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MSK > Tendon problems > Flashcards

Tendon problems Flashcards

1
Q

What is a tendinopathy?

A

Disease of a tendon - tendon related pain

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2
Q

What is tendonitis?

A

Inflammation of a tendon

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3
Q

What is tendonosis?

A

Chronic tendon injury with damage to a tendon ECM

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4
Q

What is tenosynovitis?

A

Inflammation of the tendon sheath

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5
Q

What is enthesopathy?

A

Inflammation of the tendon origin or the insertion onto a bone

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6
Q

What is the purpose of tendons?

A

To transmit load from muscle to bone

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7
Q

What is the composition of a tendon?

A

Water
Collagen type 1
Proteiglycans

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8
Q

What do fibroblasts produce?

A

Collagen

Proteoglycan

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9
Q

What is the hierarchial structure of tendons?

A

Microfibrils make up subfibrils which inturn make up fibrils
Hundreds of fibrils make a fasicle
Fasciles are separated by endotenon which is covered by an epitenon

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10
Q

What is the blood supply to tendond?

A

3 sources:
Perimyseum
Periosteal insertion of the tenson
Paratenon

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11
Q

What are the principles of management of tendon issues?

A

RICE
PT
Analgesics - NSAIDs
Injections - rotator cuff, tennis elbow but NOT achillles tendon or extensor mechanism
Splinting - achilles
Surgical: depridement, decompression (supraspinatous tendonitis and subacromial decompression)
Synovectomy (prevent rupture, extensor tendons of wrist, tibialis posterior)
Tendon transfer - tibialis posterior, extensor pollicis longus

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12
Q

What are the clinical findings of rotator cuff pathology?

A

Achy painful arm
Difficulty sleeping on affected side, reaching overhead and on lifting
Painful arc
Weakness on testing of rotator cuffs
Positive impingement tests (hawkins kennedy, jobes, scarf test)

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13
Q

How are rotator cuff pathologies managed?

A

Conservative - PT, steroid injections

Surgical - subacromial decompression

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14
Q

What is the gold standard for imaging a rotator cuff tear?

A

USS

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15
Q

What can cause biceps tendinopathy?

A

Overuse, instability, impingement or trauma

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16
Q

Where will the pain be in biceps tendionpathy?

A

Pain anterior shoulder radiating to the elbow particularly over the biciptal groove
Aggravated by shoulder flexion

17
Q

How is biceps teniopathy managed?

A

Conservative (PT and rest)

Surgical

18
Q

What are the clinical examination findings or a biceps rupture?

A

Popeye sign
Extensive brusing
Hook test

19
Q

What is lateral epicondylitis?

A

Tendonosis and inflammation at the ECRB origin

Peritendinous inflammation leads to angiofibroblastic hyperplasia leading to breakown and fibrosis

20
Q

What actions will cause pain in lateral epicondylitis?

A

Pain and tenderness over the lateral epicondyle
Pain with resisted extension of the middle finger
Non-inflammatory
Worse when stretching muscles e.g. opening a jar

21
Q

What is the management for lateral epicondylitis?

A

Self-limting
Injections - can take up to 4 years
Surgical release and debridemnt of ECRB origin

22
Q

What other associated conditions is medial epicondylitis associated with?

A

Ulnar neuropathy - paraesthesia of ulnar nerce

Consider decompression of cubital tunnel

23
Q

Why should steroid injections be involved in medial epicondylitis?

A

The ulnar nerve is very close by

24
Q

What are the common clinical findings of a quads or patellar rupture?

A

Palpable gap
NO SLR
Patella may be high or low depending on what tendon ruptures

25
Q

How is a quads/ patellar tendon rupture treated?

A

Surgical repair

26
Q

What can predispose to a tendon rupture?

A

Associated with blunt or penetrating trauma
Steroid use
Ciprofloxacin
RhA

27
Q

What is traction apophysitis??

A

At the tibial tubercle = osgood-schlatters disaese

Insertion of patellar tendon onto tibial tuberosity leaves a prominet bony lump

28
Q

What is the classical history of an achilles tendon rupture?

A

Sudden accelration and then a feeling of being kicked or shot in the back of the leg

29
Q

What are the clinical findings of achilles tendon rupture?

A

Palpable gap
Unable to tiptoe stand
Simmonds’s test +ve

30
Q

How is achilles tendon rupture treated?

A

Serial equinus cast

Surgical repair

31
Q

What is a positive simmonds’s test?

A

When squeezing the calf the foot should plantarflex but in achilles tendon rupture it will not move

32
Q

What will tibialis posterior tendon dysfunction lead to?

A

Progressive flat fett

Valgus hindfoot

33
Q

How can tibialis posterior tendon dysfunction be treated?

A 
NSAIDs
Orthotics
Cast
Inject
Debride
Tendon transfer (last resort)

MSK (34 decks)

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