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YEAR 1 MED > Soft tissue disorders > Flashcards

Soft tissue disorders Flashcards

1
Q

What is tendinopathy?

A
  • strain or injury to tendons and their insertions to bone
  • enthesitis refers to inflammation of tendon/ligament insertion into the bone
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2
Q

What are the 2 main ways in which tendinopathy can occur?

A
  • injury from overuse
  • or as part of a systemic inflammatory condition
  • (most cases are idiopathic)
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3
Q

What are the 3 most common sites of tendinopathy and what are the clinical features?

A
  • Common sites: shoulder, elbow, Achilles tendon
  • Symptoms: pain (worse with movement especially against resistance), tenderness of tendon and insertion point
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4
Q

What is frozen shoulder, what are the clinical features, and what is the management?

A
  • painful, stiff shoulder caused by adhesive capsulitis
  • symptoms: gradual onset pain and stiffness in shoulder, reduced mobility (external rotation mainly), unclear pathophysiology
  • management: analgesia (NSAIDs), physio/exercise, local intra-articular injection
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5
Q

What is rotator cuff tendinopathy (aka. subacromial bursitis)?

A
  • beneath the acromion is the subacromial space
  • if this space becomes narrowed, irritation of supraspinatus can occur giving rise to tendinopathy
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6
Q

What is tennis elbow?

A
  • lateral epicondylitis
  • pain is exacerbated by resisted wrist extension
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7
Q

What is golfer’s elbow?

A
  • medial epicondylitis
  • pain is exacerbated by resisted wrist flexion
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8
Q

Tennis elbow and Golfer’s elbow diagram…

A
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9
Q

What is the management for tendinopathy?

A
  • REST
  • NSAIDs
  • physio
  • local corticosteroid injection (if needed)
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10
Q

What is tenosynovitis?

A
  • inflammation of the synovial lining of a tendon sheath
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11
Q

What is De Quervain’s tenosynovitis?

A
  • inflammation of the abductor pollicis longus and extensor pollicis brevis tendons
  • presentation: pain at base of thumb (exacerbated by abduction of thumb, gripping, and ulnar movement of wrist), associated with people who carry out repetitive thumb abduction (office workers, musicians)
  • treatment: splint and analgesia
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12
Q

What is trigger finger?

A
  • occurs as a result of mechanical impingement of the A1 pulley (affects flexor tendons)
  • results in locking or catching of the affected digit
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13
Q

De Quervains tenosynovitis diagram…

A
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14
Q

Trigger finger diagram…

A
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15
Q

What is the management for tenosynovitis?

A
  • Rest
  • Splintage
  • Local corticosteroid injection
    (surgical decompression of the sheath may be required)
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16
Q

What are the 2 main causes of tendon rupture?

A
  • chronic inflammation or degeneration (eg. rupture of extensor tendons of fingers seen in RA)
  • trauma
17
Q

What are the clinical features of a tendon rupture?

A
  • loss of movement at the joint to which the tendon provides power
  • deformity and sometimes swelling
  • Popeye sign: rupture of the long head of the biceps tendon
  • Mallet finger: extensor tendon rupture at the distal phalanx
18
Q

What causes mallet finger?

A
  • usually occurs after a direct blow to the fingertip, causing aggressive flexion of the DIP joint
  • it results in an inability to extend the flexed DIP joint
19
Q

Popeye sign…

A
20
Q

What is the management for tendon ruptures?

A
  • usually self-limiting with a splint and adequate analgesia
  • surgery if tendon repair is needed or a tendon transfer
21
Q

What is the pathology of bursitis?

A
  • Bursitis = inflammation of a bursa
  • bursae are small sacs of fibrous tissue that are lined with synovial membrane and secrete synovial fluid (they reduce friction where ligaments and tendons pass over bone)
  • can be due to systemic inflammatory disease, injury, or idiopathic
22
Q

What are the 3 most common types of bursitis?

A
  • Olecranon bursitis
  • Prepatellar bursitis
  • Trochanteric bursitis
23
Q

What is olecranon bursitis caused by and what is the management?

A
  • caused by excessive friction at the elbow
  • infection can occur in addition to olecranon bursitis
  • bursa usually tender but no pain on movement
  • Management: NSAIDs and rest (local corticosteroid injection if needed), aspirate if infected and course of antibiotics
24
Q

Why should you avoid aspiration of bursae if possible?

A
  • risk of chronic sinus and chronic infection
25
Q

What are the clinical features of prepatellar bursitis (housemaid’s knee)?

A
  • inflammation and swelling of the pre-patellar bursa, located anterior to the patella
  • symptoms: localised pain and swelling of anterior knee, common in people who spend a lot of time kneeling (eg. carpet fitter)
26
Q

Prepatellar bursa and infrapatellar bursa diagram…

A
27
Q

What does tenderness over the trochanter indicate?

A
  • trochanteric bursitis
28
Q

What is Dupuytren contracture?

A
  • result of progressive, fibrotic thickening of the palmar fascia
29
Q

What are the clinical features of Dupuytren contracture?

A
  • fixed flexion deformity of 4th and 5th digits, and contraction of MCP and IP joints
  • no pain
  • positive tabletop test: palm of hand cannot be placed flat on a table
30
Q

What is Achilles tendonitis (definition), what are the clinical features, and what is the management?

A
  • inflammation of the tendon sheath
  • clinical features: posterior ankle pain, pain on palpation of Achilles tendon, swelling of Achilles tendon
  • management: conservative; rest, analgesia (NSAIDs)
31
Q

What is a Baker’s cyst and what can sometimes occur?

A
  • an extension of the knee synovium between the medial head of gastrocnemius and the semi-membranous muscle
  • the cyst may occasionally rupture, resulting in sharp pain, swelling and calf redness. It is essential to rule out a VT in these cases
32
Q

What is patella tendonitis?

A
  • aka. ‘jumpers knee’
  • inflammation of the patella tendon at the tibial tuberosity, commonly occurs as a result of jumping
  • symptoms: anterior knee pain (exacerbated by movement)
33
Q

What is plantar fasciitis?

A
  • inflammation of the plantar fascia associated with repeated micro trauma to the sole of the foot
  • pain in plantar of foot
34
Q

What is trochanteric bursitis?

A
  • inflammation of the bursa overlying the grater trochanter of the femur
  • symptoms: tenderness over greater trochanter
35
Q

What is the general management for soft tissue injuries?

A
  • RICE
  • analgesia (NSAIDs)
  • if needed: corticosteroid injections

YEAR 1 MED (49 decks)

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