Disruption of the normal smooth motion of the scapulothoracic joint
- posterior scapula pain with overhead motion
1. Bony abnormalities
- osteochondromas
- prominence of the superior medial border of the scapula / Luschka tubercle
2. Soft tissue abnormalities
- bursitis / scar tissue
- muscular weakness
3. Masses
Labral tear
Cam / pincer impingement
Loose bodies / trauma / synovial proliferation
Operative v Nonoperative
Levy et al Arthroscopy 2009
- systematic Review
- improved outcomes with operative management
https://pubmed.ncbi.nlm.nih.gov/19341932/
Vicenti et al. Injury 2019
- systematic review
- two studies compare operative v nonoperative
Metaphyseal
Extra-articular
Congenital
Acquired
- trauma
- post ACL reconstruction / TKR
- chronic quadriceps rupture
Decreases ROM
Associated with early OA of the PFJ
Blackburne-Peel ratio at 30 degrees flexion
Facet joint dislocations secondary flexion distraction injury
10%
1. Unifacet subluxation - interspinous process widening
2. Unifacet dislocation - 25% anterolisthesis
3. Bifacet dislocation - 50% anterolisthesis
4. Complete vertebral translation - 100% anterolisthesis
1. Direct lateral blow to patella
- usually with knee partly flexed and quadriceps relaxed
2. Indirect low energy injury
Instability in at least 2 planes
- postero-inferior
- antero-inferior
- antero-postero-inferior
Recognised as a common problem
- often misdiagnosed
Most patients athletic