Medial Tibial Stress Syndrome
- pain along the tibial origin of tibialis posterior or soleus
Pain anterior aspect of shin
- running
- soccer
- basketball
Compartment Syndrome
Stress fracture of tibia
Usually 2° to changes in activity
- increase in mileage
Groin pain in athletes
- secondary to tear in external oblique fascia
Sports with aggressive adduction
- hockey / soccer
Tears in external oblique fascia
- tend to be central
- around spermatic cord and ilioinguinal nerve
- pain may be from nerve entrapment
Adductor Longus Tear
The deposition of calcium in joints
- often in degenerative cartilage
- many different causes
Crystals can be salts of
- Calcium pyrophosphate dihydrate (CPPD)
- Dicalcium phosphate hydrate
- Calcium hydroxyapatite
- Calcium oxalate
WHIP A DOG
Wilson's
Haemochromatosis, hyperparathyroidism
Surgical Diagnosis
1. Prosthetic loosening and failure
2. Infection
3. Patellofemoral tracking problems
4. Instability
5. Recurrent intra-articular soft-tissue impingement / Component overhang
Nonsurgical Diagnoses
1. Referred pain - Hip / Back
1. Establish a differential
2. Stage locally and systemically
3. Biopsy
4. Definitive Treatment
Questions
- what do you think it is?
OCD
OA - Osteophytes
Meniscus
Pain
Locking
Clicking
Can cause chondral damage
OA Loose Bodies
Repetitive friction of iliotibial tract over GT
Overuse in athletes
Common post THR
May be associated with gluteus medius tears
Pain over upper lateral thigh with activity
- often related to hip flexion
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
Hyperextension of MTPJ and PIPJ / DIPJ flexion
- usually all toes affected
1. Complex hammer
- hammer toe with MTPJ extension
- hammer usually affects second toe
2. Curly toe
OA
Psoriasis
CREST (scleroderma)
RA (rare form)
Other seronegative arthropathies
Hyperparathyroidism
Reactive arthropathy
Gout