tendon problems Flashcards
what is tendinopathy?
painful tendon
what is tendonitis?
inflammation of tendon
what is tendonosis
degeneration of tendon
what is tenosynovitis?
inflammation of fluid filled sheath
what is enthesopathy?
pain at enthesis- attachment of tendon and ligaments to bone
what are intrinsic risk factors for tendinopathies?
age, gender, obesity, RA, malalignment, leg length differences
what are extrinsic risk factors for tendonopathies?
trauma or injury, repetitive injury, steroids & antibiotcs, sports
describe tendonosis
degeneration of collagen and extracellular matrix, not necessarily painful, occurs in areas of poor blood supply
what is the treatment for tendonosis?
rest, physio, analgesia, injections in rotator cuff or tennis elbow, splinting in achilles tendon
what are surgical options for tendonosis?
debridement- remove diseased tissue
decompression- supraspinatus tendonitis
synovectomy- prevents rupture- extensor tendons of wrist and tibialis posterior
tendon transfer- tibialis posterior and extensor pollicis longus
describe rotator cuff problems
seen in athletes and manual workers
ache down arm, difficulty sleeping on side, reaching up and lifting
positive impingement tests
what is the management for rotator cuff problems?
physio, steroid injections into shoulder
surgical- subacromial decompression
what imaging is used for rotator cuff?
ultrasound
describe biceps tendinopathy
pain in anterior shoulder radiating to elbow, worse on shoulder & elbow flexion, forearm pronation
snapping on shoulder movement if subluxation
how to diagnose and treat biceps tendinopathy?
clinical exam, ultrasounds
conservative or surgical management
what is the clinical sign of biceps rupture?
popeye sign (also extensive bruising)
describe tennis elbow (lateral epicondylitis)
pain and tenderness over lateral epicondyle
describe golfers elbow (medial epicondylitis)
medial elbow pain from repetitive stress
self- limiting - do not inject as can damage ulnar nerve
describe De Quervain’s tenosynovitis and how to diagnose and treat
pain over radial styloid process
do finklestein’s and eichoff’s tests
ultrasound / x-ray to rule out OA
management- splint, rest physio, analgesia, injections, surgical decompression
how does extensor tendon rupture occur?
autoimmune attack on synovium leading to tendon degeneration and rupture- dropped finger.
synovectomy prevents this
describe EPL rupture
can occur in RA or after Colles fracture
substantial loss of function
treat with tendon transfer
describe knee extensor mechanism rupture
caused by a fall onto flexed knee, or almost falling
patellar tendon rupture in younger patients, quadriceps in older
failure to straight leg raise
x-ray, ultrasound, mri to diagnose
don’t inject- treat surgically
describe Osgood- Schlatter’s disease
at tibial tubercle- insertion of patellar tendon into tibial tuberosity
seen in adolescent boys
leaves prominent bony lump
describe achilles tendon rupture
feels like being kicked in the calf
seen in sudden acceleration or deceleration when running
cant stand on tiptoes, +ve simmond’s test
conservative (cast) or surgical management
describe tibialis posterior tendon rupture
tensosynovits –> progressive elongation –> rupture
unclear cause
causes flat foot an valgus hindfoot
treatment- NSAIDs, orthotics, cast, injections, debridement
tendon transfer may help
