Tendonopathies

Question 1

What is the difference between tendonitis and tendonosis?

Answer 1

Tendonitis involves acute injury + inflammation

Tendonosis is chronic damage at a cellular level with no inflammation

Question 2

What is an enthesopathy?

Answer 2

Inflammation of tendon at its insertion into bone

Question 3

What is the predominant cell in tendons?

Answer 3

Fibroblast (maintain type 1 collagen)

Question 4

List clinical features of rotator cuff tear

Answer 4

Achy pain
Tenderness over shoulder/ACJ
Difficulty sleeping on side
Painful arc

Question 5

Which imaging is the gold standard for viewing rotator cuff?

Answer 5

Ultrasound

Question 6

Biceps tendonopathy predominately affects which head of biceps brachii?

Answer 6

Long head

Question 7

List clinical features of biceps tear

Answer 7

Anterior shoulder pain
“Snapping”
Popeye sign
Bruising

Question 8

Which part of the epicondyle is affected in Golfer’s and Tennis elbow?

Answer 8

Golfer = medial (shoot to centre)
Tennis = lateral (hit to lateral edges)

Question 9

Which muscles are inflamed in Golfer’s and Tennis elbow respectively?

Answer 9

Flexor forearm muscles

Extensor forearm muscles

Question 10

Which area is affected in De Quervain’s tenosynovitis?

Answer 10

First compartment of thumb (APL, EPB)

Pain over radial styloid process

Question 11

What is the main conservative treatment for tendonopathies?

Answer 11

Rest
Analgesia
Injections (steroid)
Splinting

Question 12

What are some surgical treatments for tendonopathies?

Answer 12

Debridement
Decompression
Synovectomy
Tendon transfers/grafts

Question 13

What is the mechanism of injury for De Quervain’s tenosynovitis?

Answer 13

Repetitive strain injury
Pregnancy
RA

Question 14

Which test is used to diagnose De Quervain’s tenosynovitis?

Answer 14

Finklesteins’ test (fist over thumb and ulnar deviation)

Question 15

Extensor mechanism tendon rupture and Achilles tendon rupture cannot be treated with…

Answer 15

CCS injection

Question 16

What is the classical sign of extensor mechanism tendor rupture?

Answer 16

Palpable gap

No straight leg raise

Question 17

What is Osgood-Shlatter’s disease?

Answer 17

Excessive pull by patella tendon caused damage to tibial tubercle, resulting in a prominent bony lump over the tibial tubercle

Question 18

Who typically gets Osgood-Shlatter’s disease?

Answer 18

Adolescent active boys

Question 19

Which test should be performed if Achilles tendon rupture is suspected?

Answer 19

Simmonds test

No plantarflexion when back of calf is squeezed

Question 20

What are the clinical features of De Quervain’s tenosynovitis?

Answer 20

Inflamed red, swollen tendon to thumb

Painful