Transcript signs and symptoms Specific site: pressure point, masses Pain

Chronic Injury of Locomotor System
HUANG, Shilong
Department of Orthopedics, Tongji Hospital
 Chronic Injury of Locomotor
System
Classification
Chronic
Injury
of Soft
Tissue
Cartilage
chronic
injury
Classification
chronic
musculoskeletal
injuries
Entrapment
Syndrome
of
Peripheral
Nerve
signs and symptoms
Pain
Specific site:
pressure point,
masses
signs and
symptoms
Local inflammation
is not obvious
overuse
Related with vocation,
sitting position, work
habits, etc.
principle of treatment
1
Rest
2
Physical
therapy,
massage
3
Corticostero
id injection
4
5
3
NASIDs
Surgery
Chronic Injury of Soft Tissues
mechanical back pain
muscle- or ligament-related injuries.
Causes

Strained muscles

Sprained ligaments
Signs and symptoms
1
pain
2
obvious
pressure
point
3
musculus
sacrospinalis
contracture
sign
4
radiating
pain
Treatment
Pain relief, Non
Steroid Anti
Inflammatory
Drugs (NSAIDs)
and Muscle
relaxants.
 (eperisone
hydrochloride)

Bursitis
the inflammation of one or more bursae (small
sacs) of synovial fluid in the body
Example of Elbow Bursitis
Signs and symptoms

Bursitis symptoms vary from local
joint pain and stiffness, to stinging
pain that surrounds the joint around
the inflamed bursa. In this condition,
the pain usually is worse during and
after activity, and then the bursa and
the surrounding joint become stiff
the next morning.
Treatment
rest, ice, elevation,
physiotherapy
anti-inflammatory
drugs
and pain medication
bursectomy
Stenosing tenosynovitis
Stenosing tenosynovitis
(often called trigger finger,
trigger thumb, stenosing
tenovaginitis) is a painful
condition caused by the
inflammation (tenosynovitis)
and progressive restriction of
the superficial and deep
flexors fibrous tendon sheath
adjacent to A1 pulley at a
metacarpal head.
trigger finger
Causes
overuse from
chronic repetitive
activities using
the hand or the
involved finger
Signs and
symptoms
Treatment
Pain
Modification
of hand
activities
Catching
Locking
Swelling
Corticosteroid
injections
Surgical
release
Surgical release
Ganglion
is a swelling that
often appears on
or around joints
and tendons in
the hand or foot.
Treatment

Aspiration

Surgical treatments
Lateral epicondylitis
known as tennis
elbow, is a
condition where
the outer part of
the elbow
becomes sore and
tender.
Causes
•direct blows to the epicondyle
•a sudden forceful pull
•forceful extension
Signs and symptoms
1.Pain on the outer
part of elbow.
2.Gripping and
movements of the
wrist hurt.
3.Activities that use
the muscles that
extend the wrist.
Treatment
4
3
2
NSAIDs
1
prevent reirritation of
the tendon
Corticoster
oid
injection
Surgery
Frozen shoulder

is a disorder in which
the shoulder capsule,
the connective tissue
surrounding the
glenohumeral joint of
the shoulder, becomes
inflamed and stiff,
greatly restricting motion
and causing chronic
pain.
Signs and diagnosis
1
3
Female＞Male
Left＞Right
Commonly in
quinquagenarian
2
The joint
becomes so
tight and stiff
that it is nearly
impossible to
carry out simple
movements.
The active range
of motionare the
same or almost
the same as the
limits to the
passive range of
motion
4
An arthrogram
or an MRI scan
may confirm the
diagnosis
Treatment

restoring joint
movement and
reducing shoulder pain,
involving medications,
physical therapy,
and/or surgical
intervention.
Avascular Necrosis of Femoral Head
avascular necrosis
of the femoral head

is a disease where
there is cellular death
(necrosis) of bone
components due to
interruption of the
blood supply.
Causes
post trauma
others
alcoholism
vascular compression
Causes
caisson disease
excessive steroid use

Femur head showing a
flap of cartilage
(osteochondritis
dissecans) due to
avascular necrosis.
Specimen from total hip
replacement surgery.
Signs and symptoms

Patients may have
tenderness around the
affected bone

Both active and passive
joint movements may be
restricted and painful.

Cause joint deformity
and muscle wasting
Diagnosis



X-ray images of
avascular necrosis
in the early stages
usually appear
normal
CT
MRI
Treatment
1
2
conservati
ve
treatment
core
decompress
ion
3
the free
vascular
fibular
graft
4
5
transplant
ing MSCs
total hip
replaceme
nt
Chronic Trauma of Bone and Cartilage
chondromalacia patellae
Chondromalacia is due to an irritation
of the undersurface of the kneecap.
Signs and symptoms
1.Pain at the front/inner
side of the knee is
common in young
adults
2.The pain of
chondromalacia
patellae is typically felt
after prolonged sitting,
like for a movie, and
so it is also called
"movie sign" or
"theater sign."
Treatment
physiotherapy
RICE
(rest, ice,
compression,
elevation)
anti-inflammatory
medications
Intra-articular
injection cortisone
(Careful)
surgery
(good outcomes
without surgery)
Legg-Perthe disease

Legg–Calvé–Perthes
syndrome is a form of
osteochondritis of the
hip joint, where
growth/loss of bone
mass leads to some
degree of collapse of
the hip joint and to
deformity of the ball of
the femur and
sometimes the surface
of the hip socket.The
disease is typically
found in young
children
Entrapment Syndrome of Peripheral
Nerve
entrapment syndrome of
peripheral nerve

It is a medical condition
caused by direct pressure on
a single nerve. Its symptoms
include pain, tingling,
numbness, and muscle
weakness. The symptoms
affect just one particular part
of the body, depending which
nerve is affected.
carpal tunnel syndrome
is an entrapment
median neuropathy,
causing paresthesia,
pain, numbness, and
other symptoms in
the distribution of the
median nerve due to
its compression at
the wrist in the carpal
tunnel.
Causes
1
pressure
on the
median
nerve at
the wrist
2
3
intrinsic
factors
that
exert
pressure
within
the
tunnel
extrinsic
factors
(pressure
exerted
from
outside
the tunnel)
Treatment
Immobilizing braces
Localized corticosteroid injections
Signs and symptoms
numbness, tingling, or burning
sensations in the thumb and fingers.
Untreated Carpal Tunnel Syndrome
Treatment
Carpal tunnel release surgery
The End!