lower limb bone and joint pain Flashcards
CASE 1: Mdm GLK is a 55 year old housewife and she complains of right
knee pain over the medial side for 2 weeks. It is exacebated
whenever she walks up and down stairs
* There was tenderness along the medial aspect of the right knee,
below the medial joint line at the pes anserine bursa.
How do you differentiate between medial and per anserine bursitis?
Palpate both areas.
Tenderness at medial joint line: Medial Bursities
Tenderness below joint line: Per anserine bursitis
CASE 1: Mdm GLK is a 55 year old housewife and she complains of right
knee pain over the medial side for 2 weeks. It is exacebated
whenever she walks up and down stairs
* There was tenderness along the medial aspect of the right knee,
below the medial joint line at the pes anserine bursa.
What are the three tendons of bursa?
Sartorius
Gracilis
semiTendous
Sip Good Tea
CASE 2: Mdm LFS is a 45 year old CEO of a multinational
company. She complains of bilateral sole pain for
2 months which is progressively worse. It was
exacebated when she wears high heel shoes.
* Clinically there is pes planus noted on both feet.
She is unable to repeat stand on tip toes for 10
cycles as she feels fatigue in her calf muscles.
Where is the problem?
Muscles
CASE 2: Mdm LFS is a 45 year old CEO of a multinational
company. She complains of bilateral sole pain for
2 months which is progressively worse. It was
exacebated when she wears high heel shoes.
* Clinically there is pes planus noted on both feet.
She is unable to repeat stand on tip toes for 10
cycles as she feels fatigue in her calf muscles.
Which calf muscle is weak?
Posterior Tibialis Muscle
What does posterior tibiliais insufficiency lead to?
1) Transverse tarsal joints
fail to lock
2) Failure of whiplesh
mechanism
3) Lead to hind foot vulgus
deformity
4) Gastronemus tighten to help with toe off
CASE 2: Mdm LFS is a 45 year old CEO of a multinational
company. She complains of bilateral sole pain for
2 months which is progressively worse. It was
exacebated when she wears high heel shoes.
* Clinically there is pes planus noted on both feet.
She is unable to repeat stand on tip toes for 10
cycles as she feels fatigue in her calf muscles.
Treatment?
Strengthening of muscle
Mr TKW is a 66 year old retired bartender. He has a history
of diabetes mellitus, hyperlipidaemia, hypertension and
ischaemic heart disease with irregular heart beats (atrial
fibrillation). He complains of sudden onset of severe pain
in his right ankle while having dinner.
* Examination reveals a pale looking right foot. There was no
tenderness over the joints of the foot. Movement of the
ankle joint was only slightly painful. His dorsalis pedis and
posterior tibial arteries are not palpable.
What is the problem?
Blood Vessels: Embolism
(Results in a pale foot)
