Tendon Problems

Question 1

Tendonitis vs tendonosis

Answer 1

Tendonitis - acute injuries accompanied by inflammation

Tendonosis - Chronic tendon injury with damage to a tendon at cellular level

Question 2

what is tenosynovitis

Answer 2

inflammation of the tendon sheath

Question 3

embryology - where do tendons arise from

Answer 3

lateral plate mesoderm

Question 4

Conservative Mx for tendon problems

Answer 4

Rest
Analgesics/NSAIDs
Steroid injections
Splinting

Question 5

what conditions are not given steroid injections and why not

Answer 5

Achilles tendon or extensor knee mechanisms

risk of rupture

Question 6

surgical Mx for tendon problems

Answer 6

debridement
decompression
synovectomy - helps to present rupture
tendon transfer

Question 7

muscles of the rotator cuff

Answer 7

supraspinatous
infraspinatous
subscapularis
teres minor

Question 8

clinical findings of a rotator cuff tear

Answer 8

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

Question 9

what are the impingement tests

Answer 9

Hawkins-Kennedy
Jobe’s
Scarft

Question 10

what is the gold standard test for rotator cuff tear

Answer 10

Ultrasound

Question 11

which head of bicep is typically affect in biceps tendinopathy

Answer 11

predominantly long head

Question 12

what can be causes of biceps tendinopathy

Answer 12

overuse, instability,, impingement, trauma

Question 13

symptoms of biceps tendinopathy

Answer 13

Pain anterior shoulder radiating to elbow
Aggravated by shoulder flexion, forearm pronation and elbow flexion
Snapping with shoulder movements

Question 14

Ix for biceps tendinopathy

Answer 14

USS

Question 15

sign of biceps rupture

Answer 15

popeye sign

Question 16

what is Golfer’s elbow

Answer 16

Medial epicondylitis

inflammation of flexor forearm muscles

Question 17

symptoms of Golfer’s elbow

Answer 17

medial elbow pain
aggravated by wrist flexion and pronation
associated ulnar neuropathy/muscle weakness

Question 18

Ix for medial epicondylitis

Answer 18

USS

MRI

Question 19

Mx for medial epicondylitis

Answer 19

rest
physio
injection
surgical release

Question 20

what is tennis elbow

Answer 20

lateral epicondylitis

Pain and tenderness over the lateral epicondyle (the origin of extensors muscles)

Question 21

what test is positive in lateral epicondylitis

Answer 21

Mill’s test - pain is reproduced by resisted wrist extension with palm pronated whilst moving the palm sideways in the direction of the thum

Question 22

Ix for tennis elbow

Answer 22

USS
MRI
NCS - to see if the ulnar nerve has been hurt

Question 23

what is affected in De Quervain’s Tenosynovitis

Answer 23

first compartment

- APL and EPB

Question 24

where is pain felt in De Quervain’s Tenosynovitis

Answer 24

over radial styloid process

Question 25

what test is positive in De Quervain’s Tenosynovitis

Answer 25

Finklestein’s test

Question 26

Ix for De Quervain’s Tenosynovitis

Answer 26

USS

Xray to rule out CMC OA

Question 27

what are the clinical findings of extensor knee problems

Answer 27

palpable gap
No straight leg raise (SLR)
can’t walk on it anymore

Question 28

Ix for extensor knee problems

Answer 28

XR - in case they have # patella
USS
MRI

Question 29

Mx for extensor knee problems

Answer 29

surgical repair

Question 30

what predisposes to Achilles tendon

Answer 30

RhA
Steroids
Tendonitis

Question 31

features of Achilles tendon

Answer 31

sudden force

‘feels like being shot’ - very painful

Question 32

clinical findings in Achilles Tendon

Answer 32

palpable gap
unable to tiptoe stand
bruising
Simmond’s test +ve

Question 33

Ix for achilles tendon

Answer 33

USS

MRI