Diff Diagnosis of the Septic Arthritis
– See: Synovial F. Exam – ewing’s sarcoma – neuroblastoma – rheumatoid flare – monarticular JRA – knee is less painful, and ROM is > than expected w/ large effusion; – … Read more
Arthroscopy
DeQuervain’s Disease
– See: – Anatomic Snuff Box – First Compartment – Discussion: – a stenosing tenosynovitis of APL & EPB tendons (first compartment) at the styloid process of the radius; – inflammation causes thickening & stenosis of synovial sheath of first compartment & pain w/ tendon movement; – most common in women between 30 and 50 … Read more
Deltoid Ligament Injuries arising from Ankle Frx
– Discussion: – in absence of a medial malleolar fracture deltoid ligament may be stretched or torn in all oblique frx of fibula; – this ligament prevents posterior tibial tendon from slipping into ankle joint; – ligament ultimately heals in a lengthen position; – these … Read more
Washout and Debridement: for Acutely Infected TKR
– See: TKR Infection Menu – debridement w/o component removal: – see debridement and washout of infected THR – IV antibiotic therapy has limited success in treatment of infected TKR; managed with wound debridement, polyethyene exchange, application of temporary antibiotic beads, and IV antibiotics; – acute hematogenous infection: – early acute hematogenous infection … Read more
Debridement of Chondral Defects of the Knee
– Discussion: (see osteochondral injury) – these injuries are distinct from degenerative arthritic lesions and management of these lesions should remain distinct as well; – theory is that penetration of subchondral bone causes bleeding from underlying vessels which allows clot formation in the cartilaginous defect and subsequent formation of fibrocartilage; – some argue that subchondral drilling … Read more
Carpal Tunnel References
Review Articles: Current Concepts: Entrapment Neuropathies of the Upper Extremities. Carpal tunnel syndrome in patients who are receiving long-term renal hemodialysis. The carpal tunnel syndrome. A study of carpal canal pressures. Spontaneous rupture of the flexor carpi radialis tendon. Deep postoperative wound infection after carpal tunnel release. Symptomatic restrictive thumb-index flexor tenosynovitis: incidence of musculotendinous … Read more
Caput Ulnae Syndrome
– See: – Radial Ulnar Joints – Rheumatoid Arthritis – Discussion: – ulnar caput syndrome results from synovitis stretching ulnar carpal ligaments; – there is dorsal dislocation of distal ulna, supination of carpus on hand, volar subluxation of the ECU; – left untreated, ulnar translocation … Read more
Calcific Tendinitis of Shoulder
– See: Rotator Cuff Tear – Discussion: – deposits lie in the rotator cuff and contain H[2O, CO[3, & PO[4]; – usually does not occur until 4 th decade; – diabetic patients are more likely to develop asymptomatic rotator cuff calcium deposits; … Read more
Bupivacaine / Marcaine
– Dose: – maximum single doses should not > 150-175 mg w/o Epi; – Local Anesthesia: – 5 ml to the maximal recommended dose (25 milligrams to maximal dosage) w/ 0.5% solution, which produces moderate to complete motor blockade; – Arthroscopic surgery: – 30 mL of 0.75% bupivacaine was injected … Read more
Bucket Handle Meniscus Tear
– See: Meniscal Tears – Discussion: – vertical longitudinal tear w/ displacement of inner margin – more common in younger pts & are frequently assoc w/ ACL tear; – 3 times more common in the medial as compared to the lat compartment – can produce the classic … Read more