Orthropaedics part 2 Flashcards
What is a tendon?
Dense, highly structured
What is Tendonitis & Tendinopathy?
inflammation of the tendons, it happens when a person overuses or injure a tendon during a physical activity.
What are the red flags for tendonitis ?
- Sudden Pain
- Severe with ‘ popping’ or ‘snapping’ sound
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What is Tendinopathy
a broad term for any tendon condition that causes pain
It is a degeneration not inflammation where patients will get pain, decline in function and they won’t be able to exercise aswell
Treatment for tendinopathy?
- Rest
- ice pack, anti-inflammatory pain killers such as ibuprofen
- Physiotherapy
What is Lateral Epicondylitis ?
**Tennis Elbow **
cause damage to tendons around the elbow (overuse injury) by ecentric (muscle lengthening)
This causes tendinosis and inflammation of the extensor carpi radialis brevis ( ECRB)
What is the prevelance of Lateral Epicondilitis ?
- common in dominant arm
- 1-3 % of adults are affected annually
- 50% of tennis players develop this condition
- age - 30-50 years
- 5% assoc with radial nerve injury
What are the symtpoms of tennis elbow -lateral epicondilitis ?
pain with resisted wrist extension
pain with gripping activities and decreased grip strength
What are the history questions or things to look for ?
- Joint swelling
- history of trauma
- Ask about the severity, onset, duration & exabberating factors
- Pain ( +/- burning sensation ) lateral epicondyle with radiation down extensor aspect of forearm
- grip weakness
What would you expect in examination?
- Point tenderness at lateral epicondyle
- Decreased grip strength
What test & examination would you do for Lateral Epicondylitis ?
- Resisted wrist extension
- Check for **Tinel’s sign **at the elbow to r/o Cubital Tunnel Syndrome
- Assess neck and Shoulder (reffered pain) - always asses joint above & below for this reason
- In msk, when youe examine a joint, make sure to examinae both above and below of the joint and whenever the pt comes in with knee pain always examine the hip.
What is cubital tunnel syndrome ?
occur when the ulnar nerve which runs through the elbow’s cubital tunnel become compressed or irritated.
What is the Management of Lateral Epicodylitis ?
- Aim - to relief the pain & restore functionally
- Apply heat/ice to relieve the pain
- Activity modification for 6 weeks- also avoid tasks that involeve hand gripping
- Elbow brace
- Analgesia ( paracetamol as first line/ topical NSAIDS such as ibuprofen gel)
- 2nd line PO NSAID
However if the pain does not settle after 6 weeks reassess and refer to physiotherapy
Again, if there is no response to initial treatment after 6 weeks then refer to ortho Surgeon
What is the surgery for Lateral Epicondylitis ?
- (Open / orthoscopic debridement and or release)
What is the prognosis after the surgery ?
The average duration if between 6 months to 2 years but 89% of people will be recoevered within one year however 5-10% do not resolve and require surgery.
