Present with varying degrees of shoulder pain, loss of motion, weakness, and scapular deformity Electromyography (EMG) is the definitive study to evaluate for scapular winging originating from muscular or neurologic abnormalities Primary winging : medial(long thoracic nerve injury) or lateral(spinal accessory nerve injury) secondary winging : intrinsic glenohumeral conditions (e.g., rotator cuff pathology and glenohumeral instability) that disrupt scapular motion…
Synovium is susceptible to bacterial seeding Kochers predictors : Refusal to bear weight, Temperature >38.5°C, White blood cell count >12,000 cells/mm3, Erythrocyte sedimentation rate >40 mm/hr, C-reactive protein (CRP) levels >2.0 mg/dL (>20 mg/L) Ultrasound is useful for demonstrating effusion as well as for guiding aspiration MRI is indicated if ultrasound or aspiration is negative Antibiotics should not be unduly…
Most common disorder affecting adolescent hips Associated conditions : Hypothyroidism, Renal osteodystrophy, Growth hormone deficiency Southwick Slip Angle Classification: 0-30, 30-50 and >500 X rays- AP & frog-leg lateral of right and left hip MRI-may help diagnose a preslip condition when radiographs are negative To avoid delayed diagnosis, physicians should consider SCFE in any patient 10 to 15 years of age with…
Present with neurogenic claudication Conservative management : 85% of patient remained symptomatic over 4 years Epidural injections are frequently used as a first approach Spine (Phila Pa 1976), June 15, 2010: Surgically treated – greater improvement N Engl J Med, April 24, 2016 : No benefit of fusion JBJS-Am, November 16, 2016 : Instrumentation –no use Complications following surgery are…
Spinal involvement starts at the thoracolumbar spine and finally involves whole spine Leads to progressive kyphosis of thoracic spine and loss of lordosis of cervical and lumbar spines and compensatory flexion deformity of hips and knees Costovertebral joints affected which leads to restrictive lung capacities Sacroiliitis occurs early in the course of ankylosing spondylitis and is regarded as a hallmark…
Cervical spine is commonly affected in RA Following involvement is seen in decreasing order: Anterior atlontoaxial subluxation, atlantoaxial subluxation combined with subaxial Subluxation, Isolated subaxial subluxation, Superior migration of odontoid (a/k/a basilar invagination or vertical atlontoaxial instability Present with neck pain and paraesthesia / numbness in upper/lower extremities X rays are useful in identifying cervical spine changes Non operative management…
