MSK pathology (LL 2) Flashcards
What is plantar fasciitis?
enthesitis at the insertion of the tendon into the calcaneum
symptoms are localised pain on walking/standing and midline tenderness
What causes plantar fasciitis?
can occur alone or in seronegative spondyloarthropathy
What is the management of plantar fasciitis?
Heel pads
Reduced walking
Splint to hold the foot dorsiflexed and stretch the plantar fascia is preferable to a corticosteroid injection
What is subcalcaneal bursitis?
pressure induced bursa that produces pain and tenderness under the heel
compression
compression of the heel from the sides is painful which distinguishes it from plantar fasciitis
How is subcalcaneal bursitis managed?
heel pads
reduced walking
What is Achilles enthesitis?
pain at insertion of the Achilles tendon into the calcaneus
raising the shoe heel causes pain
traumatic or complicates spondyloarthritis
What is the management of Achilles enthesitis?
low pressure corticosteroid injection near the enthesis
What is enthesitis?
inflammation of the entheses (the site where the tendons or ligaments insert into the bone)
What is Achilles tendonosis?
causes a painful tender swelling a few cm above the tendons insertion
How is Achilles tendonosis managed?
advise against walking barefoot or jumping
therapeutic US may be useful
(Local injection may cause the tendon to rupture!!)
What is Achilles bursitis?
lies clearly anterior to the tendon and can be safely injected with corticosteroid
What are the differentials for a patient presenting with muscle stiffness and pain?
normal response to strenuous exercise polymyalgia rheumatica rheumatica arthritis ankylosing spondylitis primary muscle disease primary hypothyroidism early manifestation of occult malignancy
What are the differentials for polyarthritis?
viruses rheumatoid arthritis sjoren's syndrome associated diabetes mellitus, hypothyroidism rheumatic fever SLE Ulcerative colitis Crohn's disease Drug reaction Reiter's syndrome Psoriasis
