– Discussion: – polymyalgia rheumatica is a clinical syndrome that affects shoulder and hip girdles and causes severe pain and stiffness; – usually pt is in the sixth to seventh decade of life; – diff dx: – frozen shoulder (usually frozen shoulder is not associated w/ an elevated sed … Read more
(see also: juvenile RA menu) Discussion definition: > 5 involved joints; large and small joint may be affected; accounts for about 50% of patients w/ JRA; may occur at 1-3 yrs or during early adolescence (after age 10); children w/ seronegative arthritis usually present before age 5 years and have iridocyclitis if fewer than five … Read more
– Discussion: – indicated for displaced surgical neck, 3 part, and 4 part fracture; – deforming forces: – pectoralis major pulls the shaft medially, anteriorly and internally rotates; – supraspinatus abducts the head fragment in two part fractures; – w/ greater tuberosity is fracture, it will be pulled superiorly … Read more
– Discussion: – by definition, is a decrease of more than 2-5 mm in the verticle distance of the femoral stem; – minor subsidence is to be expected in the first year or two following surgery; – more than 5 mm of subsidence … Read more
– Discussion: – its essential to consider the differential dx and to examine the patient from the neck down to the finger tips; – in taking the history, be sure to inquire as to whether the patient’s main complaint is hand/wrist pain versus paresthesias; – it is also important … Read more
– Signs and Symptoms: (see C-spine Exam) – pain is earlly symptom, which may be ischemic in origin; – Myelopathy: – characterized by weakness (upper > lower extremity); – ataxic broad based suffling gait, sensory changes; – rarely urinary retention; – myelopathy hand: … Read more
– See: – Brachial Plexus – Neuro Exam – Diff Dx of Cervical Pathology: – Neuro Exam: – PE of Lumbar Spine: – Upper Cord Involvement: (see: cervical radiculopathy / myelopathy) C5 C6 C7 C8 T1 Sens: Lat arm Thumb … Read more
– Discussion: – pt w/ anterior dislocation keep affected arm at side of body in external rotation; – shoulder will loose its usual roundness and will be full anteriorly to palpation; – axillary nerve f(x) should be documented; – rotator cuff is frequently damaged & should be … Read more
– See: Peroneus Longus / Peroneus Brevis: – Discussion: – acute dislocation occurs by sudden forced dorsiflexion w/ concomitant eccentric contraction of the peroneal muscles; – classic teaching that the tendon dislocation occurs from a combination of dorsiflexion and eversion (like skiing), where as other authors feel that the injury occurs from dorsiflexion and inversion … Read more
– Discussion: – cartilaginous tumor that arises from surface of cortex deep to the periosteum producing broad based cartilaginous mass that may extend into soft tissues; – often develops after adolescence (in contrast to osteochondroma) – persists as mass of mature cartilage w/o calcification or ossification (in contrast to chondrosarcoma); … Read more