Transcript CHRONIC INJURY OF LOCOMOTOR SYSTEM Pro. Feng Yin Dr

CHRONIC INJURY OF LOCOMOTOR SYSTEM
Pro. Feng Yin
Dr Min Ma
Shanghai East Hospital
Dept.Joint Surgery & Sports Medicine
Chronic Injury in Locomotor
System
Lumbar Muscle Strain
Trauma of Supraspinous Ligment
Bursitis
Stenosing Tendinitis
Scapulohumeral Periarthritis
External Humeral Epicondylitis(Tennis Elbow)
Ganglion Cyst
You Should Comprehend
The Diagnosis
The Treatment Principles
The Diagnosis
• History of Excessive Activity ,Career
Injury,trauma is Not Clear
• Long-term Pain
• Tenderness or Swelling
• Local Inflammation is Not Obvious
Treatment Principles
• Posture and Position
• Improve Local Circulation
(Massage,drug)
• Steroid Injection
• NSAIDs
• Surgery
Key Point
The Diagnosis and Treatment of
Tendon Sheath Cyst and Tenosynovitis
The Diagnosis and Differential Diagnosis of
Common Locomotor System Chronic Injury
Bursitis
• Anatomy
• Anatomical Slippery Bursa
• Additional Slippery Bursa
Elbow
Shoulder
Anatomy
Anatomical Slippery Bursa
Hip Knee
Clinical Features
Long-term Friction of Bone Calcification
•Sitting Position —— Ischiogluteal Bursitis
•Kneeling Position —— Prepatellar Bursitis
•High Heels，Pointed Shoes ——Toe Bursitis
Diagnosis
• Cystic Mass of Bone Calcification
• Hard,Fluctuations,Tenderness,Lowmobility
• Puncture (Clear, Viscous or Bloody)
• Secondary Infection （suppurative
bursitis）
Treatment
• Puncture Pumping Liquid
and Compression Bandage
• Surgery
Tendon Sheath Cyst
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Active Part of Upper and Lower Limbs
Slow Growth Mass
Maybe History of Trauma
Smooth Surface, Fluctuation
Tenderness or not
Popliteal Fossa Cyst (Baker Cyst)
Treatment
• Puncture Pumping Liquid and
Extrusion Rupture
• Surgery
Lumbar Muscle Strain
• Anatomy
•Spinal Instability
•The Bearing of Lower
Lumbar
•Chronic Strain
Diagnosis
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History of Trauma is Not Explicit
Persistent Low Back Pain
Fixed Pressure Point
Lumbar Muscle Strain
Scoliosis Deformity
Treatment
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Prevention and Health Care
Strength Training
Rehabilitation Training
NSAIDs
Trauma of Supraspinous(interspinal) Ligment
• Anatomy
C:Wide，Thick
T:Slim
L:Wide，Thick
Diagnosis
• History of Trauma or Bend to Work For A Long
Time
• Pain in the Extension/Flexion Position
• Laxity / Tenderness on Supraspinal Ligament
Treatment
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Prevention
Brace
Steroid Injection
Physical Treatment
Tennis Elbow
• Anatomy
Tendon Attachment Points on Lateral
Epicondyle of Humerus
Etiology ＆ Pathology
• Etiology ：
Repeatedly Wrist (Finger) Activities
• Pathology：
Synovitis
Nerve Pinched
As the injuries heal, scar tissue develops.
Chronic re-injury causes the scar tissue to
remain weak and painful.
Diagnosis
• Pain on Lateral of Elbow
• Pain on Lateral Epicondyle of Humerus
• Mills（+）
Treatment
• Limit Activities
• External NSAIDs
• Focal Sealing
• Surgery
Scapulohumeral Periarthritis
• Chronic Inflammation of Muscle，Tendon，Slippery
Bursa
• Pain + Restrict + Dysfunction
• Factor：Strain + Degeneration + Inappropriate
Treatment
• During abduction of
the arm– rubbing and
pinching of the
tendons and bursa
against the acromion
and coracoacromial
ligaments can occur.
• With overuse this can
cause inflammation
and swelling of the
bursa.
• Continuous
irritation and
friction can cause
bone spurs to
develop on the
acromion.
• All of this results in
the space between
the acromion and
the humerus
becoming very
narrow.
• This causes
impingement and
eventual tearing of
the supraspinatus
tendon.
Diagnosis
• Pain
• Muscle atrophy
• Limited Activities of Shoulder Joint
Treatment
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Self-healing
Physiotherapy
External NSAIDs
Oral NSAIDs
康复治疗
Thanks！