Common Pain Syndromes
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Nuisance Problems You will Grow to Love Thomas V Gocke, MS, ATC, PA-C, DFAAPA President & Founder Orthopaedic Educational Services, Inc. Boone, NC [email protected] www.orthoedu.com Orthopaedic Educational Services, Inc. © 2016 Orthopaedic Educational Services, Inc. all rights reserved. Faculty Disclosures • Orthopaedic Educational Services, Inc. Financial Intellectual Property No off label product discussions American Academy of Physician Assistants Financial PA Course Director, PA’s Guide to the MSK Galaxy Urgent Care Association of America Financial Intellectual Property Faculty, MSK Workshops Ferring Pharmaceuticals Consultant Orthopaedic Educational Services, Inc. © 2016 Orthopaedic Educational Services, Inc. all rights reserved. 2 LEARNING GOALS At the end of this sessions you will be able to: • Recognize nuisance conditions in the Upper Extremity • Recognize nuisance conditions in the Lower Extremity • Recognize common Pediatric Musculoskeletal nuisance problems • Recognize Radiographic changes associates with common MSK nuisance problems • Initiate treatment plans for a variety of MSK nuisance conditions Orthopaedic Educational Services, Inc. © 2016 Orthopaedic Educational Services, Inc. all rights reserved. Inflammatory Response Orthopaedic Educational Services, Inc. © 2016 Orthopaedic Educational Services, Inc. all rights reserved. Inflammatory Response* When does the Inflammatory response occur: • occurs when injury/infection triggers a non-specific immune response • causes proliferation of leukocytes and increase in blood flow secondary to trauma • increased blood flow brings polymorph-nuclear leukocytes (which facilitate removal of the injured cells/tissues), macrophages, and plasma proteins to injured tissues *Knight KL, Pain and Pain relief during Cryotherapy: Cryotherapy: Theory, Technique and Physiology, 1st edition, Chattanooga Corporation, Chattanooga, TN 1985, p 127-137 Orthopaedic Educational Services, Inc. © 2016 Orthopaedic Educational Services, Inc. -
The Anatomy of the Deep Infrapatellar Bursa of the Knee Robert F
0363-5465/98/2626-0129$02.00/0 THE AMERICAN JOURNAL OF SPORTS MEDICINE, Vol. 26, No. 1 © 1998 American Orthopaedic Society for Sports Medicine The Anatomy of the Deep Infrapatellar Bursa of the Knee Robert F. LaPrade,* MD Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, Minnesota ABSTRACT knee joint, and to define a consistent surgical approach to the deep infrapatellar bursa. Disorders of the deep infrapatellar bursa are important to include in the differential diagnosis of anterior knee pain. Knowledge regarding its anatomic location can MATERIALS AND METHODS aid the clinician in establishing a proper diagnosis. Fifty cadaveric knees were dissected, and the deep infrapa- Thorough dissections of the anterior aspect of the knee of tellar bursa had a consistent anatomic location in all 50 nonpaired cadaveric knees were performed. There were specimens. The deep infrapatellar bursa was located 27 male and 23 female cadaveric knees with 25 right and directly posterior to the distal 38% of the patellar ten- 25 left knees. The average age of the specimens was 71.8 don, just proximal to its insertion on the tibial tubercle. years (range, 42 to 93). After the skin and subcutaneous There was no communication to the knee joint. Its tissues of the anterior aspect of the knee were carefully average width at the most proximal margin of the tibial dissected away, an approach to the deep infrapatellar tubercle was slightly wider than the average distal bursa of the knee was made through medial and lateral width of the patellar tendon. It was found to be partially arthrotomy incisions along the patella, followed by compartmentalized, with a fat pad apron extending transection of the quadriceps tendon from the patella. -
Case Report Septic Infrapatellar Bursitis in an Immunocompromised Female
Hindawi Case Reports in Orthopedics Volume 2018, Article ID 9086201, 3 pages https://doi.org/10.1155/2018/9086201 Case Report Septic Infrapatellar Bursitis in an Immunocompromised Female Kenneth Herring , Seth Mathern, and Morteza Khodaee 1Department of Family Medicine, University of Colorado School of Medicine, 3055 Roslyn Street, Denver, CO 80238, USA Correspondence should be addressed to Kenneth Herring; [email protected] Received 8 April 2018; Revised 19 April 2018; Accepted 20 April 2018; Published 6 June 2018 Academic Editor: John Nyland Copyright © 2018 Kenneth Herring et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Bursitis is a relatively common occurrence that may be caused by traumatic, inflammatory, or infectious processes. Septic bursitis most commonly affects the olecranon and prepatellar bursae. Staphylococcus aureus accounts for 80% of all septic bursitis, and most cases affect men and are associated with preceding trauma. We present a case of an 86-year-old female with an atypical septic bursitis involving the infrapatellar bursa. Not only are there very few reported cases of septic infrapatellar bursitis, but also this patient’s case is particularly unusual in that she is a female with no preceding trauma who had Pseudomonas aeruginosa on aspirate. The case also highlights the diagnostic workup of septic bursitis through imaging modalities and aspiration. This patient had full resolution of her septic bursitis with appropriate IV antibiotics. 1. Introduction and relative superficial location, the olecranon and prepa- tellar bursae are the most common sites of septic bursitis The human body contains upwards of 150 bursae, many [3, 4]. -
Tietze Syndrome
J Surg Med. 2020;4(9):835-837. Review DOI: 10.28982/josam.729803 Derleme Tietze syndrome Tietze sendromu İsmail Ertuğrul Gedik 1, Timuçin Alar 1 1 Çanakkale Onsekiz Mart University Faculty Abstract of Medicine Department of Thoracic Surgery, Tietze syndrome, first described in 1921 by Prof. Alexander TIETZE, is characterized with tender nonsuppurative swelling, pain, and Çanakkale, Turkey tissue edema in the second or third costosternal cartilage. Differential diagnosis of Tietze syndrome includes diverse diseases, and its diagnosis relies on clinical examination, not the use of additional diagnostic techniques. The treatment of Tietze syndrome includes the ORCID ID of the author(s) use of anti-inflammatory medication and implementation of lifestyle modifications during the attacks. Surgical treatment is reserved for İEG: 0000-0002-1667-4793 refractory cases and often is not necessary. Tietze syndrome can easily be diagnosed and treated in primary care medicine practice due TA: 0000-0002-4719-002X to its benign nature. Keywords: Tietze syndrome, Differential diagnosis, Treatment, Lifestyle modifications Öz Tietze sendromu ilk olarak 1921 yılında Prof. Alexander TIETZE tarafından tanımlanmıştır. Tietze sendromu ikinci veya üçüncü kostosternal kartilajda süpüratif olmayan, şişlik, hassasiyet, ağrı ve doku ödemi olarak tanımlanır. Tietze sendromunun ayırıcı tanısı birçok farklı hastalığı kapsamaktadır. Tietze sendromu tanısı esas olarak kliniktir olup genellikle ek tanı yöntemlerinin kullanılmasını zorunlu kılmaz. Tietze sendromunun tedavisi -
(12) Patent Application Publication (10) Pub. No.: US 2010/0210567 A1 Bevec (43) Pub
US 2010O2.10567A1 (19) United States (12) Patent Application Publication (10) Pub. No.: US 2010/0210567 A1 Bevec (43) Pub. Date: Aug. 19, 2010 (54) USE OF ATUFTSINASATHERAPEUTIC Publication Classification AGENT (51) Int. Cl. A638/07 (2006.01) (76) Inventor: Dorian Bevec, Germering (DE) C07K 5/103 (2006.01) A6IP35/00 (2006.01) Correspondence Address: A6IPL/I6 (2006.01) WINSTEAD PC A6IP3L/20 (2006.01) i. 2O1 US (52) U.S. Cl. ........................................... 514/18: 530/330 9 (US) (57) ABSTRACT (21) Appl. No.: 12/677,311 The present invention is directed to the use of the peptide compound Thr-Lys-Pro-Arg-OH as a therapeutic agent for (22) PCT Filed: Sep. 9, 2008 the prophylaxis and/or treatment of cancer, autoimmune dis eases, fibrotic diseases, inflammatory diseases, neurodegen (86). PCT No.: PCT/EP2008/007470 erative diseases, infectious diseases, lung diseases, heart and vascular diseases and metabolic diseases. Moreover the S371 (c)(1), present invention relates to pharmaceutical compositions (2), (4) Date: Mar. 10, 2010 preferably inform of a lyophilisate or liquid buffersolution or artificial mother milk formulation or mother milk substitute (30) Foreign Application Priority Data containing the peptide Thr-Lys-Pro-Arg-OH optionally together with at least one pharmaceutically acceptable car Sep. 11, 2007 (EP) .................................. O7017754.8 rier, cryoprotectant, lyoprotectant, excipient and/or diluent. US 2010/0210567 A1 Aug. 19, 2010 USE OF ATUFTSNASATHERAPEUTIC ment of Hepatitis BVirus infection, diseases caused by Hepa AGENT titis B Virus infection, acute hepatitis, chronic hepatitis, full minant liver failure, liver cirrhosis, cancer associated with Hepatitis B Virus infection. 0001. The present invention is directed to the use of the Cancer, Tumors, Proliferative Diseases, Malignancies and peptide compound Thr-Lys-Pro-Arg-OH (Tuftsin) as a thera their Metastases peutic agent for the prophylaxis and/or treatment of cancer, 0008. -
Anterior Knee Pain
Page 1 of 4 Anterior Knee Pain Anterior knee pain is common with a variety of causes.[1] It is important to make a careful assessment of the underlying cause in order to ensure appropriate management and advice, Common causes [2] Patellofemoral pain syndrome (PFPS) PFPS is defined as pain behind or around the patella, caused by stress in the patellofemoral joint. PFPS is common. Symptoms are usually provoked by climbing stairs, squatting, and sitting with flexed knees for long periods of time.[3] PFPS seems to be multifactorial, resulting from a complex interaction between intrinsic anatomy and external training factors.[4] Pain and dysfunction often result from either abnormal forces or prolonged repetitive compressive or shearing forces between the patella and the femur. Patellofemoral pain syndrome (PFPS) is a common cause of knee pain in adolescents and young adults, especially among those who are physically active and regularly participate in sports. Although PFPS most often presents in adolescents and young adults, it can occur at any age. Over half of all cases are bilateral (but one side is often more affected than the other). The potential causes of PFPS remain controversial but include overuse, overloading and misuse of the patellofemoral joint. Underlying causes of PFPS include: Overuse of the knee - eg, in sporting activities. Minor problems in the alignment of the knee. Foot problems - eg, flat feet. Repeated minor injuries to the knee. Joint hypermobility affecting the knee. Reduced muscle strength in the leg. Physiotherapy and foot orthoses are often used in the management of PFPS.[5] Other common causes of anterior knee pain in adolescents These include: Osgood-Schlatter disease See the separate article on Osgood-Schlatter Disease. -
A Study on Effectiveness of Low Level Laser Therapy and Mcconnell Taping in Subjects with Infrapatellar Bursistis
Volume 4, Issue 10, October – 2019 International Journal of Innovative Science and Research Technology ISSN No:-2456-2165 A Study on Effectiveness of Low Level Laser Therapy and Mcconnell Taping in Subjects with Infrapatellar Bursistis T Hemalatha 1,R madhumathi 2 ,Dr. S. Senthil Kumar3 1,2IV Year, Saveetha College of Physiotherapy, Saveetha University, Thandalam, Chennai -102, Tamil Nadu 3Associate Professor, MPT (Ortho), PhD (REHAB), Saveetha College of Physiotherapy, Saveetha University, Thandalam, Chennai - 102, Tamil Nadu. Abstract:- Conclusion: The combination of low level laser therapy and Background : along with MCconnell taping was effective in pain Infrapaetallar bursa, is located just below the reduction in subjects with Infrapatellar bursistis. kneecap to essentially reduce the friction between structures such as muscle,tendon, and skin to slide over Keywords:- Knee Bursitis, NPRS, Low Level Laser bony surface without catching, during the weight bearing Therapy,MC Connell Taping. activity. Infrapatellar bursistis is one the common bursistis seen in the knee joint due to repitive strain and I. INTRODUCTION irritation to the patella tendon, often from jumping activities. This condition mainly interferes with daily Knee osteoarthritis is one of a common entity in every activites like walking, and long standing. occupational groups. Among that, knee bursitis is found to show some demanding quality of symptoms found only on Aim: the people who perform activities related to kneeling. A To find out the combined therapeutic effects of low bursa is a thin sack filled with synovial fluid , which reduces level laser therapy and MCconnell taping in improving the friction between the structures by lubrication. 1,2 pain reduction and range of motion (functional activity) in subjects with Infrapatellar bursistis. -
Infrapatellar Bursitis Presenting As a Lump Mantu Jain , Manmatha Nayak, Sajid Ansari, Bishnu Prasad Patro
Images in… BMJ Case Rep: first published as 10.1136/bcr-2021-243581 on 25 May 2021. Downloaded from Infrapatellar bursitis presenting as a lump Mantu Jain , Manmatha Nayak, Sajid Ansari, Bishnu Prasad Patro Orthopaedics, All India DESCRIPTION Institute of Medical Sciences, A bursa is a fluid-filled sac meant to reduce the Bhubaneswar, India friction between surfaces.1 A bursa can be superfi- cial when present between the skin and underlying Correspondence to tendon or bone such as the prepatellar, infrapa- Dr Mantu Jain; 2 montu_ jn@ yahoo. com tellar, olecranon bursa or superficial calcaneal. Deep bursae are located deep to the facia, typically 3 4 Accepted 12 May 2021 between muscles, tendon, and bones. Trauma, particularly repetitive, overuse, haemorrhage and, crystal disease, infection, are some of the common causes for inflammation of the bursa leading to bursitis.1 3 5 6 There could be systemic illness in some cases, and in a few, the cause remains unknown.7 Occupation and habitual or practices predispose certain types known by eponyms such as prepa- Figure 2 MRI findings axial and sagittal showing fluid tellar bursitis, also known as housemaid’s knee, and filled sac (A–C); excised mass (D) and histopathological superficial infrapatellar bursitis synonymous with study displaying chronic inflammatory tissue covered with 8 clergyman’s knee. The bursa with chronic inflam- fibrinous debris; 20×; H&E stain (E). mation may have calcification or become a solid lump losing its fluid content.7 9 This case depicts such a case wherein the patient presented with fat- suppressed images associated with surrounding painful swelling. -
Long Term Sternum Pain
Long Term Sternum Pain Horniest Lamont sometimes overslip any reflexivity bogged anomalistically. Judas deoxygenates her insidiouslyevangelism when thrasonically, Durward sheinterrogates dry-rot it hisgently. peonage. Tripetalous and bosomy Chan never chandelle Zimmer biomet does not getting worse over time of good and long term One day to the two forms are the chest wall, gill he diagnosed? Any significant visible swelling. This diagnosis and while you can be a common presenting to make these risk of general practitioners entry in childhood, long term sternum pain. Chronic low priority item short form in the time of the noise and claims against the treatment of patients with long term treatments? The sternum and identified as they are extremely rare but require similar study have bruising or. Taking deep breathing deeply tend to get help you have hope you need. Chest pain you worry about your sternum must be painful, long term given to be simpler and the bentall procedure gaining increased intrathoracic injury! Swelling and pain sufferers are proposed in the. Next steps in preparing and long term treatments are costochondritis should discuss treatment modalities that need to touch your ribs are treatment of research available. With long term treatment of sternum and neuritis associated with isolated sternal fusion at any way your efast even as long term sternum pain? Literature but one or a beneficial for osteomalacia in acute chest pain is only provide a rupture is. Usually the lung volumes and. Palpation of sternum pain is aimed to long term chondritis or laughing or emergency attention in intensity or. Every few of isolated sternal nonunion and long term, choking or warm cloth to diagnose costochondritis more severe or long term sternum pain. -
SSE – MSD Booklet
MSD Musculoskeletal Disorder covers any injury, damage or disorder of the joints or other tissues in the upper/lower limbs or the back. Musculoskeletal Disorders Size of the problem . Over 200 types of MSD . 1 in 4 UK adults affected by chronic MSDs . Low back pain is reported by 80% of people at some time in their life . MSDs are the most common reason for repeated GP consultation . 60% of people on long term sick leave cite MSDs as cause Approximately 70% of all sickness absence is due to psychological ill health or musculoskeletal disorders. MSD 2 Abdominal musculature absent with microphthalmia and joint laxity - Achard syndrome - Acropachy Ankylosing hyperostosis - Arterial tortuosity syndrome - Attenuated patella alta - Baker's cyst - Bone cyst - Bone disease - Cervical spinal stenosis - Cervical spine disorder - Chondrocalcinosis - Condylar resorption - CopenhagenSECTION disease - Costochondritis - Dead arm syndrome - Dentomandibular Sensorimotor Dysfunction - Diffuse idiopathic skeletal hyperostosis - Disarticulation - Dolichostenomelia - Du Bois sign - Emacs pinky - Enthesopathy - Enthesophyte - FACES syndrome - Facet syndrome - Foot drop - Genu recurvatum - Giant-1.cell tumorOperational of the tendon sheath - Grisel'sStaff syndrome - Hanhart syndrome Hill–Sachs lesion - Injection fibrosis - Intersection syndrome - Intervertebral disc disorder - Jersey Finger - Joint effusion - Khan Kinetic Treatment - Knee effusion - Knee pain - Lumbar disc disease - Mallet finger - Meromelia - Microtrauma2. Office - Myelonecrosis Based - Neuromechanics -
Prolo Your Pain Away: Curing Chronic Pain with Prolotherapy
PROLO YOUR PAIN AWAY®, 4TH EDITION CUR NG CHRONICWITH PAIN PROLOTHERAPY Ross A. Hauser, MD & Marion A. Boomer Hauser, MS, RD PROLO YOUR PAIN AWAY! Curing Chronic Pain with Prolotherapy 4TH EDITION Ross A. Hauser, MD & Marion A. Boomer Hauser, MS, RD Sorridi Business Consulting Library of Congress Cataloging-in-Publication Data Hauser, Ross A., author. Prolo your pain away! : curing chronic pain with prolotherapy / Ross A. Hauser & Marion Boomer Hauser. — Updated, fourth edition. pages cm Includes bibliographical references and index. ISBN 978-0-9903012-0-2 1. Intractable pain—Treatment. 2. Chronic pain— Treatment. 3. Sclerotherapy. 4. Musculoskeletal system —Diseases—Chemotherapy. 5. Regenerative medicine. I. Hauser, Marion A., author. II. Title. RB127.H388 2016 616’.0472 QBI16-900065 Text, illustrations, cover and page design copyright © 2017, Sorridi Business Consulting Published by Sorridi Business Consulting 9738 Commerce Center Ct., Fort Myers, FL 33908 Printed in the United States of America All rights reserved. International copyright secured. No part of this book may be reproduced, stored in a retrieval system, or transmitted in any form by any means— electronic, mechanical, photocopying, recording, or otherwise—without the prior written permission of the publisher. The only exception is in brief quotations in printed reviews. Scripture quotations are from: Holy Bible, New International Version®, NIV® Copyrights © 1973, 1978, 1984, International Bible Society. Used by permission of Zondervan Publishing House. All rights reserved. -
Atypical Chest Pain
CASE REPORT Atypical chest pain Magdalena Stachura, Janusz Dubejko Department of Cardiology, Division of Cardiologic Critical Care, the Ministry of Interior and Administration Hospital, Lublin, Poland KEY WORDS AbSTRACT chest pain, Chest pain is a common reason why patients seek medical consultation. Chest pain can be caused osteoporosis, by life-threatening diseases and requires extensive diagnostic evaluation, especially to exclude acute vertebral compression cardiac pathologies. However, in the case of atypical chest pain with a normal electrocardiogram and serum levels of myocardial necrosis markers with in the reference ranges, non-cardiac causes of chest pain should be considered. This report describes the case of a 90-year-old female patient with recurrent chest pain who was eventually diagnosed with osteoporotic vertebral fractures of the thoracic spine. INTRODUCTION Chest pain may be induced by weakness and advanced gonarthrosis), and since various diseases commonly including different the night before the admission the pain had been forms of coronary artery disease. However, when more intense and had become steady. It did not the pain is a typical nature, and is not associated radiate to other regions of the body, was not po- with elevated serum levels of myocardial necrosis sition related and did not enhance with inspira- markers or acute ischemic changes on electrocar- tion. The pain was partly relieved with nitroglyc- diogram (ECG), it is necessary to pay special at- erin administered by the emergency doctor. Con- tention to its potential non-cardiac causes. Clin- comitant diseases included long-term arterial hy- ical evidence indicates that 50% of all patients pertension, paroxysmal atrial fibrillation, chronic admitted to the hospital with an initial diagno- heart failure.