natural history

Incidence

Epidemiology

National Spinal Cord Injury Statistical Center (2021) Facts and figures at a glance

- road traffic accident 40%

- falls 30%

- sports 10%

Chen et al Arch Phys Med Rehab 2016

- 80% male

- cervical (60%), thoracic (30%), lumbar (10%)

Definition

Transient disturbance of spinal cord function

- +/- vertebral column injury

- no pathological changes in spinal cord

Mechanism

Rapid change in velocity following trauma

- football / ice hockey

Associations

Congenitally narrow spinal cord

Hypermobility

Definition

Radius rotates externally in relation to the ulna

- posterior displacement of the radial head relative to the capitellum

- in flexion

Anatomy LCL

Non-operative Management

Natural history

Return to Sport

Shelbourne et al. Am J Sports Med 1999

- 133 patients with isolated PCL injuries followed for mean of 5 years

- 1/2 returned to sport at same level of play

- 1/3 returned to sport at lower level of play

https://pubmed.ncbi.nlm.nih.gov/10352760/

Agolley et al. Bone Joint J 2017

Definition

Pigmented Villo-Nodular Synovitis

- benign inflammatory process that arises in synovial tissues

- contains significant amounts of hemosiderin

Epidemiology

Age: 20 - 50

Sex: M > F

Types

A.  Diffuse

- throughout joint synovium

- more difficult to treat / excise fully

Definition

CP is a permanent disorder of movement and posture 

- non-progressive 

- brain injury before the age of two years

Strict definition excludes familial & progressive congenital problems & those acquired in childhood as a result of head injuries

Incidence

2-3 per 1000 live births

Higher in 

Definition

Self limiting syndrome of unknown aetiology

- hip pain associated with osteoporosis of proximal femur 

DDx

AVN

- AVN of the hip in pregnancy is rare but possible

- TOH tends to be diffuse on MRI, while AVN is localised

- extends to neck and metaphysis

- transient osteoporosis has normal bone scan

Incidence

Rare

- M: F 3:1

Definition

Non-traumatic or traumatic condition of femoral head with bone death

Epidemiology

20 - 50 yo (average 38)

- M: F 4:1

NHx  

70-80% with AVN will progress within 1 year

AVN  

Largely related to degree of displacement

Incidence

Hawkins Type I

- 0% to 13% 

Hawkins Type II 

- 20% to 50% 

- usually only patchy and not a problem (rarely collapses)