Soft tissue injuries Flashcards
In what 7 body structures can soft tissue injuries present?
Tendon, muscle, fat, skin, joint, ligament, neurovascular structures
In what 3 body structures are soft tissue injuries most common?
Muscle
Tendon
Ligament
What causes haematoma/bruising to present in a soft tissue injury, and what are 2 associated symptoms?
Bleeding into soft tissue, that can occur when injury occured by direct trauma
presents with swelling and discolouration
What causes a sprain, and give 4 examples of associated symptoms?
Overstretching or tearing of ligament
Presents with discolouration, sudden pain onset, loss of ability/power to bear weight, swelling
What type of soft tissue injury is acromioclavicular joint dislocation?
Sprain
What is acromioclavicular joint dislocation, and why does it commonly occur?
Acromioclavicular and/or coracoclavicular ligaments are stretched or torn, causing lateral end of clavicle to dislocate and elevate from acromion process
Commonly occurs due to fall and landing directly on AC joint
What are the grades of an acromioclavicular joint dislocation?
Grades I-VI
Least severe to most severe
Give 3 examples of symptoms of AC joint dislocation?
Bruising/haematoma
Swelling
Noticeable bump on shoulder, at site of dislocation
What 2 imaging mediums can be used to identify an AC joint dislocation?
MRI
X-ray
What are the 4 conservative treatments commonly used for AC joint dislocation management?
RICE
Physiotherapy
Pain relief
Sling for 6 weeks
If AC joint location is severe/high grade, how is this managed?
Surgery
Give 4 examples of symptoms of anterior cruciate ligament tear?
Unable to bear weight on affected leg
Rapid swelling
Loud/popping sensation in knee
Pain outside and back of knee
What 2 special tests are positive when there is anterior cruciate ligament tear?
Anterior draw test
Lachman’s test
How do you perform the anterior draw test, and what is the positive result?
Sit on patient’s foot, place thumbs on tibial tuberosity and pull forward
Positive: Tibia pulled forward by 5 mm or more
How do you perform the Lachman’s test, and what is the positive result?
Flex knee 30 degrees, put your hand on thigh to stabilise femur, pull tibia forward
Positive: tibia moves forward on affected leg but doesn’t move on other leg
Which special test is the most reliable for anterior cruciate ligament tear, and why?
Lachman’s test is more reliable than anterior draw test, as stabilising femur reduces affect of hamstrings which distort result
What imaging medium is used to identify an ACL tear?
MRI
What are 4 conservative treatments for ACL tear management?
RICE, pain relief, physiotherapy, brace
How is surgical reconstruction of a torn ACL completed?
Graft taken from another tendon (eg. patella tendon), this is used to create new ACL
What is whiplash injury?
Strain or sprain of the soft tissues around the neck area from rapid hyperextension and flexion of neck
What causes a strain, and give 3 examples of associated symptoms?
Muscle overstretches or contracts too quickly, causing partial/complete tear of muscle and/or tendons
Presents with swelling, discolouration, pain on movement
What is a distal biceps rupture?
Complete/partial detachment of distal biceps tendon from radial tuberosity insertion
What is the most common cause of a distal biceps rupture?
Eccentric (opposite direction from weight) contraction of biceps when lifting heavy load
Give 5 symptoms of a distal biceps rupture?
Bruising
muscle bunches near shoulder/above elbow
anterior arm and elbow swelling
painful flexion and forearm supination
popping sensation in arm
What special test is used to identify a distal biceps rupture, and what is the positive result?
Abduct patient’s shoulder to 90 degrees, flex elbow to 90 degrees, supinate forearm and hook your finger under distal biceps tendon from lateral to medial side.
Positive test if there isn’t a hookable structure
What 2 imaging mediums are used to identify a distal biceps rupture?
Ultrasound or MRI
Are distal biceps tendon ruptures easy to identify or are they often missed soft tissue injuries?
Often missed
Give 4 examples of treatments for distal biceps tendon rupture?
RICE, physiotherapy, sling
Surgical reconstruction of tendon
Which group of individuals are distal biceps tendon ruptures most prevalent in?
Men aged late 40s to 50s
What is an overuse injury?
Injury that develops slowly over time due to repetitive friction, pulling, twisting, or compression
What is Achilles tendon tear and how does it commonly occur?
Partial/complete tear commonly arising from repetitive sprinting and jumping movements
Give 4 symptoms of Achilles tendon tear?
heel pain/along Achilles tendon when walking or running
difficulty standing on toes
popping sound when tendon tears
clear tendon structure not visible behind foot
When treating an Achilles tendon tear, what physical aid does the individual wear and why?
Walking boot with raised heel that is gradually removed for 3 months, as it holds foot in way so that tendon ends are held together so can heal
What 2 imaging mediums are used to identify Achilles tendon tear?
Ultrasound or MRI
Why is it important to educate patients about soft tissue injury management?
If they don’t modify activities, they can reinjure injury whilst it is still healing
What are the 5 initial conservative treatments of soft tissue injuries?
Sling/splint, pain relief, RICE, physiotherapy, educating patients
Are X-rays and CT scans used to identify soft tissue injuries?
Not soft tissue injuries themselves, but used to identify associated features
Why are physical examinations and special tests of soft tissue injuries important?
Determine range of movement
