symptoms

Definition

Inflammation and degeneration of the achilles tendon in the midsubstance 2 - 6 cm from insertion

Definition

Adult form

- 45 year old females

- more severe than Kohler's

Symptoms

Intense pain +/- oedema & inflammation

- often pronounced limp

- marked flat foot with prominant navicular

Radiology

Navicular narrowed

- lateral part dense, sclerotic & thin

- occasional fracture line

Epidemiology

Rare

- unilateral

- bilateral

Mechanism

Compression

Lateral Compression

Rotation

Clinical

Skull base pain

Cock Robin

Cranial nerve injury

Classification Anderson & Montesano

Type I

Impaction of a condyle 

Definition

Isolated posterior ligament injuries

- PLL / Posterior interspinous ligament / Paraspinal muscles

Excludes fracture / dislocation / HNP

Aetiology

MVA

Sport

Hyperflexion injuries

Symptoms

Large spectrum clinical presentation

- neck ache 

- nausea & vomiting 

- headache 

- visual symptoms

Definition

Chronic Regional Pain Syndrome

CRPS 1

Sympathetically mediated pain syndrome

- excessive or exaggerated response of extremity to injury, surgery or disease

Manifested by

- intense or unduly prolonged pain

- vasomotor disturbances

- trophic changes

- delayed functional recovery

CRPS 2

Incidence

Knee > Hip

- superficial position

- limited cover of well vascularised muscle 

- watershed area of skin blood supply anterior to the skin incision 

- much increased in fully constrained prosthesis 

Ideal < 1%

Risk Factors

Increased with

- revision

- prior infection

- RA / Psoriatic arthropathy

- DM

Symptoms

Period of pain relief after disc surgery

- followed by increasing back pain & occasional leg pain

Pain may be disproportionate to physical findings

Low grade fever common

SLR & femoral stretch tests elicit pain in some cases 

Bloods

Symptoms

Complain of pain with prolonged standing

Complain feet tire easily

Examination

Overall alignment

Heel raises

Epidemiology

Adolescents & young adults

Usually between 12 - 21 years 

Throwing athletes / gymnasts

Little Leaguer's Elbow

- combination of capitellar OCD and MCL injury

- a repetitive throwing injury / seen in pitchers

Aetiology

1.  Trauma & Overuse

Common throwing sports / gymnastics

Epidemiology

Most common in lateral meniscus 9:1

Peak incidence 20-40

Aetiology

Probably 2° to infiltration of joint fluid into extra-articular tissues

- almost always associated with horizontal cleavage tear

- creates a flap valve in lateral 1/3 of LM

Symptoms

Usually present with pain

- activity related

May notice lump