Tendon Problems Flashcards
what percentage of MSK complaints are tendon related
30%
what is tendinopathy?
disease of a tendon
term for tendon related pain
what is tendonitis?
inflammation of a tendon
what is tendonosis?
chronic tendon injury with damage to a tendon’s ECM
what is tenosynovitis?
inflammation of the tendon sheath
what is an enthesopathy?
inflammation of the tendon origin or insertion into bone
what would you see on histology of tendon problems?
nothing
which 2 tendon problems are notorious for not having any signs on histology?
tennis elbow
golfers elbow
what is the function of a tendon?
link muscle to motor unit to enable joint function
predominant cell in tendons?
fibroblast
what do fibroblasts do?
produce and maintain collagen + other proteins
what is the main component of a tendon?
type 1 collagen
name some intrinsic factors that cause tendon problems?
age
gender
obesity
comorbidities eg RA
extrinsic factors that cause tendon problems?
trauma repetitive trauma steroids fluoroquinolones eg cipro sports
what happens in tendinosis?
degeneration of collagen and ECM
what causes the degradation in tendinosis?
matrix metallinoprteinases
is tendonosis always painful?
no, but can be painful in some
most common areas to get tendinosis?
areas of poor blood supply
analgesics of choice for managing tendon problems?
NSAIDs
what tendon problem in the lower limb is usually treated by splinting?
Achilles tendonitis
main treatment pathway for soft tissue inflammatory problems?
rest
NSAIDs
steroid injections
surgical treatment of chouce for supraspinatus tendonitis?
decompression
why would you do a synovectomy in tendon problems?
prevents rupture
most common rotator cuff to become affected?
supraspinatous
clinical presentation of rotator cuff pathology?
dull achy pain in upper arm that gradually increases
why do patients with rotator cuff pathology feel pain down their arm?
shoulder pain refers to axillary dermatome
examination findings of someone with rotator cuff pathology
tenderness around GH and AC joint
painful arc
rotator cuff weakness
+ve impingement tests eg Hawkins kennedy, jobe’s, scarf test
treatment for rotator cuff pathology?
3 months physio steroid injections (at least 2 before going to surgery)
biggest muscle of the rotator cuff?
subscapularis