MSK Pathology 1 Flashcards
Achilles tendonitis: most often impacted in this area
Avascular zone 2-6 cm above insertion of the tendon
Activities frequently associated with Achilles tendonitis:
Running
Basketball
Gymnastics
Dancing
S/s of Achilles tendonitis
- Aching/burning in posterior heel
- Tenderness over tendon
- Pain with increased activity
- Swelling/thickening in the tendon area
- Mm weakness due to pain
- Morning stiffness
Adhesive capsulitis: soft tissue contracture causes loss of
Active/passive shoulder ROM
Adhesive capsulitis is caused by fibrosis and scarring between the:
- capsule
- rotator cuff
- subacromial bursa
- deltoid
Adhesive capsulitis: traumatic onset?
May be related to direct injury to shoulder or could be insidious
Adhesive capsulitis: peak incidence
40-60 yrs old
Female
Adhesive capsulitis: course
Typically self-limiting and resolves in 1-2 years
*some people have residual loss of motion
Adhesive capsulitis: s/s
- insidious onset of pain, often extending down the arm
- stiffness
- night pain
- restricted ROM in capsular pattern
Adhesive capsulitis: tx considerations
avoid overstretching and elevating pain (can results in further loss of motion)
ACL sprain: etiology
Noncontact twisting injury associated with hyperextension, varus, or valgus stress to the knee
ACL sprain: often involves other knee structures
- medial capsule
- MCL
- meniscus
ACL sprain: conservative tx
Strengthening, esp hamstrings/quads
ACL sprain: surgical graft sites
- patellar tendon
- IT band
- HS tendon
ACL sprain: derotation brace
May be useful for pts with ACL deficient knee, but limited benefit following surgical reconstruction
What is congenital hip dysplasia?
- Malalignment of the femoral head in the acetabulum
- develops during third trimester
Congenital hip dysplasia:
Testing for the condition
- Ortolani’s test
- Barlow’s test
- dx ultrasound
Congenital hip dysplasia: clinical presentation
- asymmetrical hip abduction
- tightness and apparent femoral shortening of the involved side
Congenital hip dysplasia: treatment dependent on age and initial attempts to reposition the femoral head
- Constant use of harness, bracing, splinting, or traction
- may require open reduction and hip spica cast if conservative mgmt fails
- will require PT after cast removal for stretching/strengthening/family education
Congenital limb deficiency: types
Longitudinal
Transverse
Congenital limb deficiency: longitudinal
Reduction or absence of an element/s within the long axis of the bone
Congenital limb deficiency: transverse
Limb has developed to a particular level beyond which no skeletal elements exist
Congenital limb deficiency: etiology
- Idiopathic/genetic in origin
- Possibly due to poor blood supply, constricting amniotic bands, infection, maternal drug exposure
Congenital limb deficiency: focus of therapy
- symmetrical movements
- strengthening/ROM
- WB activities
- prosthetic training when appropriate
Congenital torticollis: characterized by
Unilateral contracture of SCM
Most commonly seen in first 2 months of life
Congenital torticollis: etiology
May be associated with malpositioning in utero (i.e. breech) and birth trauma
Congenital torticollis: s/s
- Lateral cervical flexion to same side as contracture
- rotation toward opposite side of contracture
- facial asymmetries
Congenital torticollis: surgical mgmt?
Only when conservative methods have failed and the child is over 1 year
