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MSk wk 5 > Tendon problems > Flashcards

Tendon problems Flashcards

1
Q

Tendionpathy

A

Disease of a tendon

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2
Q

Tendonitis

A

Inflammation fo a tendon

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3
Q

Tendonosis

A

Chronic tendon injury with damage to a tendon ECM

histologic degeneration of collagen and ECM

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4
Q

Tenosynovitis

A

Inflammation of the tendon sheath

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5
Q

Enthesopathy

A

Inflammation of the tendon origin or the insertion into bone

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6
Q

Tendon is made from

A

type 1 collagen, helical structures, all in a longitudinal structure

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7
Q

Aetiology tendionpathy

A

Intrinsic-old,male,obesity, pre-disposing factors e.g. Rh a and anatomical factors such as Mal-alignment and LLD

Extrinsic-truma/injury, repetitive injury, drugs (steroids, antibiotics-ciprofloxin) and sports related injury

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8
Q

Which antibiotics can cause tendon rupture

A

ciprofloxacin

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9
Q

Principles of conservative management of tendinopathy

A
  • rest
  • physio-eccetric strengthening (controlled lengthening)
  • analgesics (anti-inflammatory)
  • injections ( RC, tennis elbow, not achilles tendon or extensor knee mechanism)
  • Splinting (achilles tendon-equines)
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10
Q

Principles fo surgical management of tendinpathy

A
  • debridement-removal or diseased tissue
  • decompression-supraspinatus tendonitis and subacromial decompression
  • Synovectomy-helps to prevent rupture,extensor tendons or wrist(RA) and tibias posterior
  • Tendon transfer
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11
Q

RC aetiology

A

athletes

manual workers

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12
Q

RC clinical findings

A

achy pain down arm
difficulty sleeping on affected side,reachign overhead and on lifting
painful arc and weakness
positive impingement tests

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13
Q

RC management

A
  • conservative- at least 3 months physiology, 2 steroid injections before…
  • surgical (subacromial decompression)
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14
Q

Biceps tendinopathy

A

can be proximal or distal

caused by overuse, instability,impingment or trauma

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15
Q

If you rupture the distal tendon what is the effect on supination strength

A

40% of supination strength is lost

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16
Q

What is the pain like for biceps tendinopathy?

A

Pain anterior shoulder radiating to elbow
-aggravated by shoulder flexion, forearm pronation and elbow flexion

snapping with shoulder movement if subluxation

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17
Q

What tests can be done for biceps biceps tendinopathy?

A

Clinical exam, USS

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18
Q

What is lateral epicondylitis known as

A

tennis elbow

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19
Q

What percentage of tennis elbow is bilateral

A

10-20%

20
Q

What is the pain like for tennis elbow

A

pain and tenderness over the lateral epicondyle, the origin of the forearm extensors
pain with rested extension of middle finger

21
Q

Biceps rupture treatment

A

rest and physio

surgical repair can be carried out but runs a high risk of neuromuscular complications especially the distal end

22
Q

Lateral epicondylitis treatment

A

no-inflamamtory and self-limiting

can inject ( although non-inflammatory), surgical release is the last resort for refractory cases

23
Q

What is medial epicondylitis

A

golfers elbow

inflammation of flexor forearm muscles

medial elbow pain-origin of the first flexors

24
Q

treatment of the medial epicondylitis

A

avoid injecting- ulnar nerve

surgical release last resort

25
Q

What is golfers elbow caused by?

A

repetitive stress

self-limiting condition

26
Q

How do you test for De Quervain’s tenosynovitis

A

Finklestein’s test

27
Q

What does De Quervain’s tenosynovitis present with and why

A

pain over radial styloid process

first extensor compartment- AP and EPB

28
Q

What is the investigations and management for De Quervain’s tenosynovitis

A

Ix-USS,XR rule out CMC OA

Mx-splint,rest,physio,analgesics,inject,surgical decompression

29
Q

What is extensor tendon rupture?

A

Autoimmune attack on synovial-> tendon degeneration -> rupture

weakness wrist extension or dropped finger

30
Q

The best treatment for diseased tendon is repair T/F

A

F- can’t repair diseased tendon

Instead tendon transfer

31
Q

Who is extensor tendon rupture most common in

A

women aged 30-50

associated with pregnancy and RA

32
Q

What surgery can prevent extensor tendon rupture?

A

Synovectomy

33
Q

What can EPL rupture occur with

A

RA of after colles fracture

34
Q

What is the treatment for EPL rupture

A

There is substantial LOF

therefore requires tendon transfer (EIP)

35
Q

What is trigger finger progression

A

Stenosing tenosynovitis-> fibrocartilaginous metaplasia -> nodule FDS tendon

36
Q

What is trigger finger?

A

nodule catches on A1 pulley –> triggering
any age ( even kids)
observe, inject, surgical release

37
Q

What is the extensor mechanism of the knee

A

quadriceps muscle, the quadriceps tendon , the patella and the patella tendon

38
Q

Always inject tendonitis T/F

A

F- don’t inject tendonitis

39
Q

What are the clinical findings for the patellar tendon rupture

A

Palpable gap
No SLR
may be high or low patella on X-ray

40
Q

What is the investigation for a patellar tendon rupture

A

x-ray –> may shoe effusion or patella sitting in the wrong place
USS of MRI which may show a partial or complete tear

41
Q

Management of tendon rupture

A

surgery- with gradual increase in ROM post-operatively as part of the phi regime

42
Q

What is traction apophysitis at tibial tubercle called

A

Osgood-Schlatter’s

insertion of patellar tendon into tibial tubersity
adolescent active boys
leaves prominent bony lump
can also happen at patella and achilles

43
Q

Who is achilles tendon ?

A

middle aged
caused by sudden accelaration /decceleration- running/squash,RA,steroids or tendonitis
feels like being kicked or shot
clinical findings- Palpable gap, unable to tiptoe stand, Simmond’s test +ve

44
Q

What investigations and management for Achilles tendon?

A

Ix- USS,MRI

Mx-plaster vs repair

45
Q

Tibialis posterior what is the progression of problems?

A

Tenosynovitis
progressive elongation
rupture

46
Q

What does tibialis posterior rupture lead to

A

leads to progressive flat foot and values hindfoot

47
Q

Treatment of tibias posterior rupture

A

NSAIDs
orthotics/cast
inject
debride

may be helped by a tendon transfer

MSk wk 5 (8 decks)

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