definition

Definition

Entrapment neuropathy of posterior tibial nerve within the tibial tunnel

Anatomy

Flexor Retinaculum 

- medial malleolus to posterior calcaneum

Tarsal tunnel

- roof is flexor retinaculum

- tibia anteriorly

Definition

Crushing osteochondritis of metatarsal head

Epidemiology

Usually 2nd metatarsal (80%)

- occasionally third

- can occur in any

Age 10-15 years

- peak 15 year old girls

- F:M = 3:1

- occurs during the growth spurt at puberty

Bilateral in 6%

Aetiology

Definition

Neuropathic Arthropathy

Progressive destructive arthropathy 2° to neurological condition

- usually minimal to no trauma

Aetiology

Definition

Spondylolithesis caused by

- facet joint degeneration

- no pars or dysplastic pathology

- disc space usually preserved

Most common at L4/5 level

Epidemiology

More common in elderly females

- F: M = 5:1

Diabetics

Definition

Lateral deviation of the spine that develops after the age of 50

- minimal structural vertebral deformity

Lower lumbar

- convex left

Aetiology

Unknown

Definition

Different entity to thoracic Scheuermann's

- end plate abnormal but no kyphosis or wedging

Natural History

Self - limiting condition

Epidemiology

Young athlete / labourer

Symptoms

Adolescent who presents with low grade levels of low back pain

- more pain than thoracic

Signs

Definition 

Structural kyphosis of thoracic or thoracolumbar spine

- characterised by vertebral wedging & subsequent growth disturbance of vertebral end plate

X-ray Diagnostic Criteria Sorensen 1964

1.  Kyphosis > 45°

2. > 5° wedging 3 or more adjacent apical vertebrae

Other features

- Schmorl nodes

Definition

Pain in region of coccyx

Epidemiology

Women

- often obese

- mean age 40 years

Aetiology

Fracture

Difficult vaginal delivery

Subluxation / hypermobile coccyx

Anatomy

3 or 4 fused coccygeal vertebrae

Triangular structure

Definition

A HLA B27 positive, seronegative spondyloarthropathy with sacroiliac joint & spine involvement

Mainly affects the cartilaginous joints of the axial skeleton

Diagostic Criteria (1966 New York)

1. Positive X-ray Sacroiliitis

Definition

Presentation of scoliosis deformity after skeletal maturity

- must be > 21 years at first presentation

- any of usual causes

Typically

- thoracolumbar / lumbar

Epidemiology

Idiopathic 

- most common cause of adult scoliosis

- incidence is  ~ 5% in population