The Hip - book

Amyotrophic Lateral Sclerosis

– See: – El Escorial Revisited: Revised Criteria for the Diagnosis of Amyotrophic Lateral Sclerosis – Disorders of Nerves: – Anterior Horn Cell Disorders: – ALS Society Homepage – Discussion: – amyotrophic lateral sclerosis is a syndrome characterized by both upper and lower motor neuron disease; – destruction of anterior horn cells & descending corticospinal tracts; … Read more

Allografts

– see bone graft menu – Discussion of Allografts:     – see autograft menu and bone healing:      – allografts are most indicated when bone grafting is required along with need for mechanical structural support;     – morselized bone graft:     – structural bone grafts:      – fresh allografts            – generally … Read more

Alendronate / Fosamax

– Discussion: (see bisphosphonates)     – type of aminobisphosphonate (a synthetic analogs of pyrophosphate) which acts as an inhibitor of osteoclast-mediated bone resorption;     – due to substantial reduction in bone resorption, bone formation exceeds bone resorption at these remodeling sites, which leads to                progressive gains in bone mass;     – this … Read more

Adult Scoliosis

Discussion cardiopulmonary problems (thoracic curves > 60-65 deg alter PFT’s; curves > 90 deg may cause myelopathy & may affect mortality; progression is unlikely in curves < 30 deg single major thoracic curves > 60-80 deg are likely to increase in size even after growth was complete; rate of progression is about one degree per … Read more

Adult Degenerative Spondylolisthesis

– Discussion:     – often occurs as a result of degenerative disc disease and facet deficiency;     – it is often associated w/ intersegmental instability and w/ central stenosis;     – more commonly involves older black females and diabetics (affects females 6 times as much as males);     – involves L4-L5 … Read more

Adolescent Sternoclavicular Joint Injury

– See: SC Joint Injury – Medial SC Joint Injury:     – injury is due separation of proximal clavicular physis rather than dislocation;     – need to determine if proximal clavicular metaphysis (distal fragment) is anterior or posterior;     – anterior and superior displacement of medial end of clavicle or x-ray appearance … Read more

Adhesive Capsulitis of the Shoulder

– Discussion: – refers to a condition in which the shoulder capsule becomes contracted and thickened; – patients note a dramatic decrease in shoulder ROM; – in many cases there is spontaneous resolution after 1-3 years and motion is re-gained; – associated disorders: – cervical spondylosis – hypothyroidism – ref: Prevalence of hypothyroidism in patients … Read more

Acromioclavicular Joint

Discussion AC joint is situated between the clavicle and acromion; acromion has two ossification centers which fuse at age 22 yrs; it permits motion in three planes: AP gliding of acromion during protraction & retraction of scapula; tilting of acromion during abduction & adduction of arm; rotation of the clavicle; rotation occurs during abduction & … Read more

Achondroplasia

(see also: Pseudoachondroplasia) Discussion autosomal dominant disorder; arises due to a point mutation for the gene encoding a fibroblast growth factor (Fibroblast growth factor receptor 3) over 80% of all persons with this disorder are born to parents who are not achondroplastic, & such parents rarely have second achondroplastic child; it is presumed in these … Read more