differential diagnosis

DDx Radial wrist pain

DOG WRIST RIFT

 

De Quervain tenosynovitis

OA CMC / STT

G   Ganglion - volar 

 

W  Wartenberg's Syndrome (Compression Superficial Branch Radial nerve)

R   Radial artery thrombosis

I    Intersection syndrome (ECRL/B crossed by APL & EPB)

S   Scaphoid fracture / non-union / SL instability / SLAC wrist

T   Tumour

Lateral Epicondylitis / Tennis Elbow

Incidence

 

Lateral : Medial 9:1

 

Epidemiology

 

4th & 5th decades

- M = F

- 75% dominant arm 

 

50% of regular tennis players

- especially > 2 hrs / week

 

Aetiology

 

Insertion pathology / Enthesopathy

 

Over-extension of the elbow with supination / pronation

 

Anatomy

 

Lateral epicondyle

- anconeus from posterior face

- ECRB and EDC from anterior face (CEO)

AVN

 

SONK              vs                          Atraumatic AVN

 

>55                                              Often mid 30's

Painful THA

Aetiology

 

Intrinsic

 

Infection

 

Loosening

 

Thigh pain in uncemented

- micro motion at distal end of stem

- modulus mismatch

 

Stress fracture / insufficiency fracture

- pubic rami, sacral

 

Intra-operative fracture

 

Prosthesis failure

 

Subtle instability

 

Extrinsic

Toe Walking

Epidemiology

 

70% male

70% positive FHx

20% learning difficulties

 

DDx toe walking

 

Early / late onset

Unilateral  / bilateral

 

1.  Habitual

 

Toddlers - child can heel walk

 

2.  Structural

 

Fixed equinus - CTEV / arthrogryposis

Short / tight T Achilles

Space occupying lesion in calf