This document summarizes musculoskeletal disorders of the lower extremity, including skeletal and muscle disorders. It describes various joint disorders of the hip, knee, ankle and foot. Specific conditions mentioned include osteoarthritis, avascular necrosis, Legg-Calvé-Perthes disease, slipped capital femoral epiphysis, hip dislocation, labral injuries, and impingement syndromes of the hip. Injuries to various muscle groups like the quadriceps, hamstrings, adductors and plantar fascia are also summarized.
Iliotibial Band Syndrome (ITBS) is an overuse injury of the iliotibial band, a thick fascia that runs down the outside of the thigh. ITBS is caused by training errors like increasing mileage too quickly, running on uneven surfaces, or having poor form. Anatomical factors like tight muscles or leg length differences can also contribute. Diagnosis involves pain tests like the Renne Test or Noble Compression Test. Treatment starts with rest, ice, stretching, and anti-inflammatories. Later stages may include corticosteroid injections, surgery for refractory cases. Prevention focuses on gradual mileage increases, proper footwear, stretching, and avoiding uneven terrain.
Therapeutic management of knee osteoarthritis; physiotherap case studyenweluntaobed
The document discusses the therapeutic management of knee osteoarthritis. It provides background on the epidemiology and economic burden of the condition. Key points include that knee OA prevalence is rising with population aging and affects nearly 10% of those over 55 years old. Treatment involves a multidisciplinary approach including pharmacological interventions, physiotherapy, and sometimes surgery, with the overall goals of reducing pain and improving joint function and quality of life. Assessment involves evaluating pain levels, range of motion, muscle strength, and radiological imaging to determine the severity and appropriate treatment.
Osgood-Schlatter disease is an irritation of the patellar ligament at the tibial tuberosity that commonly occurs in adolescent athletes during periods of rapid growth. It is caused by small repetitive injuries to the tibial tuberosity before skeletal maturity. Symptoms include a painful swelling and bump over the shin. Conservative treatment includes rest, bracing, anti-inflammatories, and physiotherapy. The condition typically resolves on its own once skeletal maturity is reached.
Low back pain is a common condition affecting the lumbar region of the back. It has many potential causes, including muscle strains, injuries to bones or discs, and underlying medical conditions. Diagnosis involves taking a history and conducting a physical exam. Common tests used to evaluate low back pain include x-rays, MRI, and CT scans. Treatment focuses on pain relief through medications, physical therapy, exercise, and in severe cases, surgery. Proper posture and lifting techniques can help prevent low back pain.
This document provides information on low back pain, including its definition, prevalence, costs, causes, examination, diagnosis, and treatment options. Some key points:
- Low back pain is very common, affecting 60-80% of adults at some point. It costs the US over $90 billion annually in direct medical expenses and lost work.
- Causes can be non-spinal (e.g. hernia, infection) or spinal (e.g. arthritis, herniated disc, stenosis).
- Examination involves assessing gait, range of motion, motor strength, sensation, and reflexes. Common diagnostic tests are x-rays, MRI, CT.
- Treatment depends on cause but
Iliotibial Band Syndrome (ITBS) is an overuse injury of the iliotibial band, a thick fascia that runs down the outside of the thigh. ITBS is caused by training errors like increasing mileage too quickly, running on uneven surfaces, or having poor form. Anatomical factors like tight muscles or leg length differences can also contribute. Diagnosis involves pain tests like the Renne Test or Noble Compression Test. Treatment starts with rest, ice, stretching, and anti-inflammatories. Later stages may include corticosteroid injections, surgery for refractory cases. Prevention focuses on gradual mileage increases, proper footwear, stretching, and avoiding uneven terrain.
Therapeutic management of knee osteoarthritis; physiotherap case studyenweluntaobed
The document discusses the therapeutic management of knee osteoarthritis. It provides background on the epidemiology and economic burden of the condition. Key points include that knee OA prevalence is rising with population aging and affects nearly 10% of those over 55 years old. Treatment involves a multidisciplinary approach including pharmacological interventions, physiotherapy, and sometimes surgery, with the overall goals of reducing pain and improving joint function and quality of life. Assessment involves evaluating pain levels, range of motion, muscle strength, and radiological imaging to determine the severity and appropriate treatment.
Osgood-Schlatter disease is an irritation of the patellar ligament at the tibial tuberosity that commonly occurs in adolescent athletes during periods of rapid growth. It is caused by small repetitive injuries to the tibial tuberosity before skeletal maturity. Symptoms include a painful swelling and bump over the shin. Conservative treatment includes rest, bracing, anti-inflammatories, and physiotherapy. The condition typically resolves on its own once skeletal maturity is reached.
Low back pain is a common condition affecting the lumbar region of the back. It has many potential causes, including muscle strains, injuries to bones or discs, and underlying medical conditions. Diagnosis involves taking a history and conducting a physical exam. Common tests used to evaluate low back pain include x-rays, MRI, and CT scans. Treatment focuses on pain relief through medications, physical therapy, exercise, and in severe cases, surgery. Proper posture and lifting techniques can help prevent low back pain.
This document provides information on low back pain, including its definition, prevalence, costs, causes, examination, diagnosis, and treatment options. Some key points:
- Low back pain is very common, affecting 60-80% of adults at some point. It costs the US over $90 billion annually in direct medical expenses and lost work.
- Causes can be non-spinal (e.g. hernia, infection) or spinal (e.g. arthritis, herniated disc, stenosis).
- Examination involves assessing gait, range of motion, motor strength, sensation, and reflexes. Common diagnostic tests are x-rays, MRI, CT.
- Treatment depends on cause but
Acromioclavicular (AC) joint injury is a term used to describe an injury to the top of the shoulder, where the front of the shoulder blade (acromion) attaches to the collarbone (clavicle).
The document discusses spinal canal stenosis, including:
1. It describes spinal canal stenosis as the narrowing of the spinal canal and compression of the spinal cord and nerve roots, most commonly occurring in the lumbar vertebrae.
2. Symptoms include back pain radiating into the legs, numbness, and weakness that is relieved by bending forward and made worse by standing upright or walking.
3. Treatment options range from non-surgical approaches like medication, physical therapy, and epidural injections for mild-to-moderate cases to surgical decompression like laminectomy or the X-STOP implant for more severe cases.
Plantar fasciitis is an inflammation of the plantar fascia in the foot that causes heel pain. It is caused by overuse from activities like long-distance running or tight calf muscles limiting the foot's range of motion. Symptoms include pain, swelling, and warmth in the heel area. Conservative treatments include stretching exercises, orthotics, night splints, taping, and manual therapies to increase flexibility and support the arch. Treatment may last several months to two years and surgery is an option for severe cases that do not improve.
Dr. Manoj Das' document provides an overview of examining the foot and ankle. It discusses the anatomy of the foot and ankle including bones, joints, ligaments and muscles. The examination involves taking a history, observing gait, posture and deformities, palpating for tenderness, and assessing range of motion, neurovascular status, and performing special tests. The goal is to assess, diagnose and treat conditions of the foot and ankle.
Golfer elbow, also known as medial epicondylitis, is an overuse injury caused by repetitive motions that place stress on the tendons where the forearm muscles attach to the inner bump of the elbow. The condition causes pain on the inner elbow and difficulty with wrist movement. It commonly affects people over 30 years old who participate in sports like golf or tennis that involve swinging motions, or those with occupations requiring strong gripping. Conservative treatment includes rest, anti-inflammatory medications, physiotherapy, and bracing to decrease stress on the tendons.
Limb length discrepancy can be congenital or acquired. It is defined as a difference in leg length of 2.5 cm or more. A short leg causes an awkward gait, increased energy expenditure, and back pain. Treatment depends on the severity and includes shoe lifts for mild cases and epiphysiodesis, shortening, or lengthening procedures for larger discrepancies. Limb lengthening uses either external fixators like the Ilizarov or internal devices to gradually lengthen the bone through the process of distraction osteogenesis, where the bone is slowly pulled apart to stimulate new bone growth. Treatment must be tailored based on the individual's age, growth remaining, and specific condition.
- The ACL originates on the lateral femoral condyle and inserts on the tibia, providing primary stability to prevent anterior tibial translation.
- Most ACL tears are non-contact injuries involving sudden deceleration, change of direction, or landing from a jump with the knee near full extension.
- Physical exam includes Lachman, anterior drawer, and pivot shift tests to assess knee stability. MRI is used to confirm ACL tear.
- Treatment options include conservative rehab for partial or low-grade tears or ACL reconstruction surgery using grafts like patellar tendon or hamstring tendons fixed with interference screws. Post-op rehab emphasizes early range of motion and weight bearing.
hip osteoarthritis is most disabling condition and surgery is a consequence of the same. but if this condition can assess on time so it can be manageable with conservative treatment and decrease the prevalence of AVN. further life of an individual become better.
This document provides information on examining the foot, including anatomical features, common deformities, and examination techniques. It describes examining the child's foot for clubfoot and conditions like varus of the heel. Common mature foot issues are explored, such as hallux valgus, pes planus, claw toes, and hammer toes. Examination of movements, classifications of foot deformities, and specific conditions like flat foot are covered. Surgery for hallux valgus is also discussed.
Physiotherapy plays an important role in restoring patients after abdominal surgery through a variety of interventions. The goals of physiotherapy are to control postoperative pain, promote wound healing, prevent complications like atelectasis and DVT, and strengthen and mobilize weakened muscles. Treatments include breathing exercises, electrotherapy modalities like TENS and interferential therapy for pain management, soft tissue massage, and corrective positioning with passive and active movements to prevent stiffness. Physiotherapy aims to restore patients' optimum functional ability in both the short term to aid recovery and long term to improve strength, endurance, and functional capacity.
Knee braces are supports that you wear for a painful or injured knee. Some people use them to prevent knee injuries during sports. They come in many sizes, colors and designs. With such a huge range of knee supports it can be very difficult choosing the correct one. The pain can be caused from a variety of reasons, some of the most common being knee surgery, knee replacements, sports injuries. Have categorized our supports into Low, Medium, High and Ultimate level groups to help you make the correct choice for your knee injury. Braces are made from combinations of metal, foam, plastic, elastic material and straps.
more visit:- http://www.tradusway.com/personal-safety/medical-supply.html?p=1
Foot drop is the inability to lift the front part of the foot. It can be caused by injuries or conditions that damage the common peroneal nerve. Symptoms include difficulty lifting the foot and dragging the toes. Treatment depends on the underlying cause but may include bracing, nerve stimulation, tendon transfers, or joint fusions. The goal is to improve mobility and gait.
The document discusses the lumbar spine and low back pain. It describes the five lumbar vertebrae and structural adaptations of L5. The lumbo-sacral angle is discussed, which is formed between L5 and S1 and influences lumbar curvature. A subjective examination checklist is provided to assess location, quality, intensity, aggravating/easing factors of low back pain. Special questions are listed to evaluate for potential cauda equina syndrome or other neurological issues. Common causes of low back pain and spinal conditions like spondylolysis and spondylolisthesis are briefly mentioned.
This document discusses rehabilitation principles for multiple sclerosis (MS). It begins by defining MS as a chronic, progressive disease of the central nervous system characterized by demyelination of the brain and spinal cord. It then covers the epidemiology, pathogenesis, subtypes, common symptoms and signs, diagnosis using the McDonald criteria, disease severity as measured by EDSS, disease-modifying therapies, and approaches to managing common issues like gait impairment and fatigue through rehabilitation and exercise.
Spasticity, rigidity, hypotonia, dystonia, decerebrate rigidity, and decorticate rigidity are abnormal tones that can occur. Examination of tone includes initial observation, passive and active motion testing using scales like the Modified Ashworth Scale. Typical patterns of spasticity in upper and lower limbs are described for upper motor neuron lesions.
1. The document discusses various causes of low back pain (LBP), including injuries or conditions that affect the muscles, ligaments, bones, discs, nerves or blood vessels in the back.
2. Specific causes discussed include osteoporotic fractures, herniated discs, spinal stenosis, infections, ankylosing spondylitis, and conditions like pancreatitis or kidney infections that can cause referred pain in the back.
3. Diagnosis involves determining if the pain is nonspecific, radicular (down the leg), or indicates a serious underlying problem like cancer or infection based on risk factors, symptoms, and imaging tests.
This document discusses the assessment of the cervical spine. It begins with an introduction to the anatomy and biomechanics of the cervical spine. It then describes taking a patient history, including questions about pain and symptoms. The examination involves observation, palpation, range of motion testing, muscle strength testing, sensory testing, and special tests like Spurling's test. Diagnostic imaging options like x-rays, CT scans, and MRI are also discussed.
Lower Limb Orthotics - Dr Rajendra Sharmamrinal joshi
This document provides information on lower limb orthotics. It defines an orthosis and describes their clinical objectives in treating conditions like pain, deformities, abnormal range of motion, etc. It discusses different types of orthoses like foot, ankle-foot, knee-ankle-foot orthoses. Principles of bracing like distributing forces over large areas and applying forces to control joints are covered. Characteristics of an ideal orthosis in terms of function, comfort, cost are outlined. The document also discusses shoes, foot orthoses, ankle-foot orthoses made of plastic, metal and patellar tendon bearing designs.
Patellar tendinopathy, also known as jumper's knee, is a chronic overuse injury caused by repetitive stress on the knee extensor mechanism from activities like jumping, running, and kicking. It results from microtears in the patellar tendon from forces that are 3 times greater than normal during movements like acceleration, deceleration, takeoff, and landing. Symptoms include dull aching knee pain after exercise that worsens with sitting or stairs. Treatment focuses on eccentric strengthening exercises and bracing to promote healing of the tendon.
This document summarizes various musculoskeletal pathologies of the upper extremity that can be evaluated using nuclear medicine techniques like bone scintigraphy. It describes common conditions like impingement syndrome, osteomyelitis, fractures, and overuse injuries of the shoulder, elbow, and forearm that present with pain. Nuclear medicine imaging plays an important role in identifying these pathologies when plain radiographs are negative or inconclusive.
The document discusses various pathologies that can cause enlargement of different parts of the heart and pulmonary vasculature. It lists conditions such as mitral regurgitation, pulmonary venous hypertension, mitral stenosis, left atrial myxoma, and papillary muscle dysfunction that can lead to enlargement of the left atrium. It also lists increased blood flow, ventricular septal defects, patent ductus arteriosus, pulmonary arterial hypertension, and pulmonary venous hypertension as causes of enlargement of the main pulmonary artery. Finally, it discusses cardiomyopathy, pericardial effusion, multiple valve disease, and coronary artery disease as potential causes of cardiac dilation.
Acromioclavicular (AC) joint injury is a term used to describe an injury to the top of the shoulder, where the front of the shoulder blade (acromion) attaches to the collarbone (clavicle).
The document discusses spinal canal stenosis, including:
1. It describes spinal canal stenosis as the narrowing of the spinal canal and compression of the spinal cord and nerve roots, most commonly occurring in the lumbar vertebrae.
2. Symptoms include back pain radiating into the legs, numbness, and weakness that is relieved by bending forward and made worse by standing upright or walking.
3. Treatment options range from non-surgical approaches like medication, physical therapy, and epidural injections for mild-to-moderate cases to surgical decompression like laminectomy or the X-STOP implant for more severe cases.
Plantar fasciitis is an inflammation of the plantar fascia in the foot that causes heel pain. It is caused by overuse from activities like long-distance running or tight calf muscles limiting the foot's range of motion. Symptoms include pain, swelling, and warmth in the heel area. Conservative treatments include stretching exercises, orthotics, night splints, taping, and manual therapies to increase flexibility and support the arch. Treatment may last several months to two years and surgery is an option for severe cases that do not improve.
Dr. Manoj Das' document provides an overview of examining the foot and ankle. It discusses the anatomy of the foot and ankle including bones, joints, ligaments and muscles. The examination involves taking a history, observing gait, posture and deformities, palpating for tenderness, and assessing range of motion, neurovascular status, and performing special tests. The goal is to assess, diagnose and treat conditions of the foot and ankle.
Golfer elbow, also known as medial epicondylitis, is an overuse injury caused by repetitive motions that place stress on the tendons where the forearm muscles attach to the inner bump of the elbow. The condition causes pain on the inner elbow and difficulty with wrist movement. It commonly affects people over 30 years old who participate in sports like golf or tennis that involve swinging motions, or those with occupations requiring strong gripping. Conservative treatment includes rest, anti-inflammatory medications, physiotherapy, and bracing to decrease stress on the tendons.
Limb length discrepancy can be congenital or acquired. It is defined as a difference in leg length of 2.5 cm or more. A short leg causes an awkward gait, increased energy expenditure, and back pain. Treatment depends on the severity and includes shoe lifts for mild cases and epiphysiodesis, shortening, or lengthening procedures for larger discrepancies. Limb lengthening uses either external fixators like the Ilizarov or internal devices to gradually lengthen the bone through the process of distraction osteogenesis, where the bone is slowly pulled apart to stimulate new bone growth. Treatment must be tailored based on the individual's age, growth remaining, and specific condition.
- The ACL originates on the lateral femoral condyle and inserts on the tibia, providing primary stability to prevent anterior tibial translation.
- Most ACL tears are non-contact injuries involving sudden deceleration, change of direction, or landing from a jump with the knee near full extension.
- Physical exam includes Lachman, anterior drawer, and pivot shift tests to assess knee stability. MRI is used to confirm ACL tear.
- Treatment options include conservative rehab for partial or low-grade tears or ACL reconstruction surgery using grafts like patellar tendon or hamstring tendons fixed with interference screws. Post-op rehab emphasizes early range of motion and weight bearing.
hip osteoarthritis is most disabling condition and surgery is a consequence of the same. but if this condition can assess on time so it can be manageable with conservative treatment and decrease the prevalence of AVN. further life of an individual become better.
This document provides information on examining the foot, including anatomical features, common deformities, and examination techniques. It describes examining the child's foot for clubfoot and conditions like varus of the heel. Common mature foot issues are explored, such as hallux valgus, pes planus, claw toes, and hammer toes. Examination of movements, classifications of foot deformities, and specific conditions like flat foot are covered. Surgery for hallux valgus is also discussed.
Physiotherapy plays an important role in restoring patients after abdominal surgery through a variety of interventions. The goals of physiotherapy are to control postoperative pain, promote wound healing, prevent complications like atelectasis and DVT, and strengthen and mobilize weakened muscles. Treatments include breathing exercises, electrotherapy modalities like TENS and interferential therapy for pain management, soft tissue massage, and corrective positioning with passive and active movements to prevent stiffness. Physiotherapy aims to restore patients' optimum functional ability in both the short term to aid recovery and long term to improve strength, endurance, and functional capacity.
Knee braces are supports that you wear for a painful or injured knee. Some people use them to prevent knee injuries during sports. They come in many sizes, colors and designs. With such a huge range of knee supports it can be very difficult choosing the correct one. The pain can be caused from a variety of reasons, some of the most common being knee surgery, knee replacements, sports injuries. Have categorized our supports into Low, Medium, High and Ultimate level groups to help you make the correct choice for your knee injury. Braces are made from combinations of metal, foam, plastic, elastic material and straps.
more visit:- http://www.tradusway.com/personal-safety/medical-supply.html?p=1
Foot drop is the inability to lift the front part of the foot. It can be caused by injuries or conditions that damage the common peroneal nerve. Symptoms include difficulty lifting the foot and dragging the toes. Treatment depends on the underlying cause but may include bracing, nerve stimulation, tendon transfers, or joint fusions. The goal is to improve mobility and gait.
The document discusses the lumbar spine and low back pain. It describes the five lumbar vertebrae and structural adaptations of L5. The lumbo-sacral angle is discussed, which is formed between L5 and S1 and influences lumbar curvature. A subjective examination checklist is provided to assess location, quality, intensity, aggravating/easing factors of low back pain. Special questions are listed to evaluate for potential cauda equina syndrome or other neurological issues. Common causes of low back pain and spinal conditions like spondylolysis and spondylolisthesis are briefly mentioned.
This document discusses rehabilitation principles for multiple sclerosis (MS). It begins by defining MS as a chronic, progressive disease of the central nervous system characterized by demyelination of the brain and spinal cord. It then covers the epidemiology, pathogenesis, subtypes, common symptoms and signs, diagnosis using the McDonald criteria, disease severity as measured by EDSS, disease-modifying therapies, and approaches to managing common issues like gait impairment and fatigue through rehabilitation and exercise.
Spasticity, rigidity, hypotonia, dystonia, decerebrate rigidity, and decorticate rigidity are abnormal tones that can occur. Examination of tone includes initial observation, passive and active motion testing using scales like the Modified Ashworth Scale. Typical patterns of spasticity in upper and lower limbs are described for upper motor neuron lesions.
1. The document discusses various causes of low back pain (LBP), including injuries or conditions that affect the muscles, ligaments, bones, discs, nerves or blood vessels in the back.
2. Specific causes discussed include osteoporotic fractures, herniated discs, spinal stenosis, infections, ankylosing spondylitis, and conditions like pancreatitis or kidney infections that can cause referred pain in the back.
3. Diagnosis involves determining if the pain is nonspecific, radicular (down the leg), or indicates a serious underlying problem like cancer or infection based on risk factors, symptoms, and imaging tests.
This document discusses the assessment of the cervical spine. It begins with an introduction to the anatomy and biomechanics of the cervical spine. It then describes taking a patient history, including questions about pain and symptoms. The examination involves observation, palpation, range of motion testing, muscle strength testing, sensory testing, and special tests like Spurling's test. Diagnostic imaging options like x-rays, CT scans, and MRI are also discussed.
Lower Limb Orthotics - Dr Rajendra Sharmamrinal joshi
This document provides information on lower limb orthotics. It defines an orthosis and describes their clinical objectives in treating conditions like pain, deformities, abnormal range of motion, etc. It discusses different types of orthoses like foot, ankle-foot, knee-ankle-foot orthoses. Principles of bracing like distributing forces over large areas and applying forces to control joints are covered. Characteristics of an ideal orthosis in terms of function, comfort, cost are outlined. The document also discusses shoes, foot orthoses, ankle-foot orthoses made of plastic, metal and patellar tendon bearing designs.
Patellar tendinopathy, also known as jumper's knee, is a chronic overuse injury caused by repetitive stress on the knee extensor mechanism from activities like jumping, running, and kicking. It results from microtears in the patellar tendon from forces that are 3 times greater than normal during movements like acceleration, deceleration, takeoff, and landing. Symptoms include dull aching knee pain after exercise that worsens with sitting or stairs. Treatment focuses on eccentric strengthening exercises and bracing to promote healing of the tendon.
This document summarizes various musculoskeletal pathologies of the upper extremity that can be evaluated using nuclear medicine techniques like bone scintigraphy. It describes common conditions like impingement syndrome, osteomyelitis, fractures, and overuse injuries of the shoulder, elbow, and forearm that present with pain. Nuclear medicine imaging plays an important role in identifying these pathologies when plain radiographs are negative or inconclusive.
The document discusses various pathologies that can cause enlargement of different parts of the heart and pulmonary vasculature. It lists conditions such as mitral regurgitation, pulmonary venous hypertension, mitral stenosis, left atrial myxoma, and papillary muscle dysfunction that can lead to enlargement of the left atrium. It also lists increased blood flow, ventricular septal defects, patent ductus arteriosus, pulmonary arterial hypertension, and pulmonary venous hypertension as causes of enlargement of the main pulmonary artery. Finally, it discusses cardiomyopathy, pericardial effusion, multiple valve disease, and coronary artery disease as potential causes of cardiac dilation.
- ARDS is a clinical syndrome characterized by acute onset of respiratory insufficiency, hypoxemia, and bilateral pulmonary infiltrates. It is caused by diffuse damage to the alveolar-capillary membrane from direct or indirect lung injury.
- The pathogenesis involves an imbalance of pro-inflammatory and anti-inflammatory mediators that results in endothelial and epithelial injury. Activated neutrophils release damaging products that compromise the alveolar barrier.
- Histologically, the lungs show capillary congestion, epithelial necrosis, edema, hemorrhage, neutrophil accumulation, and hyaline membranes lining alveolar ducts. This diffuse alveolar damage impairs gas exchange and can progress to multisystem organ failure
This document provides an overview of pulmonary anatomy, physiology, and lung scintigraphy principles. It describes the positioning of the heart and lungs in the thorax, including the lobes and segments of the lungs. It discusses the pulmonary circulation and flow of oxygenated and deoxygenated blood. Key concepts covered include ventilation, regulation of breathing, and matching of ventilation and perfusion. Clinical indications for lung scintigraphy include evaluating for pulmonary embolism, COPD, and lung tumors. The document reviews radiopharmaceuticals, administration techniques, and normal scan findings for lung perfusion and ventilation imaging.
Bone densitometry uses x-rays to measure bone mineral density and detect osteoporosis, a disease where bones become porous and fragile. The DEXA machine generates two x-ray energies to measure radiation passing through bones. Bone density tests indicate if a person has low bone density before a fracture, monitor changes in density over time, predict future fracture risk, and help determine treatment. Results compare a patient's density to age-matched peers and young adults to derive z-scores and t-scores. Lower scores indicate increased risk of osteoporosis and fracture.
Nuclear medicine procedures use small amounts of radioactive materials, called radiopharmaceuticals, to diagnose and treat diseases. The nuclear medicine technologist is responsible for correctly identifying the patient, verifying the physician's order, preparing the patient, administering the radiopharmaceutical, collecting imaging or non-imaging data, ensuring technical quality, presenting results to the physician, and discharging the patient. Common nuclear medicine procedures include bone scans, renal scans, thyroid scans, and cardiac stress tests.
The thyroid gland sits in front of the trachea. It synthesizes the hormones T3 and T4 through a process involving absorption of iodine from the diet, trapping of iodide in thyroid follicular cells, organification of iodide by binding it to tyrosine residues on thyroglobulin, coupling of iodotyrosines to form the hormones, and release of T3 and T4 into circulation in response to TSH. Thyroid imaging using radiopharmaceuticals like Tc-99m pertechnetate, I-123, or I-131 allows evaluation of thyroid anatomy and function through visualization and quantification of radiotracer uptake.
Nmt631 skeletal anat, phys, bone scinti principlesljmcneill33
The document provides an overview of bone scintigraphy (bone scan), including:
1. Clinical indications for bone scans include evaluating bone pain, metastatic disease, and bone abnormalities found on other imaging tests.
2. Bone scans use radiotracers such as technetium-99m medronate that are absorbed by bone during periods of increased bone formation to identify areas of abnormal bone metabolism.
3. A normal bone scan shows symmetrical tracer uptake in bones, while abnormal scans reveal increased or decreased uptake that can indicate fractures, tumors, or other bone diseases.
Lung scintigraphy in various lung pathologiesljmcneill33
This document discusses various lung pathologies that can be evaluated using lung scintigraphy. It begins with the normal structure and function of the lung, then describes different categories of lung disease including degenerative, inflammatory, neoplastic, infectious, and occupational diseases. Specific pathologies covered in detail include atelectasis, acute lung injury, obstructive lung diseases like emphysema and asthma, interstitial lung diseases such as idiopathic pulmonary fibrosis, and granulomatous diseases including sarcoidosis and pulmonary eosinophilia. Images from lung scintigraphy and PET/CT are provided as examples for some of the pathologies.
Nmt631 scintigraphy in common bone diseasesljmcneill33
This document discusses various bone diseases and disorders. It begins by describing the different types of cells that make up bone, including osteoprogenitors, osteoblasts, osteoclasts, and osteocytes. It then discusses several specific bone diseases and disorders in more detail, including osteoporosis, Paget's disease, rickets/osteomalacia, hyperparathyroidism, and fractures. It also provides information on osteonecrosis, osteomyelitis, bone tumors, joint diseases like osteoarthritis and rheumatoid arthritis, and other conditions like gout. Throughout, it includes details on pathogenesis, morphology, clinical expression, and imaging findings for many of these diseases.
Bone scintigraphy uses radiolabeled phosphonates injected intravenously to evaluate bone formation. It produces whole body images of tracer distribution in the skeleton. Increased uptake indicates elevated osteoblastic activity such as might occur with fractures, tumors, or metastases. The scan has high sensitivity but low specificity for bone abnormalities, so findings must be interpreted in clinical context. It is useful for detecting skeletal involvement by cancer or other bone diseases.
This document provides information on non-arthritic knee pain. It discusses various causes of knee pain including intra-articular and extra-articular sources. Common overuse injuries like iliotibial band friction syndrome, patellofemoral pain syndrome, and jumper's knee are described. Examination techniques for the knee are outlined including tests for the patella. Treatment approaches are mentioned for many common causes of knee pain. The document serves as a guide for understanding, diagnosing, and managing non-traumatic knee pain.
This document provides an overview of common tendinitis conditions in different areas of the body and their rehabilitation. It discusses tendinitis of the shoulder including bicipital tendinitis and supraspinatus calcific tendinitis. Elbow tendinitis such as lateral and medial epicondylitis are covered. Hip tendinitis including iliopsoas and gluteal tendinitis is summarized. Knee tendinitis like patellar and popliteus tendinitis are described. The document also reviews tendinitis of the foot including Achilles, peroneal, and tibialis posterior tendinitis. Rehabilitation strategies like rest, ice, stretching, and strengthening exercises are recommended.
The document summarizes the main anatomical structures of the knee, including bones (femur, patella, tibia, fibula), menisci, ligaments (ACL, PCL, MCL, LCL), bursae, fat pads, muscles, and nerves. It describes the functions of these structures, common injuries such as ligament sprains and meniscal tears, and conditions affecting the patella like chondromalacia and patellar tendinitis. Rehabilitation of knee injuries is also briefly discussed.
The document summarizes the main anatomical structures of the knee, including bones (femur, patella, tibia, fibula), menisci, ligaments (ACL, PCL, MCL, LCL), bursae, fat pads, muscles and common injuries. It describes the key functions and attachments of the ligaments in stabilizing the knee joint. Common causes of ACL and PCL tears include twisting motions or dashboard injuries. The document also outlines rehabilitation approaches for knee injuries focusing on conditioning, mobilization and gradual return to activity.
In this presentation I’m going to inform you briefly about a novel arthroscopic technique for athletic pubalgia. You may have heard it as “sports hernia or groin injury………” but in fact is a groin pain syndrome, particularly common in sports that require athletes to perform repetitive kicking..
Describing some of the most important disorders of the shoulder area: frozen shoulder, biceps tenosynovitis, biceps tendon tear, rotator cuff tear, impingement syndrome, Rotator Cuff Calcified Tendonitis
This document provides an overview of common ankle and foot injuries. It describes the anatomy of the ankle joint and surrounding ligaments. The most frequent acute sports injury is ankle sprains, which typically occur due to foot inversion and result in ligament tears. Ankle sprains are classified into grades 1-3 based on severity. Other common injuries include peroneal tendon injuries, talar dome fractures, and plantar fasciitis. The document outlines symptoms, diagnostic techniques and treatment approaches for each of these injuries.
This document provides an overview of compartment syndrome, including:
- The anatomy of the arm, forearm, hand, thigh, leg, and foot compartments.
- The causes, signs/symptoms, and diagnostic criteria for acute compartment syndrome. Tissue damage can become irreversible after 6-8 hours of increased compartment pressure.
- Surgical fasciotomy is required if increased compartment pressure does not improve with simple measures like removing external compression. Complete release of all compartments is needed.
- Post-operative wound management includes wet-to-dry dressing changes or negative pressure wound therapy to promote healing and prevent infection following fasciotomy.
This document discusses fractures, including their causes, types, patterns, locations, and management. It provides information on commonly fractured bones like the clavicle, radius/ulna, and femoral neck. Key points covered include the goals of fracture treatment being sound union without deformity or loss of function. Management principles involve reduction, immobilization, and rehabilitation. Complications like infection, malunion, and compartment syndrome are also summarized.
anatomy and deformities of Elbow Joint.pptxHariraLatif1
This document provides an overview of common elbow joint disorders, including lateral epicondylitis (tennis elbow), medial epicondylitis (golfer's elbow), tricep tendonitis, medial collateral ligament injuries, medial epicondylar apophysitis, avulsion fractures, capsular tightness, rheumatoid arthritis, osteoarthritis, myositis ossificans, olecranon bursitis, and nerve entrapments around the elbow such as cubital tunnel syndrome. Treatment options discussed include PRICE, cryotherapy, stretching, strengthening, bracing, surgery, and medication depending on the specific disorder. The document is intended to help students understand elbow anatomy and common elbow conditions.
The document provides an overview of anatomy related to the lower extremities, including the pelvis, hips, femur, knee, lower leg, ankle and foot. Key points covered include common injuries such as hip dislocations, femur fractures, iliotibial band friction syndrome, hamstring injuries and knee ligament sprains. Examinations signs and treatments for various conditions are also discussed.
This document summarizes common sports injuries, including sprains, strains, tendonitis, bursitis, stress fractures, and injuries to the hand, wrist, elbow, shoulder, knee, ankle and foot. It describes the typical symptoms, signs, treatments, and rehabilitation for each type of injury. Common injuries discussed include ligament sprains, muscle strains, tendonitis, plantar fasciitis, jumper's knee, tennis elbow, rotator cuff injuries, ACL tears, ankle sprains and stress fractures. The document provides an overview of terminology, mechanisms of injury, degrees of severity, and conservative treatment approaches for athletes and active individuals.
This document provides an overview of common knee and lower leg injuries. It describes the anatomy and examinations for the knee. Specific injuries covered include patella fractures, femoral condyle fractures, tibial spine fractures, tibial plateau fractures, knee ligament injuries, knee dislocations, patella dislocations, quadriceps tendon ruptures, osteonecrosis, patellar tendinitis, fibula fractures, tibia fractures, and Achilles tendon ruptures. For each injury, the mechanism, signs, symptoms, imaging findings, and treatment options are summarized.
The document provides details about the anatomy, movements, clinical examination and common conditions of the elbow joint. It describes:
- The elbow joint is formed by the humerus, radius and ulna bones. It allows flexion-extension and supination-pronation movements.
- Clinical examination of the elbow includes inspection for swelling, deformity or muscle wasting. Palpation checks for tenderness, temperature changes and crepitus. Range of motion tests pain and limitations.
- Common conditions discussed are tennis elbow, golfer's elbow, student's elbow, bicipitoradial bursitis and elbow tunnel syndrome, which can cause pain and inflammation in the elbow region.
This document summarizes the anatomy and common injuries of the knee joint. It begins by describing the tibiofemoral and patellofemoral joints. It then discusses the bones that make up the knee, including the femur, patella, and tibia. Next, it outlines the major muscles that act on the knee, including the quadriceps, hamstrings, adductors, and sartorius. It also mentions the iliotibial band. The document concludes by briefly discussing the ligaments of the knee - ACL, PCL, MCL, LCL - and common knee injuries such as meniscal tears and ligament sprains.
The document provides information on common foot pain problems including their anatomy, causes, symptoms, physical exam findings, investigations, and treatment options. It discusses issues such as plantar fasciitis, heel fat pad syndrome, stress fractures of the calcaneus, navicular, and cuboid bones, tarsal tunnel syndrome, lateral plantar nerve entrapment, tibialis posterior tendinopathy, extensor tendinopathy, cuboid syndrome, and midfoot issues. Conservative treatments include rest, ice, stretching, orthotics, and strengthening exercises while surgical options are considered for more severe or chronic cases.
The document provides an overview of anatomy, assessment, and common injuries of the thigh, hip, groin, and pelvic regions. It describes the nerves, blood vessels, muscles, and fascia of the thigh. Assessment involves history, observation, and special tests like Thomas test and Ober's test. Common injuries discussed include quadriceps contusions, hamstring strains, femoral fractures, stress fractures, groin strains, and hip dislocations. Prevention, management, and rehabilitation strategies are outlined for each injury.
Presentation1.pptx, ultrasound examination of the knee joint.Abdellah Nazeer
This document provides an overview of ultrasound examination of the knee, including descriptions of normal anatomy and pathology. It discusses scanning techniques and planes for visualizing various structures of the knee. Examples of common knee conditions are shown through ultrasound images, such as patellar tendinopathy, prepatellar bursitis, Osgood-Schlatter disease, and injuries to the medial and lateral collateral ligaments. Ultrasound is described as a valuable tool for assessing soft tissue structures of the knee.
This document discusses the anatomy of the foot and injuries to the hindfoot and talus bone. It describes the bones and joints of the foot, including the tarsal bones, metatarsals, and phalanges. It also outlines the ligaments, tendons, nerves and blood vessels of the foot. Regarding injuries, it describes fractures and dislocations of the talus bone that can result from direct or indirect trauma. It notes the mechanisms of talus injuries and treatments such as closed or open reduction and internal fixation. The document also discusses calcaneal fractures, noting treatments for displaced or undisplaced fractures involve reduction, fixation, and immobilization.
Similar to Nmt631 msk lower extremity pathology (20)
The document discusses process modeling and data flow diagrams (DFDs). It defines key terms like process model, data flow diagramming, and DFD elements. It describes how to create DFDs through a multi-level hierarchy, with each level providing more detail. It also discusses best practices for DFD development, such as integrating use cases, validating diagrams, and avoiding common errors. The overall purpose is to explain how DFDs can be used to formally represent business processes through graphical modeling.
This document discusses the systems development life cycle (SDLC) for developing health information systems. It describes the main phases of SDLC as planning, analysis, design, and implementation. It then provides more details on the steps within each phase, including identifying business needs in planning, gathering requirements and creating system proposals in analysis, and designing the system architecture, databases, and programs in design. The implementation phase includes constructing the system, installing it, and creating a support plan. It also outlines the key roles and responsibilities of systems analysts in managing each stage of the process.
The document discusses the planning process for a new IT project, including evaluating its necessity and feasibility. It covers identifying the project based on business needs, determining a project sponsor, analyzing the technical, economic, and organizational feasibility. Technical feasibility involves assessing the team's ability to develop and implement the system. Economic feasibility requires analyzing costs/benefits over time using measures like ROI, BEP, and NPV. Organizational feasibility means determining if users will adopt the new system by examining stakeholder support and how it aligns with business goals. The feasibility study is submitted for approval before full project initiation.
The document discusses planning for IT projects, including project selection, creating a project plan, staffing the project, and managing/controlling the project. Project selection involves considering all projects within the organization's project portfolio and prioritizing based on organizational needs. The project plan defines tasks, time estimates, and other details. Staffing includes developing a staffing plan and coordinating project activities. Managing the project encompasses scope management, time-boxing, and risk assessment.
This document outlines the steps for migrating to a new health information system, including preparing the business by selecting a conversion strategy and contingency plan, preparing the technology by installing hardware/software and converting data, preparing people for change through training and change management, and post-implementation activities like system support and maintenance as well as project and system reviews.
The document discusses the process of transitioning to a new IT system, including migration planning, change management, conversion strategies, and post-implementation activities. It emphasizes the importance of managing change, preparing users, and having contingency plans. A key part of the transition is selecting a conversion strategy that balances risks, costs, and time based on converting technical aspects and training users in a phased, modular, or parallel approach. After launching the new system, ongoing support, maintenance, and project assessments are needed to fully institutionalize the changes.
The document discusses managing the programming process through assigning tasks based on experience and skills, coordinating activities, and managing schedules. It also discusses testing, including creating a test plan and conducting unit, integration, system, and acceptance tests. Finally, it addresses developing user documentation through online documentation that is easy to search and in multiple formats.
The document discusses the implementation phase of the systems development process. It covers managing the programming process, different types of testing including unit, integration, and acceptance testing, and developing documentation for both users and programmers. Testing helps ensure the system meets requirements and is done systematically through a test plan that includes different categories and types of testing. High-quality documentation takes significant time to develop and should include both system documentation for maintenance and user documentation to help users operate the new system.
This document discusses data storage design for health information systems, including data storage formats, revising logical data models to physical models, optimizing storage through normalization to reduce redundancy and denormalization for speed, and clustering, indexing and estimating data size for hardware planning.
This document discusses program design, including moving from logical to physical data flow diagrams, using structure charts to illustrate program organization and interaction, guidelines for building structure charts, and creating program specifications. The key points are physical DFDs show implementation details; structure charts show program components at a high level; guidelines include high cohesion, loose coupling, and assessing fan-in and fan-out; and specifications provide instructions for programmers.
The document discusses principles and processes for user interface design for health information systems. It covers principles for layout, navigation design using menus and messages, input design using different input types and validation, and output design. The goal is to design interfaces that are usable, learnable, and support users' tasks through application of these principles and following a process of requirements analysis, prototyping, and evaluation.
The document discusses the key principles of user interface design. It covers understanding users, organizing the interface structure, defining standards, prototyping, and evaluating the interface. Some important principles discussed include layout, consistency, minimizing user effort. It also discusses designing navigation, input and output elements following principles like clear labeling, minimizing keystrokes and validating input. The overall goal is to create an interface that is easy to use, learn and helps users complete their tasks efficiently.
The document discusses health information system architecture design. It covers architectural components including software, data storage, and hardware. It describes client-server architectures which balance processing between clients and servers. Advances like virtualization and cloud computing are mentioned. The document outlines requirements for architecture design like operations, performance, security, and cultural factors. It discusses specifying suitable hardware and software based on functions, performance, costs and other considerations.
The document discusses architecture design for information systems. It describes key components of architecture design including software components, hardware components, and different architecture models like client-server. It emphasizes that architecture design should assign software components to hardware devices in the most advantageous way based on requirements. Non-functional requirements like operational, performance, security, and cultural needs should highly influence the chosen architecture. The document also discusses creating a hardware and software specification to outline technical needs for a new system.
This document discusses different system acquisition strategies for health information systems, including custom development, packaged software, and outsourcing. Custom development allows flexibility but requires more time and resources. Packaged software is faster to implement but may not meet all needs. Outsourcing reduces costs but loses control. The design phase should gather more information on options through requests for proposals, quotes, or information. An alternative matrix can then compare options based on criteria and weights to select the best acquisition strategy.
This document discusses different system acquisition strategies for health information systems, including custom development, packaged software, and outsourcing. Custom development allows flexibility but requires more resources while packaged software has faster implementation but may not meet all needs. Outsourcing reduces costs but loses control. The design phase focuses on selecting an acquisition strategy by gathering information from vendors and an organization's own IT through requests for proposals, quotes, or information. A matrix of alternatives and criteria is used to evaluate options and select the best strategy.
The document discusses the transition from systems analysis to design. It explains that in design, the logical work from analysis is converted into physical specifications for building the system. The key steps in design include determining the acquisition strategy (e.g. custom development, purchased package, outsourcing), technical architecture, and creating a system specification. The main acquisition strategies - custom development, purchased packages, and outsourcing - are described along with their pros and cons. Factors to consider in selecting a strategy include technical needs, costs, and organizational capabilities. Developing requests for proposals, collecting information on options, and creating an alternative matrix can aid in evaluating different design approaches.
The document discusses Entity Relationship Diagrams (ERDs) which are used for data modeling. It covers the basic elements of ERDs including entities, attributes, and relationships. It provides instructions on how to create an ERD by identifying entities, adding attributes, and drawing relationships. It also discusses validating an ERD through normalization and ensuring it is consistent with other process models.
The document discusses data modeling and entity relationship diagrams (ERDs). It provides definitions of key concepts like data models, logical vs physical data models, and ERDs. It explains how to create ERDs by identifying entities, attributes, relationships and applying rules of cardinality and modality. The document also discusses validating ERDs through techniques like normalization, balancing ERDs with data flow diagrams, and using CRUD matrices. Overall, the document provides guidance on developing high quality ERDs to model the data requirements of a system.
This document discusses process modeling and data flow diagrams (DFDs). It describes the key elements of DFDs including processes, data flows, data stores, and external entities. It outlines the steps for creating DFDs, which include building a context diagram, creating DFD fragments for each use case, organizing them into a level 0 diagram, developing level 1 DFDs based on use case steps, and validating the DFDs. Common syntax errors like violating the law of conservation of data are also discussed.
This presentation was provided by Racquel Jemison, Ph.D., Christina MacLaughlin, Ph.D., and Paulomi Majumder. Ph.D., all of the American Chemical Society, for the second session of NISO's 2024 Training Series "DEIA in the Scholarly Landscape." Session Two: 'Expanding Pathways to Publishing Careers,' was held June 13, 2024.
A Visual Guide to 1 Samuel | A Tale of Two HeartsSteve Thomason
These slides walk through the story of 1 Samuel. Samuel is the last judge of Israel. The people reject God and want a king. Saul is anointed as the first king, but he is not a good king. David, the shepherd boy is anointed and Saul is envious of him. David shows honor while Saul continues to self destruct.
🔥🔥🔥🔥🔥🔥🔥🔥🔥
إضغ بين إيديكم من أقوى الملازم التي صممتها
ملزمة تشريح الجهاز الهيكلي (نظري 3)
💀💀💀💀💀💀💀💀💀💀
تتميز هذهِ الملزمة بعِدة مُميزات :
1- مُترجمة ترجمة تُناسب جميع المستويات
2- تحتوي على 78 رسم توضيحي لكل كلمة موجودة بالملزمة (لكل كلمة !!!!)
#فهم_ماكو_درخ
3- دقة الكتابة والصور عالية جداً جداً جداً
4- هُنالك بعض المعلومات تم توضيحها بشكل تفصيلي جداً (تُعتبر لدى الطالب أو الطالبة بإنها معلومات مُبهمة ومع ذلك تم توضيح هذهِ المعلومات المُبهمة بشكل تفصيلي جداً
5- الملزمة تشرح نفسها ب نفسها بس تكلك تعال اقراني
6- تحتوي الملزمة في اول سلايد على خارطة تتضمن جميع تفرُعات معلومات الجهاز الهيكلي المذكورة في هذهِ الملزمة
واخيراً هذهِ الملزمة حلالٌ عليكم وإتمنى منكم إن تدعولي بالخير والصحة والعافية فقط
كل التوفيق زملائي وزميلاتي ، زميلكم محمد الذهبي 💊💊
🔥🔥🔥🔥🔥🔥🔥🔥🔥
THE SACRIFICE HOW PRO-PALESTINE PROTESTS STUDENTS ARE SACRIFICING TO CHANGE T...indexPub
The recent surge in pro-Palestine student activism has prompted significant responses from universities, ranging from negotiations and divestment commitments to increased transparency about investments in companies supporting the war on Gaza. This activism has led to the cessation of student encampments but also highlighted the substantial sacrifices made by students, including academic disruptions and personal risks. The primary drivers of these protests are poor university administration, lack of transparency, and inadequate communication between officials and students. This study examines the profound emotional, psychological, and professional impacts on students engaged in pro-Palestine protests, focusing on Generation Z's (Gen-Z) activism dynamics. This paper explores the significant sacrifices made by these students and even the professors supporting the pro-Palestine movement, with a focus on recent global movements. Through an in-depth analysis of printed and electronic media, the study examines the impacts of these sacrifices on the academic and personal lives of those involved. The paper highlights examples from various universities, demonstrating student activism's long-term and short-term effects, including disciplinary actions, social backlash, and career implications. The researchers also explore the broader implications of student sacrifices. The findings reveal that these sacrifices are driven by a profound commitment to justice and human rights, and are influenced by the increasing availability of information, peer interactions, and personal convictions. The study also discusses the broader implications of this activism, comparing it to historical precedents and assessing its potential to influence policy and public opinion. The emotional and psychological toll on student activists is significant, but their sense of purpose and community support mitigates some of these challenges. However, the researchers call for acknowledging the broader Impact of these sacrifices on the future global movement of FreePalestine.
Andreas Schleicher presents PISA 2022 Volume III - Creative Thinking - 18 Jun...EduSkills OECD
Andreas Schleicher, Director of Education and Skills at the OECD presents at the launch of PISA 2022 Volume III - Creative Minds, Creative Schools on 18 June 2024.
2. Topics
Skeletal Disorders:
• Disorders of the Joints of the Lower Limb
– Osteoarthritis
– Disorders of the Hip Joint
• Avascular Necrosis
• Legg-Calvé-Perthes Disease
• Slipped Capital Femoral Epiphysis
• Hip Dislocation
• Labral Injuries
• Impingement Syndromes
• Disorders of the Knee Joint
– Knee Ligament Injuries
– Meniscal Injuries
– Osteochondral Lesions (Osteochondritis
Dissecans)
– Prepatellar Bursitis
• Disorders of the Ankle and Subtalar Joints
– Sprains
– Osteochondral Lesions of the Ankle
– Miscellaneous Disorders of the Ankle and
Foot
• Morton Interdigital Neuroma, Metatarsalgia,
and Sesamoiditis
• Bone Injuries of the Lower Limb
– Stress Reactions and Stress Fractures
Muscle Disorders:
• Disorders of Muscle-Tendon Groups of the
Lower Limb
– Disorders of the Iliotibial Band, Including
Trochanteric Bursitis
– Disorders of the Hamstring Muscle Group
– Disorders of the Adductor Muscle Group
– Pes Anserine Tendonitis or Bursitis
• Injuries to the Quadriceps Muscle Group
– Patellar Tendinopathy
– Osgood-Schlatter Disease and Sinding-
Larsen-Johansson Disease
– Quadriceps Strain, and Quadriceps and
Patella Tendon Rupture
– Rectus Femoris Avulsion from the Anterior
Inferior Iliac Spine
– Quadriceps Contusions and Myositis
Ossificans
• Injuries to the Anterior Leg Muscle Group
– Tibialis Anterior, Extensor Hallucis Longus,
and Extensor Digitorum Longus
• Injuries to the Posterior Leg Muscle Group
and Associated Soft Tissue Structures
– Gastrocnemius, Soleus, Tibialis Posterior,
Flexor Hallucis Longus, and Flexor Digitorum
Longus
– Sever Disease
– Flexor Hallucis Longus Overload
– Tibialis Posterior Overload or Medial Tibial
Stress Syndrome
• Injuries to the Lateral Leg Muscle Group
– Compartment Syndrome
• Injury to the Plantar Foot Muscles and
Plantar Fascia
– Plantar Fasciitis
3. Disorders of the Iliotibial Band:
Including Trochanteric Bursitis
• Symptoms: Pain on rising
up from sitting, pain to lie
on
• Bursa irritated between
femoral trochanter and
gluteus medius/iliotibial
tract
• Trauma/hip Sx/ repetitive
movement/spontaneous
• Tenderness over gt.
Trochanter
• Female:Male= 4:1.
Incidence 2/1000
• Tx: injection/NSAID/PT
Focal increased uptake of
99mTc-MDP in left greater
trochanteric region compatible
with bursitis (arrow)
4. Disorders of the Hamstring
Muscle Group
• Muscle overload
– challenged with a sudden
load
– stretched beyond it’s limit
• Muscle gets stretched too
far
• Seen in running sports:
– football, basket ball,
soccer, runners, dancers,
young athletes still growing
• Signs/symptoms: swelling,
tenderness, bruising/
discoloration
• Ischial avulsion injury
possible Ischial avulsion fracture (arrow). A 17-year-old
female cheerleader who had sudden onset of
buttock pain with a high-kicking maneuver.
5. Disorders of the
Adductor Muscle Group
• Groin strain:
– from acute or repetitive
overload
– sudden twinge or tearing
– pain, weakness, and internal
hemorrhaging
• Usually adductor longus
injury
• Avulsion fractures of inferior
pubic ramus possible
• Causes: running, jumping,
twisting with hip external
rotation, over-stretching/too
forceful contraction
• Tx: RICE (rest, ice,
compression, elevation)
therapy, NSAIDs MRI of the thighs, showing a tear of the left
adductor muscle group in a hockey player.
99mTc-MDP muscle uptake. Significant
injury due to weight lifting damage in
adductor muscle groups of medial thighs
(arrow). Biochemical evidence of elevated
muscle enzymes was also present.
6. Combined Muscle Group Injury
Pes Anserine Tendonitis or Bursitis
• Anteromedial knee pain,
occasional swelling
• Acute inflammation of:
– one or more of three
conjoined tendons near
their insertion
(tendonitis)
– Bursa lying 2 inches
below the medial knee
joint (bursitis)
• Causes: overuse/ friction
(from valgus, flatfoot,
rotatory stresses, direct
contusion)
• Tx: Ice, NSAIDS, steroid
inj.
NM imaging of blood-
pool showing
hyperemia of synovial
lining (pes anserine
bursitis) and bony
lateral tibial plateau.
Arrow points to
bursitis. (B) MRI shows
large joint effusion and
anserine bursitis
(arrow) in same medial
area of knee as in A.
J. Nucl. Med. Technol. June 2007 vol. 35 no. 2 64-76
7. Injuries to the Quadriceps Muscle Group
Patellar Tendinopathy (Jumper’s knee)
• Pain usually at the
inferior pole of patella
• Patellar tendon
overload from
repetitive knee flexion
and extension
• At risk: basketball
players, volleyball
players, bicyclists,
rowers, mogul skiers,
baseball catches,
supermarket shelf
stockers, carpenters,
and carpet layers.
• Tx: RICE, NSAIDs, Rehab
MRI showing patellar tendonitis. The pale
area indicates inflammation and swelling.
Chronic patella
tendinitis. Triathlete
with long history of
recurrent pain in the
proximal left tibia in
spite of multiple
corticosteroid
injections. The
SPECT/CT images
demonstrate schlerosis
of the tibial tubercle
and calcification of the
adjacent patella
tendon in the CT
images (arrowheads)
with intense uptake at
both sites.
8. Injuries to the Quadriceps Muscle Group
Osgood-Schlatter Disease (OSD)/
Sinding-Larsen-Johansson Disease (SLJD)
• More common in
older children/ young
adults
• Repetitive overload
at the patella tendon
insertion at the tibial
tuberosity (OSD), or
at the origin of the
patella tendon at the
inferior pole of the
patella (SLJD)
• Significant pain,
tenderness,
inflammation, or
partial avulsions of
the tibial tuberosity
(in OSD)
J Nuc Med 28:1768-1770,1
a: Normal lateral 99mTc-MDP blood-pool image of right
knee, b: Lateral blood-pool image of the left knee with
abnormalities (arrows) corresponding to the inferior
patellar border and tibial tuberosity (left knee).
9. Injuries to the Quadriceps Muscle Group
Quadriceps Strain, and Quadriceps & Patella Tendon Rupture
• Injury following
forceful quadriceps
contraction with
foot planted
• “unstable knee”
• Anterior knee
swelling
• Unable to extend
knee
– Patella will move
up for PTR, but
will not move for
QTR
• Palpable defect
proximal or distal to
patella
• Tx: knee
immobilizer,
crutches, and Sx MRI showing Normal (L); Quadriceps tendon rupture (R)
Lateral radiograph of the
knee, showing an abnormally
highriding patella after an
acute patella tendon rupture.
The patient was a 40-yearold
airline pilot who described
“landing a little aft of center”
while alpine skiing. A sudden
forceful quadriceps
contraction while attempting
to regain balance resulted in
this injury.
10. Injuries to the Quadriceps Muscle Group
Rectus Femoris Avulsion from the Anterior Inferior Iliac Spine
• Pain at front of the hip
• occur most often in
young
• Possible from forceful
contraction of rectus
femoris
• RICE, NSAIDs, Rehab, Sx
(if > 3cm separation)
http://gamma.wustl.edu/bs137te144.html
11. Injuries to the Quadriceps Muscle Group
Quadriceps Contusions and Myositis Ossificans
• From direct & forceful
trauma to front of thigh
• Ant. thigh pain, stiffness,
tenderness, ecchymosis,
swelling, antalgic gait
• Intramuscular hematoma
calcific transformation
myositis ossificans
(quads – most common
site)
A bone scintigram (A) shows marked accumulation of
radiotracer in the region of Rt. Hip. Plain radiograph
(B) of Rt. Hip shows ossification in soft tissues.
12. Injuries to the Anterior Leg Muscle Group
Tibialis Anterior, Extensor Hallucis Longus, and
Extensor Digitorum Longus
• Overload injuries less
common
• Overload of tibialis
anterior – eg. down hill
running
– Pain in muscle belly, or
musculotendinous
junction, or
anteromedial midfoot
tendon insertion site
This 57 year-old male experienced
spontaneous pain in medial side of left foot.
SPECT/CT helped enable a diagnosis of
tibialis anterior tendinosis and enthesopathy
and also calcaneocuboidal artrosis.
13. Injuries to the Posterior Leg Muscle Group and
Associated Soft Tissue Structures
Achilles Tendon Issues
• Achilles tendon (AT) overload is
common
• Chronic: swollen, nodular, &
tender AT (tendinitis), with
collagen breakdown &
microscopic tearing (tendinosis)
• Acute: sudden, powerful
eccentric force (eg. basketball)
rupture of AT (audiable pop)
• RICE, Sx if needed, rehab Bilateral Achilles
tendinopathy.
Intense uptake
around the Achilles
tendons with
associated bursitis
(arrowheads)
14. Injuries to the Posterior Leg Muscle Group and Associated Soft Tissue Structures
Sever Disease
• Traction apophysitis of
Achilles tendon insertion
on posterior calcaneus
• Seen in active adolescents
during rapid growth (bones
lengthen, muscles tight)
• Exacerbated with activities
and improved with rest
• Calcaneal pain, tight
gastrocnemius-soleus
• Tx: ice, rest, brace, rehab
15. Injuries to the Posterior Leg Muscle Group and Associated Soft Tissue Structures
Shin Splints
(Anterior/ Medial Tibial Stress Syndrome)
• Common in runners,
dancers and military
recruits
• overload dysfunction of:
– tibialis anterior, extensor
digitorum longus and
extensor hallucis longus
(anterolateral shin splint)
– tibialis posterior, medial
gastrocnemius, or medial
soleus (posteromedial shin
splint)
• Bone overload persistant
stress periostitis tibial
stress fracture
16. Injuries to the Lateral Leg Muscle Group
Compartment Syndrome
• Pressure within a
muscle compartment
(95% cases in
lateral/ant) is
abnormally elevated
causing ischemia
• Causes:
– Acute: trauma (eg.
fracture, crush injury);
can cause permanent
muscle damage;
surgical emergency
– Chronic: occurs in
runners, military
recruits; lower limb
affected;
pathophysiology
poorly understood
(↑muscle relaxation
pressure ischemia);
Tx with NSAIDs, Rest
99mTc-MDP bone imaging showing compartmental syndrome in a
patient following lithotomy position for 6 hours. Urine bag &
catheter (closed arrows)
Clinical Nuclear Medicine Vol 38, Number 5, May 2013
Rhabdomyolysis Associated
with Compartment Syndrome
17. Injury to the Plantar Foot Muscles and
Plantar Fascia; Plantar Fasciitis
• A.k.a plantar heel pain
syndrome
• Painful inflammatory
process of plantar
fascia; pain in volar
heel, esp. 1st few
steps in morning
• Overload injury due to
biomechanical issues
(ankle lean inward,
flat foot), repetitive
trauma (15-20%
runners affected)
22. Disorders of the Hip Joint
Legg-Calvé-Perthes Disease
• Idiopathic osteonecrosis of femoral head
• Occurs in children, typically boys 4-10yr
• Bilateral 10%
• Prognosis better if onset < 6yrs, ↑rates
of hip dysfunction into early adulthood if
older
• Wait-and-watch, braces, Sx (osteotomy),
rehab
Legg-Calvé-Perthes disease. A,
(top row) Scintigrams by
standard parallel-hole collimator
fail to reveal the abnormality.
Pinhole images of the same
patient (bottom row) reveal the
characteristic lentiform area of
decreased uptake on the left. B,
Corresponding radiograph
obtained months later reveals
deformity of the left femoral
epiphysis with flattening,
increased density and increased
distance between the epiphysis
and the acetabulum.
23. Disorders of the Hip Joint
Slipped Capital Femoral Epiphysis
• Displacement of capital
femoral epiphysis from
metaphysis (20 to disruption of
physis in the immature hip
• Cause: acute trauma/
repetitive microtrauma, obesity
• Most common hip disorder in
adolescent (8-15y), boys > girls
Pediatric Nuclear Medicine edited by S.T. Treves; P262
24. Disorders of the Hip Joint
Hip Dislocation
• Requires significant trauma
• Dislocation > fractures in
children
• Posterior dislocation
(presents with hip flexion,
internal rotation and
adduction) > anterior
dislocation (hip extension,
external rotation, abduction,
& acetabular fx)
• Needs closed reduction
under anesthesia, or Sx
• Concern for sciatic nerve
injury, osteoarthritis, AVN in
10% pts.
25. • Injury from acute or
repetitive trauma,
hypermobility,
dysplasia
• Groin pain, clicking of
hip
• MRI arthrography with
intraarticular contrast
is best imaging for Dx
• Tx: PT, NSAIDs, rest,
intraarticular steroid
shot, arthroscopic
debridement/repair
Disorders of the Hip Joint
Labral Injuries
Examples of labral
tears. (A) “Eyebrow”
pattern of uptake
corresponding to an
anterosuperior labral
tear (arrowhead). There
is also a femoral head
osteochondral fracture
(arrow) in association
with the steep
acetabular angle of hip
dysplasia. (B)
“Eyebrow” pattern of
uptake of an
anterosuperior labral
tear. (C) Focal uptake in
a tear of the superior
labrum.Clinical Nuclear Medicine • Volume 29, Number 8, August 2004
26. • Morphological
variations of
acetabulum/femora
l head resulting in
mechanical damage
to joint
• Groin pain, limited
ROM, DJD
• 2 types:
– CAM: bump @
femoral head-neck
jn.
– Pincer: acetabular
over-coverage of
femur head
• Tx: PT, NSAIDs, Sx
Disorders of the Hip Joint
Impingement Syndromes
Hip impingement. Increasing
right hip pain in a motocross bike
rider which worsened after a
number of falls. Hyperemia
(arrowhead in BP) and intense
uptake around the right hip
(arrowhead in delay) with the
SPECT/CT image showing the site
of impingement between the
anterior-superior acetabulum and
lateral femoral head (arrowheads)
27. Disorders of the Knee Joint
Knee Ligament Injuries
• MCL & ACL injuries - most
common
• MCL: valgus sprain medial
pain, swelling but no joint
effusion
– Tx: ice, elevation, knee
immobilizer, rehad
• ACL: most functional
impairment in sprains;
twisting knee injury; “pop”
sound; joint effusion possible;
Segond fx (lat. tibial plateau
avulsion)
– Tx: ice, elevation,
compression, knee brace,
rehab
• PCL: Less common, seen in
soccer, dashboard injuries
Segond fx
Anterior bone scintigraphy demonstrates a large intense lesion
in the left lateral tibial plateau which was confirmed on MRI.
The less intense lesion in the lateral femoral condyle was not
seen on MRI. The faint but definite focal uptake peripherally in
the medial femoral condyle (arrow head) was an avulsion of
the insertion of the medial collateral ligament on MRI and
confirmed at surgery. The classic triad of avulsion of the
medial collateral ligament with opposite “kissing” lesions
laterally is obvious on scintigraphy. Knowledge of this type of
injury facilitates scintigraphic diagnosis, however, avulsion
injuries could be misreported as fractures.
28. Disorders of the Knee Joint
Meniscal Injuries
• Common; can be acute
or chronic
• Acute tear: from
sudden twisting
motion
• Symptoms: pain,
swelling, clicking;
• Bucket handle tear
flipped up into
intercondylar notch
locked knee
• Tx: ice, elevation,
NSAIDs, brace
Medial meniscus tear. This was a surgically
proven injury in a patient being assessed for
patella tendinitis. The SPECT/CT study shows a
region of intense uptake and sclerosis in the
mid-body of the crescent of the medial meniscal
subchondral bone (arrowheads) in keeping with
a tear of the meniscus and adverse remodeling
of the underlying tissues.
29. Disorders of the Knee Joint
Osteochondritis Dissecans
• Mostly in 10-15yr olds
• Lesion in subchondral bone (lat. aspect
of medial femoral condyle)
progresses through stages to overlying
articular cartilage Grade 4 complete
avulsion of osteochondral fragment &
dislocation
• Mechanism unknown, causative factors
may be genetic/ vascular/ trauma
• Symptoms: recurrent pain & swelling
(worse with stress, better with rest)
• Tx: Rest, Sx
A B
30. Disorders of the Knee Joint
Prepatellar Bursitis
• A.k.a “carpet layer's
knee”/ “nun’s knee”
• Associated with
kneeling for extended
time
• Swelling & pain
anterior to patella
• Tx: RICE therapy to
swelling & pain,
aspiration & steroid
inj., Sx (rare)
31. Disorders of the Ankle and Subtalar Joints
Sprains
• Most common MSK injury of leg (25% of
all sports injuries); predisposing factor:
previous sprain
• Inversion/lateral ankle sprain of ant.
talofibular ligament (weakest, most
common), eversion (deltoid,
uncommon), Syndesmotic high-ankle
sprain (uncommon, severe)
• Small (Gr-I) to partial (Gr-II) to full tear
(Gr-III)
• Diffuse pain, swelling, hematoma
discoloration possible
• Tx: RICE, brace, rehab
Partial
avulsion
fracture
after sprain
Am J Nucl Med Mol Imaging 2015;5(4):305-316
32. Disorders of the Ankle and Subtalar Joints
Osteochondral Lesions of Ankle
• Causes: sprains, trauma
• Deep ankle pain, worse
with activity, better with
rest
• Can affect medial talus
(usually from inversion, less
severe, heals
spontaneously) or lateral
talus (forced eversion,
more severe, difficult to
self-heal)
• Rehab, Sx if severe
osteochondral lesion
(arrow) in the inferior
posterior talus
J Nuc Med 32:2241-2244
(OCTDF = osteochondral
talar dome fractures)
33. Disorders of the Ankle and Foot
Morton Interdigital Neuroma, Metatarsalgia, and Sesamoiditis
• Similar presentations (Diff. Dx challenging)
• Morton’s neuroma: irritation of an interdigital foot
nerve (b/w 3rd & 4th metatarsal head most common)
leading to pain (“pebble in shoes”), worse with
metatarsal (MT) head, interdigital nerve loading (eg.
high heels)
• Metatarsalgia: Pain coming from metatarsal heads
(instead from b/w heads), 2nd head pain most common,
from overload of MT heads (running, toe walking, high
heels)
• Sesamoiditis: Pain in 1st MT head following sesamoid
bone injury
• Bone scans, MRI helful for Dx
• Tx: Unloading of forefoot (large toe box shoe, avoid
high heels, gel insoles for wt. distribution
Am J Nucl Med Mol Imaging 2015;5(4):305-316
34. Stress Reactions and Stress Fractures
• Repetitive overload injury to bone
• Stress response ( bone
remodeling) stress reaction
(maladaptive areas w/ resorption >
deposition) stress Fx (hairline
break)
• Causes: Female athlete triad
(disordered eating, amenorrhea,
osteopenia), pes cavus, pes planus,
leg length discrepancy, Q-angle,
improper shoe fit/ cushion
• Tx: ice, rest, NSAIDs, image non-
healing > 6 wk (bone scans very
sensitive, MRI good for grading)
• Prevention: strengthen muscles
( strain on bone)