clinical photos

Examination

Diagnostic Issues

 

Supraclavicular

- nerve root patterns of sensation and motor disturbance

 

Infraclavicular

- peripheral nerve root pattern / cord

 

Supraclavicular preganglionic

- dorsal scapular / long thoracic / suprascapular nerves injured

- Horner's

- lack of sensation supraclavicular

- no tinel's

 

Background

Definition

 

A fixed equinus deformity of the forefoot in relation to the hindfoot 

- resulting in an abnormally high arch that fails to flatten with weight bearing

- deformity may be forefoot, hindfoot or combination

 

Foot CavusFoot Cavovarus

 

Aetiology

 

Background

Aetiology

 

Intrinsic

- inflammatory

- degenerative

 

Extrinsic

- traumatic

- spur

 

Epidemiology

 

F > 40

 

Associations 60% of cases  

- hypertension

- diabetes

- obese

- trauma 

- prior surgery

- steroids

 

Proximal Hamstring Tear

EpidemiologyProximal Hamstring Tear

 

Adolescent apophyseal avulsion

- treat non operatively

- unless displaced > 2 cm

 

Adult

- soft tissue avulsion

 

Aetiology

 

Usually associated with sporting activities

- skiing

- water skiing

 

Violent contraction

- knee extended

- hip flexing

 

Anatomy

 

Rheumatoid Fingers

ConditionsBoutonniere Fingers

 

1.  PIPJ Synovitis

- synovectomy via dorsomedial approach

2.  Flexor tenosynovitis

- may cause trigger finger

- trial HCLA

- remove synovits but don't release A1 pulley

- will worsen ulna drift

3.  DIPJ

- rarely affects

Hand RA Exam

Screening of Joints

 

Neck

-  ROM

 

Shoulder

- behind head / to mouth

- to back pocket 

 

Elbows

- flexion / extension elbows 

- pronation / supination with thumb up & elbows by side

 

Wrist

- flexion / extension

 

Hand

- make fist with thumb in and out 

Distal Biceps Tendon Rupture

Epidemiology

 

Dominant arm of middle aged men

- between 40 and 60

 

Aetiology

 

Sudden dramatic event

- sporting / weightlifting injury

- resisting heavy extension load

 

Pathology

 

Degenerative changes seen on histology

 

Types

 

Complete

- retracted / rupture of lacertus fibrosis

- minimally retracted

RA Hand Exam

Screening of Joints

 

Neck

-  ROM

 

Shoulder

- behind head / to mouth

- to back pocket 

 

Elbows

- flex / extend elbows 

- pronation / supination with thumb up & elbows by side

 

Wrist

- flexion / extension

 

Hand

- make fist with thumb in and out