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MSK > O: Tendinopathies > Flashcards

O: Tendinopathies Flashcards

1
Q

general aetiology of tendinopathies?

A

intrinsic: age, gender
extrinsic: trauma, repetitive injury, drugs (steroids, ciprofloxacin)

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2
Q

mx for tendinopathies?

A

conservative: rest, analgesia, physio, splinting
mx: debridement, synovectomy, tendon transfer

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3
Q

upper limb tendinopathies…

A 
RC tendonosis 
bicep tendinopathy 
epicondylitis 
De Quervain's Tenosynovitis 
EPL rupture 
Trigger finger
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4
Q

what are the 4 muscles of the RC?

A

subscapularis, infraspinatous, supraspinatous, teres minor

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5
Q

s/s of RC tendonosis?

A

achy pain down arm/neck/ shoulder, difficulty sleeping on affected side, reaching overhead and arc are painful

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6
Q

ix for RC tendonosis?

A

+ve impingement tests, USS, MRI

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7
Q

aetiology of bicep tendinopathy?

A

overuse, trauma

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8
Q

which Bicep tendon is more prone to injury?

A

long head rupture

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9
Q

s/s of bicep tendonopathy?

A

pain anterior shoulder that radiates to elbow, swelling, possible bulge felt

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10
Q

mx for bicep tendinopathy?

A

long head= leave alone

distal bicep tendon rupture= surgical

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11
Q

types of epicondylitis

A 
lateral humeral epicondyle (tennis elbow)
medial epicondyle (golfers elbow)
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12
Q

pathophysiology of epicondylitis?

A

site where insertion of tendon into bone becomes inflamed

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13
Q

s/s of epicondylitis?

A

local tenderness, pain radiates into forearm on using affected muscle

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14
Q

tx for epicondylitis?

A

self limiting-rest, corticosteroid injections at point of max tenderness, splint
surgical options: release in very advance cases

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15
Q

what is de Quervain’s tenosynovitis (dQT)?

A

6 extensor compartments in hand- stenosing due to inflammation of 1st extensor dorsal compartment (inflammation within synovial sheath)

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16
Q

what is in the 1st extensor dorsal compartment of the hand?

A

abductor pollicis longus, extensor pollicis brevis

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17
Q

epi of dQT?

A

W>M, 30-50yo

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18
Q

aetiology of dQT?

A

idiopathic, repeated unaccustomed use, inflammatory arthritis, postpartum

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19
Q

types of dQT?

A
  1. flexor tenosynovitis: finger pain when gripping
  2. dorsal tenosynovitis: hourglass swelling from back of hand
  3. dQT
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20
Q

s/s of dQT?

A

pain and swelling over radial styloid process, red, pain worsened by flexing thumb into palm

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21
Q

ix for dQT?

A

thickened sheath may be palpable, tenderness, USS

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22
Q

what is the specialist test for dQT?

A

Finklestein’s test

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23
Q

mx of dQT?

A

self-resolves, conservative (thumb spica splint)

surgery- decompression

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24
Q

what is EPL rupture?

A

rupture of EPL tendon which may be due to RA or a Colles Fracture

25
s/s of EPL rupture?
substantial loss of function in hand
26
mx of EPL rupture?
conservative or surgery (tendon transfer using EIP)
27
pathophysiology of trigger finger?
small nodule present in tendon sheath, nodule catches as finger flexed and tendon gets stuck under A1 pulley
28
define trigger finger?
trapping of fixed flexed finger
29
T/F: lower limb tendinopathies should NEVER be injected
T: LL tendiopathies shouldn't be injected with steroids, upper limb tendinopathies can be
30
lower limb tendinopathies...
knee extensor tendinopathy, Achilles tendinopathy, tibialis posterior tendinopathy, tendo achilles tendonitis, tendo-achillea rupture, plantar fasciitis, Morton's neuroma
31
2 tendons of knee extensions?
quadricep tendon and patellar tendon
32
s/s of knee extensor tendiopathy?
palpable gap, no straight leg raise, patella Alta/baga
33
mx of knee extensor tendinopathy?
surgery
34
sudden acceleration/ deceleration is risk for which tendinopathy?
achilles
35
what is aetiology/ risk factors for all tendinopathies?
RA, steroids, previous tendiopathies, diabetes, ciprofloxacin (quinolone abx)
36
s/s of achilles tendinopathy?
feel like being kicked in the heel, palpable gap, can't tip toe, tender swelling a few cm above tendon insertion
37
which specialised test for achilles tendinopathy?
Simmond's test
38
mx for achilles tendinopathy?
plaster in acute cases, surgery if delayed presentation
39
achilles bursitis lies where?
anterior to tendon
40
mx of achilles bursitis but important NOT to do for achilles tendinopathy?
steroid injection
41
what are s/s of tibialis posterior rupture?
valgus foot, too many toes sign, no medial arch, flat foot
42
mx of tibialis posterior rupture?
conservative- NSAIDs, orthotics/cast | surgery- decried/ tendon transfer
43
what is achilles tends-achilles tendonitis
repetitive microtrauma causing failure of collagen repair with loss of fibre structure
44
aetuiology of tends-achilles tendonitis?
overuse, steroids, connective tissue disease
45
s/s of tendo-achilles tendonitis?
pain and morning stiffness that eases with heat/walking, tender swelling above tendon insertion
46
mx tendo-achilles tendonitis?
analgesia, NSAIDs, shockwave therapy
47
aetiology of tends-achilles rupture?
pre-existing tendinosis, sudden deterioration with resisted calf contraction, repetitive strains, ciprofloxacin, RA
48
s/s of tends-achilles rupture?
unable to weight bear, weak plantar flexion, palpable gap, simmond's test +ve
49
mx of tends-achilles rupture?
operative/ conservative
50
what is plantar fasciitis
inflammation of inserting of plantar fascia into calcaneum
51
aetiology of plantar fascia?
physical overload, seronegative arhtropathies, abnormal foot shape, inapporpriate footwear, obese
52
s/s of plantar fasciitis?
localised pain under heel during walking, tenderness on palpation, start-up pain, plantar medial aspect of heal swollen?
53
ix for plantar fasciitis?
tinnel's test +ve for baxter's nerve, hx of heel pad pain
54
tx for plantar fasciitis?
conservative- NSAIDs, night splints etc, surgery | self-resolves 18-24months
55
what is Morton's neuroma?
degenerative fibrosis of digital nerve near its bifurcation causing irritation and inflammation of nerve
56
s/s of Morton's neuroma?
forefoot pain, burning and tingling in toes when walking
57
where is Morton's most common?
between 3rd and 4th metatarsal heads
58
ix for Morton's neuroma?
exam and USS, Mulder's click test
59
mx for Morton's neuroma?
non-op: insoles, injection, wide-cushioned shoes | operative is excise

MSK (26 decks)

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