Congenital Talipes Equinovarus
Congenital abnormality of the foot characterised by
- hindfoot equinus & varus
- forefoot Adduction
- midfoot Supination
Latin: talus - ankle / pes - foot / equinus - horse like
Foot
- pipe stem calf
- short wide foot
- small heel
- curved lateral border
CP is a permanent disorder of movement and posture
- non-progressive
- brain injury before the age of two years
Strict definition excludes familial & progressive congenital problems & those acquired in childhood as a result of head injuries
2-3 per 1000 live births
Higher in
Self limiting syndrome of unknown aetiology
- hip pain associated with osteoporosis of proximal femur
AVN
- AVN of the hip in pregnancy is rare but possible
- TOH tends to be diffuse on MRI, while AVN is localised
- extends to neck and metaphysis
- transient osteoporosis has normal bone scan
Rare
- M: F 3:1
Extraskeletal bone formation in periarticular tissues
- HA crystals within osteoid matrix
Different to calcification
- osteoid matrix laid down
1. Myositis Ossificans
- post traumatic
Benign, bone-forming neoplasm
- characterized by a small nidus of neoplastic tissue
- surrounded by a wide zone of mature, reactive bone
10% of benign bone tumours
Age 5-25
M:F 2:1
Unknown
- thought may be glomus tumour of bone
Pain secondary to prostaglandin production
Clostridial Myonecrosis
- necrotizing, gas producing infection of skeletal muscle 2° Clostridia
- life threatening & rapidly progressive
There are 3 types of bacterial gas-forming infections
1. Classical clostridial gas gangrene
- rapid onset of sepsis / couple of days
- muscle nearly always involved
- critically ill immediately following an open injury
Inflammation of achilles tendon; insertional or noninsertional
Tendonitis / Tendonosis / Rupture
Triceps surae
- medial and lateral gastrocnemius
- soleus
- surrounded by paratenon which allows gliding and supplies nutrition
Inserts middle 1/3 calcaneal tuberosity
- 2 x 2 cm area
- 90o rotation distally
Retrocalcaneal bursa (x2)
Human papilloma virus
Occur in any part of sole
Do not project above level of skin
- because of pressure of weight bearing
- seldom more than 1cm in diameter
- skin surrounding wart thickened and raised
- edge clearly demarcated from surrounding skin
Severe localised pain on walking
Local tenderness on pressure
M:F =2:1
30-40 years
20% diabetic
50-80% identifiable source
Lumbar (50%) > Thoracic > Cervical (<10%)
1. Haematogenous
- arterial rather than venous
Risk factors
- UTI (40% of all cases)
- IVDU
- elderly
Pus collection in the epidural space
Usually haemotogenous seeding
Very rare
- 37 / 1 000 000 patients with LBP
- 1 /10 000 admissions
- most common in old men
Average age 68 years
3/4 males
Rare in paediatrics