Tendon Problems Flashcards
Tendonitis vs tendonosis
Tendonitis - acute injuries accompanied by inflammation
Tendonosis - Chronic tendon injury with damage to a tendon at cellular level
what is tenosynovitis
inflammation of the tendon sheath
embryology - where do tendons arise from
lateral plate mesoderm
Conservative Mx for tendon problems
Rest
Analgesics/NSAIDs
Steroid injections
Splinting
what conditions are not given steroid injections and why not
Achilles tendon or extensor knee mechanisms
risk of rupture
surgical Mx for tendon problems
debridement
decompression
synovectomy - helps to present rupture
tendon transfer
muscles of the rotator cuff
supraspinatous
infraspinatous
subscapularis
teres minor
clinical findings of a rotator cuff tear
Achy pain Pain in 4 tendons of RC Shoulder tenderness Difficulty sleeping on affected side, reaching overhead & on lifting Painful arc with RC weakness Positive impingement tests
what are the impingement tests
Hawkins-Kennedy
Jobe’s
Scarft
what is the gold standard test for rotator cuff tear
Ultrasound
which head of bicep is typically affect in biceps tendinopathy
predominantly long head
what can be causes of biceps tendinopathy
overuse, instability,, impingement, trauma
symptoms of biceps tendinopathy
Pain anterior shoulder radiating to elbow
Aggravated by shoulder flexion, forearm pronation and elbow flexion
Snapping with shoulder movements
Ix for biceps tendinopathy
USS
sign of biceps rupture
popeye sign
what is Golfer’s elbow
Medial epicondylitis
inflammation of flexor forearm muscles
symptoms of Golfer’s elbow
medial elbow pain
aggravated by wrist flexion and pronation
associated ulnar neuropathy/muscle weakness
Ix for medial epicondylitis
USS
MRI
Mx for medial epicondylitis
rest
physio
injection
surgical release
what is tennis elbow
lateral epicondylitis
Pain and tenderness over the lateral epicondyle (the origin of extensors muscles)
what test is positive in lateral epicondylitis
Mill’s test - pain is reproduced by resisted wrist extension with palm pronated whilst moving the palm sideways in the direction of the thum
Ix for tennis elbow
USS
MRI
NCS - to see if the ulnar nerve has been hurt
what is affected in De Quervain’s Tenosynovitis
first compartment
- APL and EPB
where is pain felt in De Quervain’s Tenosynovitis
over radial styloid process
what test is positive in De Quervain’s Tenosynovitis
Finklestein’s test
Ix for De Quervain’s Tenosynovitis
USS
Xray to rule out CMC OA
what are the clinical findings of extensor knee problems
palpable gap
No straight leg raise (SLR)
can’t walk on it anymore
Ix for extensor knee problems
XR - in case they have # patella
USS
MRI
Mx for extensor knee problems
surgical repair
what predisposes to Achilles tendon
RhA
Steroids
Tendonitis
features of Achilles tendon
sudden force
‘feels like being shot’ - very painful
clinical findings in Achilles Tendon
palpable gap
unable to tiptoe stand
bruising
Simmond’s test +ve
Ix for achilles tendon
USS
MRI
