Periarticular Flashcards
بورسیت چیه؟
کار بورسا چیه اصن؟
Bursitis is inflammation of a bursa, which is a thin-walled sac lined with synovial tissue.
The function of the bursa is to facilitate movement of tendons and muscles over bony prominences.
علل بورسیت؟
Excessive frictional forces from :
1-overuse
2-trauma
3-systemic disease (e.g., rheumatoid arthritis, gout)
4-or infection may cause bursitis.
شایع ترین فرم بورسیت؟
Subacromial bursitis (subdeltoid bursitis) is the most common form of bursitis. The subacromial bursa, which is contiguous with the subdeltoid bursa, is locatedbetween the undersurface of the acromion and the humeral head and is covered by the deltoid muscle.
کوموربیدیتی شایع بورسیت چیه؟
Bursitis often accompanies rotator cuff tendinitis.
مشخصات trochanteric bursitis?
Another frequently encountered form is trochanteric bursitis, which involves the bursa around the insertion of the gluteus medius onto the greater trochanter of the femur.
Patients experience pain over the lateral aspect of the hip and upper thigh and have tenderness over the posterior aspect of the greater trochanter.
چه مواردی باعث تشدید درد بورسیت میشن؟
External rotation and resisted abduction of the hip elicit pain as will direct pressure applied to the bursa.
میگه اکسترنال روتیشن و ابداکشن فشار مستقیم وارد میکنه به بورسا
تشخیص افتراقی های Olecranon bursitis؟ چجوری رد میکنیم اینارو؟
Olecranon bursitis occurs over the posterior elbow, and when the area is acutely inflamed, infection or gout should be excluded by aspirating the bursa and performing a Gram stain and culture on the fluid as well as examining the fluid for urate crystals.
بورسیت آشیل کدوم قسمت رو درگیر میکنه و علتش چیه ؟
Achilles bursitis involves the bursa located above the insertion of the tendon to the calcaneus
and results from
1-overuse
2-and wearing tight shoes.
Retrocalcaneal bursitis : کدوم قسمت رو درگیر میکنه؟ دردش به کجا میزنه؟ کجا باد مبکنه؟ علتش چیه؟4
Retrocalcaneal bursitis involves the bursa that is located between the calcaneus and posterior surface of the Achilles tendon.
The pain is experienced at the back of the heel, and swelling appears on the medial and/or lateral side of the tendon.
It occurs in association with : 1-spondyloarthritides, 2-rheumatoid arthritis 3-gout 4- or trauma.
بورسیت ایسکیال :
کدوم بورسا رو درگیر میکنه؟
علتش؟
Ischial bursitis affects the bursa separating the gluteus medius from the ischial tuberosity
and develops from prolonged sitting and pivoting on hard surfaces.
بورسیت ایلئوپسوآس کدوم بورسا رو درگیر میکنه؟
دردش به کجا میزنه؟
چه کارایی بدترش میکنن؟
Iliopsoas bursitis affects the bursa that lies between the iliopsoas muscle and hip joint and is lateral to the femoral vessels.
Pain is experienced over this area and is made worse by hip extension and flexion.
What is Anserine bursitis ?
چه یافته ای در معاینه دال بر آن است؟
Anserine bursitis is an inflammation of the sartorius bursa located over the medial side of the tibia just below the knee and under the conjoint tendon and is manifested by pain on climbing stairs.
Tenderness is present over the insertion of the conjoint tendon of the sartorius, gracilis, and semitendinosus.
در مورد Prepatellar bursitis :
کجا ایجاد میشه؟
چرا؟
Ddx? 2
Prepatellar bursitis occurs in the bursa situated between the patella and overlying skin and is caused by kneeling on hard surfaces. Gout or infection may also occur at this site.
روش تشخیص بورسیت؟
Bursitis is typically diagnosed by history and physical examination, but visualization by ultrasound may play a useful role in selected instances for diagnosis and directed guidance of glucocorticoid injection.
درمان بورسیت؟ 4
Treatment of bursitis consists of :
1-prevention of any aggravating situation,
2- rest of the involved part,
3-administration of a nonsteroidal anti-inflammatory drug (NSAID) where appropriate for an individual patient,
4-or local glucocorticoid injection.
شایع تربن علت درد شانه؟
Tendinitis of the rotator cuff is the major cause of a painful shoulder and is currently thought to be caused by inflammation of the tendon(s).
روتیتور کاف شامل چه تاندون هایی میشه؟
کدوم مستعد تاندونیته؟ چرا؟
The rotator cuff consists of the tendons of the supraspinatus, infraspinatus, subscapularis, and teres minor muscles, and inserts on the humeral tuberosities.
Of the tendons forming the rotator cuff, the supraspinatus tendon is the most often affected, probably because of its repeated impingement (impingement syndrome) between the humeral head and the undersurface of the anterior third of the acromion and coracoacromial ligament above as well as the reduction in its blood supply that occurs with abduction of the arm.
The tendon of the infraspinatus and that of the long head of the biceps are less commonly involved.
کووربیدتی impingement syndrome؟
Subacromial bursitis also accompanies this syndrome.
چه چیز هایی باعث تریگر شدن درد تاندونیت روتیتور کاف وImpingement syndromeمیشه؟
Symptoms can appear without a triggering cause or after injury or overuse, especially with activities involving elevation of the arm with some degree of forward flexion.
Impingement syndrome occurs in persons participating in baseball, tennis, swimming, or occupations that require repeated elevation of the arm.
Those aged >40 years are particularly susceptible.
ویژگی های درد تاندونیت روتیتور کاف؟
Patients complain of a dull aching in the shoulder, which may interfere with sleep.
یافته های تاندونیت روتیتور کاف در معاینه ؟
Severe pain is experienced when the arm is actively abducted into an overhead position.
The arc between 60° and 120° is especially painful.
Tenderness is present over the lateral aspect of the humeral head just below the acromion.
گزینه های درمانی ما برای درمان و تسکین تامدونیت روتیتور کاف؟
NSAIDs, local glucocorticoid injection, and physical therapy may relieve symptoms.
Surgical decompression of the subacromial space may be necessary in patients refractory to conservative treatment.
علت پاره شدن حاد سوپرااسپایناتوس؟
علایم؟
Patients may tear the supraspinatus tendon acutely by falling on an outstretched arm or lifting a heavy object.
Symptoms are pain along with weakness of abduction and external rotation of the shoulder.
Atrophy of the supraspinatus muscles develops.
روش تشخیص تاندونیت روایتور کاف؟
The diagnosis is established by ultrasound, magnetic resonance imaging (MRI), or arthrogram.
تاندونیت کلسیفیک چیه؟
This condition is characterized by deposition of calcium salts, primarily hydroxyapatite, within a tendon. The exact mechanism of calcification is not known but may be initiated by ischemia or degeneration of the tendon.
اندیکاسیون جراحی در تاندونیت روتیتور کاف؟
Surgical repair may be necessary in patients who fail to respond to conservative measures.
In patients with moderate-to severe tears and functional loss, surgery is indicated.
Such referral is indicated only after an appropriate period, generally at least six months, has demonstrated that nonoperative care has been ineffective, or in cases where shoulder function worsens during the course of appropriate nonsurgical treatment.
شایعترین تاندونی که دچار تاندونیت کلسیفیک میشه ؟ چرا؟ در چه سنی شایعه؟
The supraspinatus tendon is most often affected because it is frequently impinged on and has a reduced blood supply when the arm is abducted.
The condition usually develops after age 40.
کامپلیکیشن های Calcification in tendon
Calcification within the tendon may evoke acute inflammation, producing sudden and severe pain in the shoulder.
However, it may be asymptomatic or not related to the patient’s symptoms.
Diagnosis of calcific tendonitis ?
Diagnosis of calcific tendonitis can be made by ultrasound or radiograph.
چه اقدامات درمانی برای بیمار تاندونیت کلسیفیک امجام میدیم؟
Most cases are self-limited and respond to conservative therapy with physical therapy and/ or NSAIDs.
A subset of patients is refractory and requires ultrasound-guided percutaneous needle aspiration and lavage or surgery.
علت ایجاد Bicipital tendinitis
Bicipital tendinitis, or tenosynovitis, is produced by friction on the tendon of the long head of the biceps as it passes through the bicipital groove.
علائم Bicipital tendinitis ؟
When the inflammation is acute, patients experience anterior shoulder pain that radiates down the biceps into the forearm.
در معاینه چه حرکتایی برا مریض دردناکه در تاندونیت بایسیپیتال؟ 3
Abduction and external rotation of the arm are painful and limited.
The bicipital groove is very tender to palpation.
Pain may be elicited along the course of the tendon by resisting supination of the forearm with the elbow at 90° (Yergason’s supination sign).
