chronic infections.
What is a tibial plateau fracture?
This is a fracture affecting the articulating surfaces of the knee joint. They can be unicondylar ir bicondylar. Fractures affecting the lateral tibial coney are most common.
Other than recurrent dislocations, what are the other common complications of shoulder dislocations?
Axillary artery damage
Axillary nerve damage (10-40% of shoulder dislocations). This is because the axillary nerve wraps around the head of the humerus.
Fractures (in 25% of shoulder dislocations)
Rotator cuff muscle tears
