Upper limb soft tissue injury Flashcards
What is De Quervain’s tenosynovitis?
De Quervain’s tenosynovitis is a common condition in which the sheath containing the extensor pollicis brevis and abductor pollicis longus tendons is inflamed. It typically affects females aged 30 - 50 years old.
What are the features of De Quervain’s tenosynovitis?
Features include pain on the radial side of the wrist, tenderness over the radial styloid process, and painful abduction of the thumb against resistance.
What is Finkelstein’s test?
Finkelstein’s test involves the examiner pulling the thumb of the patient in ulnar deviation and longitudinal traction. In a patient with tenosynovitis, this action causes pain over the radial styloid process and along the length of extensor pollicis brevis and abductor pollicis longus.
What are the management options for De Quervain’s tenosynovitis?
Management options include analgesia, steroid injection, and immobilisation with a thumb splint (spica). Surgical treatment is sometimes required.
What are the features of lateral epicondylitis (tennis elbow)?
Pain and tenderness localized to the lateral epicondyle. Pain worsens on resisted wrist extension with the elbow extended or supination of the forearm with the elbow extended. Episodes typically last between 6 months and 2 years, with acute pain for 6-12 weeks.
What are the features of medial epicondylitis (golfer’s elbow)?
Pain and tenderness localized to the medial epicondyle. Pain is aggravated by wrist flexion and pronation. Symptoms may be accompanied by numbness/tingling in the 4th and 5th finger due to ulnar nerve involvement.
What is radial tunnel syndrome?
It is most commonly due to compression of the posterior interosseous branch of the radial nerve, thought to be a result of overuse.
What are the features of radial tunnel syndrome?
Symptoms are similar to lateral epicondylitis, making it difficult to diagnose. However, the pain tends to be around 4-5 cm distal to the lateral epicondyle. Symptoms may be worsened by extending the elbow and pronating the forearm.
What is cubital tunnel syndrome?
It is due to the compression of the ulnar nerve.
What are the features of cubital tunnel syndrome?
Initially, there is intermittent tingling in the 4th and 5th finger, which may worsen when the elbow is resting on a firm surface or flexed for extended periods. Later, there may be numbness in the 4th and 5th finger with associated weakness.
What is olecranon bursitis?
Swelling over the posterior aspect of the elbow, which may be associated with pain, warmth, and erythema. It typically affects middle-aged male patients.
What is lateral epicondylitis commonly known as?
Lateral epicondylitis is commonly known as ‘tennis elbow’.
What activities typically lead to lateral epicondylitis?
Lateral epicondylitis typically follows unaccustomed activity such as house painting or playing tennis.
What age group is most affected by lateral epicondylitis?
It is most common in people aged 45-55 years.
Which arm is typically affected by lateral epicondylitis?
Lateral epicondylitis typically affects the dominant arm.
What are the key features of lateral epicondylitis?
Key features include pain and tenderness localized to the lateral epicondyle.
How does pain present in lateral epicondylitis?
Pain worsens on wrist extension against resistance with the elbow extended or supination of the forearm with the elbow extended.
What is the typical duration of episodes in lateral epicondylitis?
Episodes typically last between 6 months and 2 years.
What is the initial acute pain duration in lateral epicondylitis?
Patients tend to have acute pain for 6-12 weeks.
What are the management options for lateral epicondylitis?
Management options include advice on avoiding muscle overload, simple analgesia, steroid injection, and physiotherapy.
