tendinopathies Flashcards
what are the 3 most common sites for tendinopathy to develop?
shoulder, lateral elbow, and heel
in what population are tendinopathies most common?
physically demanding or repetitive stress professions and in athletics
tendinitis
-itis
inflammation of the tendon
bursa of the shoulder:
subacromial bursa
under the acromion process
x2 bursa of the calcaneal area
subcutaneous calcaneal bursa
retrocalcaneal bursa
tendon epitenon:
loose connective tissue sheath with vascular, lymphatic, and nerve supply
tendon coverings:
endotenon: CT surrounding fascicles of tenocytes
epitenon: surrounding the tendon in its entirety
paratenon: fatty areolar surrounding the whole tendon
tendon appearance:
-dense, parallel collagen bundles
-sparse distribution of cells
-no fibroblast proliferation
-absence of a lot of ground substance
tendinosis
damage to the tendon itself without an inflammatory component
tendinopathy
injury or tears to the tendon
risk factors for tendon injury:
increasing age
increasing repetitions
improper technique - increased mechanical stress
bursa of the pelvic region:
iliopsoas bursa
greater trochanteric (femur) bursa
what is an apophysis?
natural cartilaginous growth plate at the insertion of a muscle via tendon to the bone
apophysitis
since its cartilage and is weaker than bone, the apophysis can become inflamed by repetitive traction/repetitive stress
osgood schlatter’s
apophysitis of the tibial tubercle at the attachment of the patellar tendon
common in growing children
rotator cuff teninopathy:
-pain to lateral shoulder (deltoid insertion)
-pain with resisted shoulder abduction (empty can test)
-pain with passive internal rotation (hawkin’s test)
-degenerative changes with absence of inflammation
elbow lateral epicondylitis
“tennis elbow”
due to overuse
affects extensor muscles (tennis backhand)
muscles that originate on lateral epicondyle of distal humerus
**extensor carpi radialis brevis (ECRB)
Cozen test
pain at the lateral epicondyle or common extensor origin with resisted wrist extension
achilles tendinopathy associated findings:
-fusiform swelling in tendon
-fluid in the bursa
-hard calcific prominences
T1 vs T2 images
T1 - bright - fat
T2 - bright - fat and water
