This is short Presentation on avascular necrosis of femoral head.This presentation gives brief description of introduction, causes investigation and treatment for AVN of hip.
Arthrodesis refers to the surgical fusion of a joint. It is indicated for pain and instability in the joint. With improvements in joint replacement surgery, arthrodesis is now less commonly performed. It permanently relieves pain by fusing the bones and eliminating joint movement, at the cost of stiffness. The optimal positions for fusing different joints are described. Common complications include malposition and nonunion.
Pes cavus and pes planus are foot deformities characterized by high and low arches, respectively. Pes cavus, or a high arched foot, can be congenital or acquired and results in clawing of the toes. Pes planus, or a flat foot, is caused by the collapse of the medial longitudinal arch. Both conditions can cause foot, ankle, and leg pain and abnormal shoe wear. Treatment involves orthotics, physical therapy, and sometimes surgery to correct muscle imbalances and bony deformities.
This document provides information on periarthritis shoulder (PA) and adhesive capsulitis/frozen shoulder (FS). It discusses the anatomy of the shoulder joint and describes PA and FS as conditions characterized by pain and progressive limitation of shoulder movement. It outlines the typical stages of FS, risk factors, clinical features, investigations, and management approaches. Management involves a multimodal approach including medications like NSAIDs, physical therapy focusing on range of motion exercises and strengthening, and in severe cases joint injections or surgery.
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.
Adhesive capsulitis is a condition characterized by a painful and progressive loss of shoulder range of motion. It typically progresses through painful, freezing, and thawing phases over 1-2 years. Treatment involves medications to manage pain, physical therapy to restore range of motion, and in refractory cases, procedures like corticosteroid injections or surgery. While pain is usually transient, some patients may develop permanent loss of range of motion.
Chondromalacia patellae, also known as runner's knee, is a softening and roughening of the cartilage under the kneecap caused by mechanical overload of the patellofemoral joint. Symptoms include pain in front of or beneath the kneecap that is aggravated by activity like climbing stairs. Examination may reveal tenderness under the kneecap edge or crepitus with knee movement. Conservative treatments include rest, ice, strengthening exercises, and anti-inflammatory medication. Surgery to realign or elevate the patella may be considered if conservative treatments fail after 6 months.
This document provides information on lateral epicondylitis (tennis elbow), including its anatomy, causes, symptoms, diagnosis, and treatment options. It describes how lateral epicondylitis is an overuse injury caused by repetitive microtrauma to the common extensor tendon at the lateral epicondyle. The diagnosis is typically made based on physical examination findings of tenderness over the lateral epicondyle with resisted wrist and finger extension. Both non-operative treatments like physiotherapy, bracing, and steroid injections and surgical options are discussed for managing lateral epicondylitis.
Shoulder impingement syndrome occurs when the tendons of the rotator cuff muscles become irritated and inflamed as they pass through the subacromial space under the coraco-acromial arch. It results in pain, weakness, and loss of movement, especially in an arc between 45-160 degrees of shoulder abduction and elevation. Causes include repeated overhead arm use, trauma, poor posture, and degenerative changes. Clinical features are pain at rest or with movement, and limited range of motion. Diagnosis involves x-rays and MRI, while special tests like Neer's and Hawkins' tests reproduce shoulder pain. Treatment consists of rest, anti-inflammatories, physical therapy including stretching,
Arthrodesis refers to the surgical fusion of a joint. It is indicated for pain and instability in the joint. With improvements in joint replacement surgery, arthrodesis is now less commonly performed. It permanently relieves pain by fusing the bones and eliminating joint movement, at the cost of stiffness. The optimal positions for fusing different joints are described. Common complications include malposition and nonunion.
Pes cavus and pes planus are foot deformities characterized by high and low arches, respectively. Pes cavus, or a high arched foot, can be congenital or acquired and results in clawing of the toes. Pes planus, or a flat foot, is caused by the collapse of the medial longitudinal arch. Both conditions can cause foot, ankle, and leg pain and abnormal shoe wear. Treatment involves orthotics, physical therapy, and sometimes surgery to correct muscle imbalances and bony deformities.
This document provides information on periarthritis shoulder (PA) and adhesive capsulitis/frozen shoulder (FS). It discusses the anatomy of the shoulder joint and describes PA and FS as conditions characterized by pain and progressive limitation of shoulder movement. It outlines the typical stages of FS, risk factors, clinical features, investigations, and management approaches. Management involves a multimodal approach including medications like NSAIDs, physical therapy focusing on range of motion exercises and strengthening, and in severe cases joint injections or surgery.
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.
Adhesive capsulitis is a condition characterized by a painful and progressive loss of shoulder range of motion. It typically progresses through painful, freezing, and thawing phases over 1-2 years. Treatment involves medications to manage pain, physical therapy to restore range of motion, and in refractory cases, procedures like corticosteroid injections or surgery. While pain is usually transient, some patients may develop permanent loss of range of motion.
Chondromalacia patellae, also known as runner's knee, is a softening and roughening of the cartilage under the kneecap caused by mechanical overload of the patellofemoral joint. Symptoms include pain in front of or beneath the kneecap that is aggravated by activity like climbing stairs. Examination may reveal tenderness under the kneecap edge or crepitus with knee movement. Conservative treatments include rest, ice, strengthening exercises, and anti-inflammatory medication. Surgery to realign or elevate the patella may be considered if conservative treatments fail after 6 months.
This document provides information on lateral epicondylitis (tennis elbow), including its anatomy, causes, symptoms, diagnosis, and treatment options. It describes how lateral epicondylitis is an overuse injury caused by repetitive microtrauma to the common extensor tendon at the lateral epicondyle. The diagnosis is typically made based on physical examination findings of tenderness over the lateral epicondyle with resisted wrist and finger extension. Both non-operative treatments like physiotherapy, bracing, and steroid injections and surgical options are discussed for managing lateral epicondylitis.
Shoulder impingement syndrome occurs when the tendons of the rotator cuff muscles become irritated and inflamed as they pass through the subacromial space under the coraco-acromial arch. It results in pain, weakness, and loss of movement, especially in an arc between 45-160 degrees of shoulder abduction and elevation. Causes include repeated overhead arm use, trauma, poor posture, and degenerative changes. Clinical features are pain at rest or with movement, and limited range of motion. Diagnosis involves x-rays and MRI, while special tests like Neer's and Hawkins' tests reproduce shoulder pain. Treatment consists of rest, anti-inflammatories, physical therapy including stretching,
Student's elbow, or 'Olecranon Bursitis' is a condition where a small sack of tissue over the tip of your elbow becomes inflamed and swollen. The pointy bit of bone at the end of your elbow is called the 'olecranon' and the small sack which sits between the bone and the skin is called a 'bursa'.
Bhaskar Health News and Medical Education is leading source for trustworthy health, medical, science and technology news and information. Providing world health information Medical Education.
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We're committed to being your source for expert health guidance. Bhaskar Health and Medical Education.
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This document defines metatarsalgia as a painful and inflamed ball of the foot. It lists the common signs and symptoms as sharp, aching or burning pain and numbness. Potential causes include abnormal foot structure, excessive activity, poor fitting shoes, and excess weight. Treatment options mentioned are resting, changing shoes, and using orthotic devices like metatarsal bars.
Trochanteric bursitis refers to inflammation of fluid-filled sacs located around the greater trochanter bone on the outside of the hip. It commonly causes deep aching pain on the outside of the hip and thigh that increases with activity and is worse when lying on the affected side. Risk factors include trauma, hip arthritis, back problems, obesity, and other conditions that alter gait or hip movement. Treatment focuses on rest, NSAIDs, physiotherapy, steroid injections, or occasionally surgery.
This document discusses coxa vara, which is a hip deformity characterized by an abnormal decrease in the femoral neck-shaft angle. It classifies coxa vara as congenital, developmental, or acquired. Developmental coxa vara is the most common type and is caused by a primary cartilage defect in the femoral neck. Clinical features include limping and pain. Treatment involves corrective valgus osteotomies to restore the neck-shaft angle and relieve stress on the femoral physis. The document describes several techniques for valgus osteotomy including Pauwel's, Borden's, and subtrochanteric osteotomy. The goal of surgery is to stimulate healing of the femoral neck defect and restore normal
Tendon transfer is a surgical procedure that moves a tendon from one location to another to restore function lost due to nerve damage or injury. The document discusses pre and post-operative physiotherapy management for tendon transfers in the hand. Key points include indications for tendon transfers when nerve recovery is unlikely, prerequisites like full range of motion, and post-operative goals like protecting the transferred tendon and regaining range of motion. Specific procedures are described to address radial, ulnar and median nerve palsies. Post-operative splinting and rehabilitation protocols aim to protect the transfer initially and progress to strengthening.
Physiotherapy Rehab After Total Hip ReplacementMozammal Rabby
This document outlines the phases of rehabilitation following a total hip replacement surgery. It discusses examination of the patient, education provided, and four phases of rehabilitation: immobilization, maximum protection, moderate protection, and minimum protection. Each phase focuses on specific goals like regaining range of motion, strengthening muscles, improving gait, and resuming normal activities. Precautions are provided to prevent dislocation and protect the new hip joint at each stage of recovery.
Olecranon bursitis is an inflammation of the bursa located over the point of the elbow. It can be caused by direct trauma, repetitive rubbing on hard surfaces, or underlying conditions like gout or rheumatoid arthritis. Acute cases present as a tender, fluid-filled swelling while chronic cases appear as a painless swelling. Treatment involves rest, ice, compression, and anti-inflammatory medications. Septic bursitis requires antibiotics while surgery may be needed for cases that do not improve with conservative care.
Recurrent Dislocation of patella -PAWANPawan Yadav
This document discusses recurrent patellar dislocation. It begins by defining recurrent patellar dislocation as the patella shifting laterally with minimal stress on knee flexion. It then discusses the anatomy and Q angle as well as predisposing causes such as increased Q angle, weak medial quads, and tight lateral structures. The document outlines clinical features, tests, x-ray findings, and treatment options including conservative immobilization and surgical procedures like realignment and patellectomy.
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 discusses total knee replacement (TKR) and the physiotherapy rehabilitation process. It covers pre-surgical physiotherapy focusing on strength and mobility. Post-surgical physiotherapy is divided into phases focusing initially on range of motion and strengthening, then adding balance and proprioception training. The goals and key exercises of each phase are outlined in detail over 12 weeks of recovery. Complications of TKR like infection, loosening and failure are also mentioned.
Plantar fasciitis is a common cause of heel pain that results from inflammation of the plantar fascia. It occurs when excess stress is placed on the fascia, often due to activities like long-distance running. Symptoms include pain along the bottom of the heel that is usually worst with first steps in the morning. Risk factors include age over 40, obesity, tight calf muscles, and wearing poorly fitting shoes. Diagnosis is based on symptoms and examination, while imaging can show thickening of the plantar fascia. Treatment focuses on reducing inflammation and stress on the fascia through stretching, orthotics, night splints, and heel pads.
The Colles' fracture is a break of the radius bone close to the wrist that results in an upward displacement of the bone. It is typically caused by falling on an outstretched hand. Treatment depends on the severity but may include casting, closed reduction, open reduction and internal fixation. Physiotherapy focuses on regaining range of motion and strength through exercises over several phases of rehabilitation. Prevention includes proper nutrition, exercise, and wrist protection.
Supraspinatus tendinitis is an inflammation of the supraspinatus tendon, which is one of the most commonly affected structures in the rotator cuff. It often results from repeated overhead arm motions or other activities that cause impingement beneath the coracoacromial arch. Symptoms include pain in the shoulder region that is worsened by motions like lifting the arm overhead. Treatment involves rest, exercises to strengthen the rotator cuff muscles, modalities like ultrasound to reduce inflammation, and manual therapy such as transverse friction massage to the tendon.
This document defines and describes cavus foot, including its causes, clinical features, diagnosis, and treatment options. A cavus foot has an abnormally high arch and accompanying toe deformities. Causes include neuromuscular conditions like Charcot-Marie-Tooth disease and polio. Clinical features include a high arch and clawing of the toes. Diagnosis involves physical exam and x-rays. Treatment depends on flexibility and severity but may include tendon lengthening, osteotomies, and joint fusions to correct deformities in the forefoot, midfoot, and hindfoot. The goal is to create a plantigrade foot.
Perthes disease, also known as Legg-Calve-Perthes disease, is caused by impaired blood flow in the femoral head that leads to bone death in children aged 3-12 years old, causing deformity of the femoral head; it is more common in boys and whites and symptoms include limping and hip pain that varies depending on the stage of bone regeneration. Genetic factors and growth abnormalities play a role in its development.
Shoulder dislocation with physiotherapy managementKrishna Gosai
The document summarizes the types, diagnosis, treatment, and physiotherapy management of shoulder dislocations. There are three main types of shoulder dislocations - anterior, posterior, and luxatio erecta. Anterior dislocations are the most common, often caused by a fall on an outstretched hand. Treatment involves reduction, immobilization for 3 weeks, followed by a mobilization phase and physiotherapy to regain full range of motion. Physiotherapy focuses on strengthening muscles around the shoulder and regaining passive range of motion to prevent recurrent dislocations and return to full function.
Spinal orthotics are external devices that limit spinal motion, correct deformities, reduce loading, or improve spinal function. They include flexible braces made of fabric or elastic and rigid braces made of thermoplastics or metals. Cervical collars come in soft and hard varieties and are used for neck injuries or post-operatively. Thoracic-lumbar-sacral orthoses (TLSO) and lumbosacral corsets (LSO) are used for lumbar injuries or fractures. The halo cervical orthosis provides the greatest cervical immobilization using pins in the skull. Drawbacks of orthotics include discomfort, skin issues, and decreased function with prolonged use.
This document discusses genu recurvatum, which is a deformity where the knee bends backwards. It defines genu recurvatum and describes the types as external rotary deformity, internal rotary deformity, or non-rotary deformity. The causes of genu recurvatum include bone growth disorders, ligament instability, leg length discrepancy, and some medical conditions. Symptoms include pain in the back of the knee and hyperextension in mid-stance. Treatment options are ankle foot orthoses, knee orthoses, or knee ankle foot orthoses depending on the cause and location of the problem.
The document discusses seronegative spondyloarthropathies, a group of disorders that share clinical features like inflammatory axial arthritis and enthesitis. It focuses on ankylosing spondylitis (AS), describing its pathology, clinical manifestations including stiffness and fusion of the spine, extra-articular involvement like uveitis, and treatments including NSAIDs and TNF inhibitors. Surgical treatments for severe AS spinal deformities like osteotomies and joint replacement are also summarized.
Low back pain is a common musculoskeletal disorder affecting 40% of people at some point in their lives. It can be acute (lasting less than 7 weeks) or chronic (more than 7 weeks). Common causes include muscle strains, poor posture, obesity, and injuries. Diagnosis involves physical examination and imaging tests like x-rays, CT scans, or MRIs. Treatment depends on whether the back pain is acute or chronic. For acute pain, conservative treatments like NSAIDs, muscle relaxants, and physical therapy are usually effective. Chronic back pain may require more intensive exercises, antidepressants if depression is present, or surgeries like laminectomy or spinal fusion if conservative treatments fail.
Student's elbow, or 'Olecranon Bursitis' is a condition where a small sack of tissue over the tip of your elbow becomes inflamed and swollen. The pointy bit of bone at the end of your elbow is called the 'olecranon' and the small sack which sits between the bone and the skin is called a 'bursa'.
Bhaskar Health News and Medical Education is leading source for trustworthy health, medical, science and technology news and information. Providing world health information Medical Education.
Bhaskar Health News and Medical Education is dedicated to medical students, physiotherapists, doctors, nurses, paramedics, physician associates, dentists, pharmacists, midwives and other healthcare professionals.
We're committed to being your source for expert health guidance. Bhaskar Health and Medical Education.
Source : https://www.bhaskarhealth.com
Health Shop: https://www.bhaskarhealth.org
@drrohitbhaskar @bhaskarhealth
#DrRohitBhaskar #BhaskarHealth
#Health #Medical #News #Physiotherapy
This document defines metatarsalgia as a painful and inflamed ball of the foot. It lists the common signs and symptoms as sharp, aching or burning pain and numbness. Potential causes include abnormal foot structure, excessive activity, poor fitting shoes, and excess weight. Treatment options mentioned are resting, changing shoes, and using orthotic devices like metatarsal bars.
Trochanteric bursitis refers to inflammation of fluid-filled sacs located around the greater trochanter bone on the outside of the hip. It commonly causes deep aching pain on the outside of the hip and thigh that increases with activity and is worse when lying on the affected side. Risk factors include trauma, hip arthritis, back problems, obesity, and other conditions that alter gait or hip movement. Treatment focuses on rest, NSAIDs, physiotherapy, steroid injections, or occasionally surgery.
This document discusses coxa vara, which is a hip deformity characterized by an abnormal decrease in the femoral neck-shaft angle. It classifies coxa vara as congenital, developmental, or acquired. Developmental coxa vara is the most common type and is caused by a primary cartilage defect in the femoral neck. Clinical features include limping and pain. Treatment involves corrective valgus osteotomies to restore the neck-shaft angle and relieve stress on the femoral physis. The document describes several techniques for valgus osteotomy including Pauwel's, Borden's, and subtrochanteric osteotomy. The goal of surgery is to stimulate healing of the femoral neck defect and restore normal
Tendon transfer is a surgical procedure that moves a tendon from one location to another to restore function lost due to nerve damage or injury. The document discusses pre and post-operative physiotherapy management for tendon transfers in the hand. Key points include indications for tendon transfers when nerve recovery is unlikely, prerequisites like full range of motion, and post-operative goals like protecting the transferred tendon and regaining range of motion. Specific procedures are described to address radial, ulnar and median nerve palsies. Post-operative splinting and rehabilitation protocols aim to protect the transfer initially and progress to strengthening.
Physiotherapy Rehab After Total Hip ReplacementMozammal Rabby
This document outlines the phases of rehabilitation following a total hip replacement surgery. It discusses examination of the patient, education provided, and four phases of rehabilitation: immobilization, maximum protection, moderate protection, and minimum protection. Each phase focuses on specific goals like regaining range of motion, strengthening muscles, improving gait, and resuming normal activities. Precautions are provided to prevent dislocation and protect the new hip joint at each stage of recovery.
Olecranon bursitis is an inflammation of the bursa located over the point of the elbow. It can be caused by direct trauma, repetitive rubbing on hard surfaces, or underlying conditions like gout or rheumatoid arthritis. Acute cases present as a tender, fluid-filled swelling while chronic cases appear as a painless swelling. Treatment involves rest, ice, compression, and anti-inflammatory medications. Septic bursitis requires antibiotics while surgery may be needed for cases that do not improve with conservative care.
Recurrent Dislocation of patella -PAWANPawan Yadav
This document discusses recurrent patellar dislocation. It begins by defining recurrent patellar dislocation as the patella shifting laterally with minimal stress on knee flexion. It then discusses the anatomy and Q angle as well as predisposing causes such as increased Q angle, weak medial quads, and tight lateral structures. The document outlines clinical features, tests, x-ray findings, and treatment options including conservative immobilization and surgical procedures like realignment and patellectomy.
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 discusses total knee replacement (TKR) and the physiotherapy rehabilitation process. It covers pre-surgical physiotherapy focusing on strength and mobility. Post-surgical physiotherapy is divided into phases focusing initially on range of motion and strengthening, then adding balance and proprioception training. The goals and key exercises of each phase are outlined in detail over 12 weeks of recovery. Complications of TKR like infection, loosening and failure are also mentioned.
Plantar fasciitis is a common cause of heel pain that results from inflammation of the plantar fascia. It occurs when excess stress is placed on the fascia, often due to activities like long-distance running. Symptoms include pain along the bottom of the heel that is usually worst with first steps in the morning. Risk factors include age over 40, obesity, tight calf muscles, and wearing poorly fitting shoes. Diagnosis is based on symptoms and examination, while imaging can show thickening of the plantar fascia. Treatment focuses on reducing inflammation and stress on the fascia through stretching, orthotics, night splints, and heel pads.
The Colles' fracture is a break of the radius bone close to the wrist that results in an upward displacement of the bone. It is typically caused by falling on an outstretched hand. Treatment depends on the severity but may include casting, closed reduction, open reduction and internal fixation. Physiotherapy focuses on regaining range of motion and strength through exercises over several phases of rehabilitation. Prevention includes proper nutrition, exercise, and wrist protection.
Supraspinatus tendinitis is an inflammation of the supraspinatus tendon, which is one of the most commonly affected structures in the rotator cuff. It often results from repeated overhead arm motions or other activities that cause impingement beneath the coracoacromial arch. Symptoms include pain in the shoulder region that is worsened by motions like lifting the arm overhead. Treatment involves rest, exercises to strengthen the rotator cuff muscles, modalities like ultrasound to reduce inflammation, and manual therapy such as transverse friction massage to the tendon.
This document defines and describes cavus foot, including its causes, clinical features, diagnosis, and treatment options. A cavus foot has an abnormally high arch and accompanying toe deformities. Causes include neuromuscular conditions like Charcot-Marie-Tooth disease and polio. Clinical features include a high arch and clawing of the toes. Diagnosis involves physical exam and x-rays. Treatment depends on flexibility and severity but may include tendon lengthening, osteotomies, and joint fusions to correct deformities in the forefoot, midfoot, and hindfoot. The goal is to create a plantigrade foot.
Perthes disease, also known as Legg-Calve-Perthes disease, is caused by impaired blood flow in the femoral head that leads to bone death in children aged 3-12 years old, causing deformity of the femoral head; it is more common in boys and whites and symptoms include limping and hip pain that varies depending on the stage of bone regeneration. Genetic factors and growth abnormalities play a role in its development.
Shoulder dislocation with physiotherapy managementKrishna Gosai
The document summarizes the types, diagnosis, treatment, and physiotherapy management of shoulder dislocations. There are three main types of shoulder dislocations - anterior, posterior, and luxatio erecta. Anterior dislocations are the most common, often caused by a fall on an outstretched hand. Treatment involves reduction, immobilization for 3 weeks, followed by a mobilization phase and physiotherapy to regain full range of motion. Physiotherapy focuses on strengthening muscles around the shoulder and regaining passive range of motion to prevent recurrent dislocations and return to full function.
Spinal orthotics are external devices that limit spinal motion, correct deformities, reduce loading, or improve spinal function. They include flexible braces made of fabric or elastic and rigid braces made of thermoplastics or metals. Cervical collars come in soft and hard varieties and are used for neck injuries or post-operatively. Thoracic-lumbar-sacral orthoses (TLSO) and lumbosacral corsets (LSO) are used for lumbar injuries or fractures. The halo cervical orthosis provides the greatest cervical immobilization using pins in the skull. Drawbacks of orthotics include discomfort, skin issues, and decreased function with prolonged use.
This document discusses genu recurvatum, which is a deformity where the knee bends backwards. It defines genu recurvatum and describes the types as external rotary deformity, internal rotary deformity, or non-rotary deformity. The causes of genu recurvatum include bone growth disorders, ligament instability, leg length discrepancy, and some medical conditions. Symptoms include pain in the back of the knee and hyperextension in mid-stance. Treatment options are ankle foot orthoses, knee orthoses, or knee ankle foot orthoses depending on the cause and location of the problem.
The document discusses seronegative spondyloarthropathies, a group of disorders that share clinical features like inflammatory axial arthritis and enthesitis. It focuses on ankylosing spondylitis (AS), describing its pathology, clinical manifestations including stiffness and fusion of the spine, extra-articular involvement like uveitis, and treatments including NSAIDs and TNF inhibitors. Surgical treatments for severe AS spinal deformities like osteotomies and joint replacement are also summarized.
Low back pain is a common musculoskeletal disorder affecting 40% of people at some point in their lives. It can be acute (lasting less than 7 weeks) or chronic (more than 7 weeks). Common causes include muscle strains, poor posture, obesity, and injuries. Diagnosis involves physical examination and imaging tests like x-rays, CT scans, or MRIs. Treatment depends on whether the back pain is acute or chronic. For acute pain, conservative treatments like NSAIDs, muscle relaxants, and physical therapy are usually effective. Chronic back pain may require more intensive exercises, antidepressants if depression is present, or surgeries like laminectomy or spinal fusion if conservative treatments fail.
Transient synovitis, also known as irritable hip, is the most common cause of acute hip pain in children aged 3-8 years. It involves transient inflammation of the hip synovium that causes pain and limping. Symptoms include unilateral hip or groin pain and limping. Diagnosis is usually made after ruling out trauma and infection via x-rays and physical exam. Treatment focuses on rest, anti-inflammatory drugs, and recovery typically occurs within 2 weeks. Legg-Calvé-Perthes disease involves osteonecrosis of the femoral head and requires containment of the hip through bracing or surgery depending on the age and extent of involvement.
Ankylosing spondylitis is a type of inflammatory arthritis associated with the HLA-B27 gene. It typically causes stiffness and fusion of the spine over time. Diagnosis involves evidence of sacroiliac joint inflammation on imaging and a positive HLA-B27 test in most cases. Treatment focuses on exercises to maintain mobility, nonsteroidal anti-inflammatory drugs, and TNF inhibitors for severe cases. Surgery may be needed to correct spinal deformities or replace affected hips in advanced ankylosing spondylitis.
Avascular necrosis of the femoral head, also known as osteonecrosis, results from interrupted blood supply to the bone and leads to bone cell death. It has traumatic causes like hip fractures or dislocations and non-traumatic causes like corticosteroid use, alcoholism, or blood disorders. MRI is the most accurate imaging test and stages the disease from pre-collapse to complete joint destruction. Early stages are treated with non-surgical options like protected weight bearing or core decompression surgery, while later stages may require joint replacement. The goal of treatment is to delay or prevent femoral head collapse through reducing pressure and promoting revascularization.
Cervical spondylosis is a common cause of neck pain and stiffness that occurs due to wear and tear on the cervical vertebrae. It involves degeneration of the discs and joints between the vertebrae. Symptoms include neck pain that may radiate to the arms, numbness, weakness, and stiffness. Diagnosis is made through x-rays or MRI showing abnormalities. Most cases are treated successfully with conservative measures like physical therapy, medications, and lifestyle changes, while a small percentage may require surgery.
Approach to the patient with Low Back Pain.pptxdoctetoo
Low back pain is very common, affecting up to 84% of adults at some point in their lives. Most cases are mechanical low back pain such as lumbar strain or sprain, and can be effectively managed in primary care. A thorough history, physical exam, and screening for red flags can identify underlying conditions that may require imaging or specialist referral. Treatment focuses on pain relief, improving function, and patient education on prevention. Referral is indicated for red flag symptoms or if pain persists after 6 weeks of conservative treatment.
The 41-year-old patient should be informed of an increased risk for polyethylene wear and osteolysis compared to his father. Younger, more active patients are at higher risk for wear particle generation and subsequent osteolysis after total hip arthroplasty due to longer prosthetic exposure over their lifetime.
OA KNEE (1) osteoarthritis of knee for undergraduate and post graduate RDJM.pptxSumitKumar108462
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This document discusses the management of patients with musculoskeletal disorders including low back pain, upper extremity conditions, foot problems, and osteoporosis. It provides information on clinical manifestations, assessment approaches, treatment strategies, and nursing interventions for related surgeries and conditions. Key points include common causes of low back pain, signs and symptoms to assess, exercise and body mechanics recommendations for low back pain patients, risk factors and prevention strategies for osteoporosis, and home care education topics for osteoporosis patients.
This document discusses slipped capital femoral epiphysis (SCFE), a condition where the femoral head slips posteriorly and inferiorly through the growth plate. Key points:
- It typically affects obese adolescents age 10-14 and is more common in males.
- Risk factors include obesity, hormonal issues, and genetic factors.
- Radiographs can detect the slip and grade its severity.
- Treatment involves immediate non-weight bearing, and may include screw fixation, osteotomies, or epiphysiodesis with bone grafting to prevent further slippage.
- Complications can include avascular necrosis, chondrolysis, and residual deformity/osteoarthritis if
Avascular necrosis of Hip - treatment modalities and current concepts.pptxVivek Jadawala
Slide 1 - Treatment modalities of Avascular Necrosis of Hip
JOURNAL CLUB PRESENTATION
Dr. Vivek Jadawala
PGY-3, Dept. of Orthopaedics,
JNMC, DMIHER
Slide 2 - image
slide 3 - image
slide 4 - Osteonecrosis of Hip - Osteonecrosis is death of living elements of involved bone (cells including marrow) with progressive destruction and alteration of bone architecture as a result of compromised vascularity.
Usually aseptic but may be incited by loss of vascularity from infection.
Slide 5 - Epidemiology - Male > Female
Average age group – 35 to 50 years
Bilateral Hip joints – 80 % of the cases
Most common site – Antero-lateral aspect of femoral head
Slide 6 - Blood supply of femoral head
Slide 7 - Classification of AVN: Ficat and Arlet -STAGE 0 :
X-ray : normal
MRI: normal
clinical symptoms: nil
STAGE I :
X-ray : normal or minor osteopenia
MRI: edema
bone scan: increased uptake
clinical symptoms: pain typically in the groin
Slide 8 - Stage I
Slide 9 - Stage II -
X-ray: mixed osteopenia and/or sclerosis and/or subchondral cysts, without any subchondral lucency (crescent sign)
MRI: geographic defect
Bone scan: increased uptake
clinical symptoms: pain and stiffness
Slide 10 - Stage III - X-ray: Crescent sign and eventual cortical collapse
MRI: same as plain radiograph
clinical symptoms: pain and stiffness +/- radiation to knee and limp
Slide 11 - Stage IV - X-ray: end-stage with evidence of secondary degenerative change
MRI: same as plain radiograph
clinical symptoms: pain and limp
Slide 12 - Stage IV
Slide 13 - image
Slide 14 - Steinberg staging of AVN
Slide 15 - Steinberg staging - STAGE 0:
- normal or non-diagnostic radiographs, MRI and bone scan of at risk hip (often contralateral hip involved, or patient has risk factors and hip pain)
STAGE I:
normal radiograph, abnormal bone scan and/or MRI
STAGE II:
- cystic and sclerotic radiographic changes
STAGE I AND II
A, mild: <15% head involvement as seen on radiograph or MRI
B, moderate: 15% to 30%
C, severe: >30%
Slide 16 - STAGE III:
- subchondral lucency or crescent sign
A, mild: subchondral collapse (crescent) beneath <15% of articular surface
B, moderate: crescent beneath 15% to 30%
C, severe: crescent beneath >30%
STAGE IV:
flattening of femoral head, with depression graded into
A, mild: <15% of surface has collapsed and depression is <2 mm
B, moderate: 15% to 30% collapsed or 2-4 mm depression
C, severe: >30% collapsed or >4 mm depression
Slide 17 - STAGE V:
- joint space narrowing with or without acetabular involvement
STAGE VI:
- advanced degenerative changes
Slide 18 - Association Research Circulation Osseous classification
Slide 19 - image
Slide 20 - Kerboul angle - Original classification was proposed on radiographs where he divided the necrotic region into small, medium and large regions:
Small - less than or equal to 160°
Medium - 161 to 199°
Large - 200 or more degrees.
Slide 21 - Modified Kerboul angle - based on MRI has much higher values as the MRI overestimates the necrotic region
Chronic Musculoskeletal Disorders and Physical Therapy Management Prochnost
This document discusses chronic musculoskeletal disorders (MSDs) that commonly affect the neck, back, shoulders, hips, knees, wrists and feet. It provides details on osteoarthritis, rheumatoid arthritis, gout, fibromyalgia, tennis elbow and other conditions. For each condition, it describes causes, signs and symptoms, assessment findings and physical therapy management approaches such as exercises, modalities and joint protection strategies.
Hip fractures in elderly - general aspectsappumaalu
This is prepared to present before doctors from different specialities. Hence here discussiuon comes only in a general practitioner's aspect. It is not going deep into the orthopaedic aspects
This document discusses spinal cord injuries, including:
- Causes include motor vehicle accidents, falls, violence, and sports or electric injuries.
- Types include complete and incomplete injuries. Complete injuries result in paraplegia or tetraplegia while incomplete injuries cause varying levels of paralysis.
- Complications include respiratory issues, autonomic dysreflexia, venous thromboembolism, and skin breakdown from immobility. Nursing management focuses on prevention and treatment of complications through positioning, skin care, respiratory treatments, and monitoring for autonomic dysreflexia.
Case discussion of perthes disease-Dr. Siddharth Deshwal PG OrthopaedicsSIDDHARTHDESHWAL3
This document discusses the case of a child with Perthes disease. Key points include:
- Perthes disease typically affects children ages 4-10 years old and presents with limping or hip/groin pain.
- Imaging shows stages of the disease from initial involvement to reossification. Staging systems like Caterall and Salter-Thompson are used to classify the extent of epiphyseal involvement.
- Treatment aims to contain the femoral head in the acetabulum during healing to promote a spherical head shape and prevent deformity. Containment is usually only beneficial in the early revasularization stage.
Ankylosing spondylitis is a chronic inflammatory disease that primarily affects the spine and sacroiliac joints. It is characterized by inflammation of the entheses, where ligaments and tendons attach to bone. Over time, this leads to ossification and fusion of the vertebrae (bamboo spine). Symptoms include chronic lower back pain and stiffness, especially early morning, as well as restricted spinal mobility. Diagnosis is based on clinical features and confirmed by presence of HLA-B27 and imaging showing sacroiliitis and vertebral squaring/syndesmophytes. There is currently no cure for ankylosing spondylitis, but treatment can help reduce symptoms and prevent deformity.
A 31-year-old man presented with low back pain radiating to his lower limbs that had been ongoing for two years since a motorcycle accident. Physical examination found tenderness at L5 and positive straight leg raise, Lasegue, and bowstring tests on the right side. MRI revealed herniation of the nucleus pulposus at L3-L4 and L4-L5. The diagnosis was low back pain due to herniated discs at L3-L4 and L4-L5. Treatment of analgesics and planned discectomy was recommended.
ISO/IEC 27001, ISO/IEC 42001, and GDPR: Best Practices for Implementation and...PECB
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Certified as an ISO/IEC 27001: Information Security Management Systems (ISMS) Lead Implementer, Data Protection Officer, and Cyber Risks Analyst, Denis brings a heightened focus on data security, privacy, and cyber resilience to every endeavor.
His expertise extends across a diverse spectrum of reporting, database, and web development applications, underpinned by an exceptional grasp of data storage and virtualization technologies. His proficiency in application testing, database administration, and data cleansing ensures seamless execution of complex projects.
What sets Denis apart is his comprehensive understanding of Business and Systems Analysis technologies, honed through involvement in all phases of the Software Development Lifecycle (SDLC). From meticulous requirements gathering to precise analysis, innovative design, rigorous development, thorough testing, and successful implementation, he has consistently delivered exceptional results.
Throughout his career, he has taken on multifaceted roles, from leading technical project management teams to owning solutions that drive operational excellence. His conscientious and proactive approach is unwavering, whether he is working independently or collaboratively within a team. His ability to connect with colleagues on a personal level underscores his commitment to fostering a harmonious and productive workplace environment.
Date: May 29, 2024
Tags: Information Security, ISO/IEC 27001, ISO/IEC 42001, Artificial Intelligence, GDPR
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A review of the growth of the Israel Genealogy Research Association Database Collection for the last 12 months. Our collection is now passed the 3 million mark and still growing. See which archives have contributed the most. See the different types of records we have, and which years have had records added. You can also see what we have for the future.
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How to Setup Warehouse & Location in Odoo 17 InventoryCeline George
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Chapter wise All Notes of First year Basic Civil Engineering.pptxDenish Jangid
Chapter wise All Notes of First year Basic Civil Engineering
Syllabus
Chapter-1
Introduction to objective, scope and outcome the subject
Chapter 2
Introduction: Scope and Specialization of Civil Engineering, Role of civil Engineer in Society, Impact of infrastructural development on economy of country.
Chapter 3
Surveying: Object Principles & Types of Surveying; Site Plans, Plans & Maps; Scales & Unit of different Measurements.
Linear Measurements: Instruments used. Linear Measurement by Tape, Ranging out Survey Lines and overcoming Obstructions; Measurements on sloping ground; Tape corrections, conventional symbols. Angular Measurements: Instruments used; Introduction to Compass Surveying, Bearings and Longitude & Latitude of a Line, Introduction to total station.
Levelling: Instrument used Object of levelling, Methods of levelling in brief, and Contour maps.
Chapter 4
Buildings: Selection of site for Buildings, Layout of Building Plan, Types of buildings, Plinth area, carpet area, floor space index, Introduction to building byelaws, concept of sun light & ventilation. Components of Buildings & their functions, Basic concept of R.C.C., Introduction to types of foundation
Chapter 5
Transportation: Introduction to Transportation Engineering; Traffic and Road Safety: Types and Characteristics of Various Modes of Transportation; Various Road Traffic Signs, Causes of Accidents and Road Safety Measures.
Chapter 6
Environmental Engineering: Environmental Pollution, Environmental Acts and Regulations, Functional Concepts of Ecology, Basics of Species, Biodiversity, Ecosystem, Hydrological Cycle; Chemical Cycles: Carbon, Nitrogen & Phosphorus; Energy Flow in Ecosystems.
Water Pollution: Water Quality standards, Introduction to Treatment & Disposal of Waste Water. Reuse and Saving of Water, Rain Water Harvesting. Solid Waste Management: Classification of Solid Waste, Collection, Transportation and Disposal of Solid. Recycling of Solid Waste: Energy Recovery, Sanitary Landfill, On-Site Sanitation. Air & Noise Pollution: Primary and Secondary air pollutants, Harmful effects of Air Pollution, Control of Air Pollution. . Noise Pollution Harmful Effects of noise pollution, control of noise pollution, Global warming & Climate Change, Ozone depletion, Greenhouse effect
Text Books:
1. Palancharmy, Basic Civil Engineering, McGraw Hill publishers.
2. Satheesh Gopi, Basic Civil Engineering, Pearson Publishers.
3. Ketki Rangwala Dalal, Essentials of Civil Engineering, Charotar Publishing House.
4. BCP, Surveying volume 1
LAND USE LAND COVER AND NDVI OF MIRZAPUR DISTRICT, UPRAHUL
This Dissertation explores the particular circumstances of Mirzapur, a region located in the
core of India. Mirzapur, with its varied terrains and abundant biodiversity, offers an optimal
environment for investigating the changes in vegetation cover dynamics. Our study utilizes
advanced technologies such as GIS (Geographic Information Systems) and Remote sensing to
analyze the transformations that have taken place over the course of a decade.
The complex relationship between human activities and the environment has been the focus
of extensive research and worry. As the global community grapples with swift urbanization,
population expansion, and economic progress, the effects on natural ecosystems are becoming
more evident. A crucial element of this impact is the alteration of vegetation cover, which plays a
significant role in maintaining the ecological equilibrium of our planet.Land serves as the foundation for all human activities and provides the necessary materials for
these activities. As the most crucial natural resource, its utilization by humans results in different
'Land uses,' which are determined by both human activities and the physical characteristics of the
land.
The utilization of land is impacted by human needs and environmental factors. In countries
like India, rapid population growth and the emphasis on extensive resource exploitation can lead
to significant land degradation, adversely affecting the region's land cover.
Therefore, human intervention has significantly influenced land use patterns over many
centuries, evolving its structure over time and space. In the present era, these changes have
accelerated due to factors such as agriculture and urbanization. Information regarding land use and
cover is essential for various planning and management tasks related to the Earth's surface,
providing crucial environmental data for scientific, resource management, policy purposes, and
diverse human activities.
Accurate understanding of land use and cover is imperative for the development planning
of any area. Consequently, a wide range of professionals, including earth system scientists, land
and water managers, and urban planners, are interested in obtaining data on land use and cover
changes, conversion trends, and other related patterns. The spatial dimensions of land use and
cover support policymakers and scientists in making well-informed decisions, as alterations in
these patterns indicate shifts in economic and social conditions. Monitoring such changes with the
help of Advanced technologies like Remote Sensing and Geographic Information Systems is
crucial for coordinated efforts across different administrative levels. Advanced technologies like
Remote Sensing and Geographic Information Systems
9
Changes in vegetation cover refer to variations in the distribution, composition, and overall
structure of plant communities across different temporal and spatial scales. These changes can
occur natural.
it describes the bony anatomy including the femoral head , acetabulum, labrum . also discusses the capsule , ligaments . muscle that act on the hip joint and the range of motion are outlined. factors affecting hip joint stability and weight transmission through the joint are summarized.
A workshop hosted by the South African Journal of Science aimed at postgraduate students and early career researchers with little or no experience in writing and publishing journal articles.
3. What isAVN of hip?
• Avascular necrosis (AVN) of femoral head, also called osteonecrosis is
defined as ischemic death of subchondral bone due to disruption of blood
supply to the femoral head.
• AVN of hip classified into 3 categories :-
1) Traumatic
2) Non-traumatic
3)Idiopathic
4. What are causes ofAVN?
Traumatic cause Non-traumatic cause Idiopathic
Dislocation of hip Corticosteroids use
Alcohol abuse
Smoking
Hemoglobinopathy (sickle cell disease)
Fracture neck of
femur
Systemic lupus erythematous
Displace hip fracture Malignancy(marrow infiltration,
malignant fibrous histiocytoma )
HIV infection
Chemotherapy
Gaucher
disease
Caisson’s disease ( Uncommon diving
related decompression sickness)
5. Blood supply
• The capsule encloses most of the
femoral neck and the entire femoral
head.
• The primary blood supply to the femoral
head and neck arises from the medial
and lateral circumflex femoral arteries.
7. Pathophysiology
• Although the pathophysiology of AVN is not fully understood.
• The final common pathway is interruption of blood flow to the bone and
resultant necrosis of marrow, medullary bone, and cortex.
• Corticosteroids induced AVN- Fat accumulates in the liver of patients
treated where serum lipid concentration also increases. It give rise to fat
embolism and AVN.
8. • Alcohol induced AVN - Hyperlipidemia is the excess of fatty cells in the
body, the increased fat content of the blood causes blockage of the blood
vessels.
• Cigarette smoking : Due to changes in nitric oxide bioavailability, there is
an increased oxidative stress level and endothelial dysfunction.
• Sickle cell induced AVN : Sickle cell disease is a disorder that causes red
blood cells to become sickled (banana-shaped), as well as sticky and rigid,
which blocks blood flow in small blood vessels of the body. This loss of
blood causes narrowing of the joint and collapse of the bone.
9. • Chemotherapy -Multiple courses of chemotherapy, resulting in increased
production of cytokines, which caused the formation of thrombi and
decreased arterial blood supply. Blood disruption to the epiphyses of the
femoral head led to the development of AVN.
10. Investigations
• Radiographs (only after a few months to as long as 2 years, that one can
diagnose avascular necrosis on X-ray).
• MRI : Highest sensitivity (99%) and specificity (99%)
• The disease can be staged radio-graphically (Ficat & Arlet, 1964).
• Steinberg’s system of classification which is progression of Ficat &
Arlet.
11.
12. Ficat and arlet classification
• Ficat & Arlet classification system of the femoral head
Classification Clinical Radiographs MRI
Stage 0 No symptoms; preclinical Normal Normal
Stage 1 Possible groin pain Normal or mild osteopenia Possible edema
Stage 2 Groin pain and stiffness; Osteopenia and/or subchondral Outlines area of
pain with activity cysts; diffuse porosis; involvement of FH
precollapse of joint space
Stage 3 Groin pain, stiffness, Crescent sign and/or subchondral
radiation of pain; collapse (flattening) of joint with
pain with activity secondary degenerative changes; Same as
radiographs
loss of sphericity of femoral head
Stage 4 Groin pain and limp; End-stage disease with collapse; Same as
radiographs ; Pain at rest extensive destruction of joint
13.
14. Steinberg staging system
• Steinberg expands the Ficat system into six stages and includes :
• Stage Features
• 0 Normal radiograph, bone scan and magnetic resonance imaging
• I Normal radiograph, abnormal bone scan and or MRI
• IA Mild (involves < 15% of femoral head)
• IB Moderate (involves 15% to 30% of femoral head)
• IC Severe (involves > 30% of femoral head)
• II Cystic and sclerotic changes in the femoral head
• IIA Mild (involves < 15% of femoral head)
• IIB Moderate (involves 15% to 30% of femoral head)
• IIC Severe (involves > 30% of femoral head)
• III Subchondral collapse (crescent sign) without flattening of the FH
15. • IIIA Mild (involves < 15% of femoral head)
• IIIB Moderate (involves 15% to 30% of femoral head)
• IIIC Severe (involves > 30% of femoral head)
• IV Flattening of the femoral head/femoral head collapse
• IVA Mild (involves < 15% of femoral head)
• IVB Moderate (involves 15% to 30% of femoral head)
• IVC Severe (involves > 30% of femoral head)
• V Joint space narrowing and/or acetabular changes
• VA Mild
• VB Moderate
• VC Severe
• VI Advance degenerative joint disease
16. History
1.Age- Osteonecrosis can affect anyone, but is more common in people
between the ages of 40 and 65.
2.Sex- Men develop osteonecrosis of the hip more often than women (7:3).
3.Chief complaints – Asymptomatic early on in the disease process.
• In symptomatic, the stated history is usually of hip pain that may radiate to
the groin and/or thigh.
• Pain aggravating Factor- Walking and climbing stairs.
• Relieving Factor – Rest (Pain will be present in absence of movements)
17. History
4 .Past medical history- History of trauma
5. Drug history- Corticosteroids and steroids have high association of
AVN.
6. Personal history- Addictions like alcohol and cigarette smoking are risk
factors of AVN.
7. BMI- Obesity: osteonecrosis is positively associated with BMI. Overweight
and obesity are, just like steroid and alcohol use, often associated with
hyperlipidemia.
18. History
8. Observation - Trendlenburg’s sign may be positive..
9. Palpation- Tenderness over the groin region and tenderness to palpation of
the hip region.
10. Painful movements
11.Shortening of limb may be present.
19. Treatment
• Treatment decisions should be based on the staging of the lesions but mainly
on the presence or absence of collapse.
• Generally, non-operative treatments or core decompression can show value
in asymptomatic and symptomatic small to medium-sized pre-collapse
lesion.
• Medium to larger-sized lesions can have treatment with bone grafting
(vascularized or non-vascularized), or osteotomies.
20. • If femoral collapse has occurred or acetabular involvement is present,
arthroplasty is indicated.
• Conservative management spans a variety of non-operative treatments. These
may include physical therapy, restricted weight-bearing, alcohol cessation,
discontinuation of steroid therapy, pain control medication, and targeted
pharmacologic therapy, among others.
21. Surgical treatment
• Core decompression: (for stages 1
and 2 of the disease) creates a tract for
example in the femoral head that
decompresses the head. Hereby
facilitating increased blood flow,
which will then promote neo-
vascularization that could possibly
stimulate new bone growth.
22. Osteotomy
• It is an surgical operation whereby a
bone is cut to shorten or lengthen it or to
change its alignment.
• It decreases the load from the necrotic
bone either by rotation of the femoral
head and neck or by a varus or valgus
angulation of the proximal femur.
• This treatment is only for young patients
without co-morbidities interfering with
bone healing.
23. Joint replacement
• Total hip arthroplasty (commonly in stages 3 and 4) is the only option. In
this total hip replacement the damaged bone and cartilage are removed and
replaced with prosthetic components.
24. Physiotherapeutic Management
• Conservative management such as physiotherapy is necessary to prevent
further deterioration of the affected hip.
• while it has been shown to delay the disease progression, physiotherapy alone
cannot cure the disease – with 70-80% of clients requiring surgical treatment.
• Physiotherapy treatment aims include:
1. To reduce pain
2. Decrease weight bearing on affected extremity.
3. Patient education.
4.To improve joint mobility.
5.To strengthen the muscle of hip joint
25. 1. Crutches or a walking aid - To decrease the weight-bearing load through
the head of the femur.
2. Patients education - Reduction of risk factors such as smoking, alcohol
abuse, obesity and corticosteroids.
3. To reduce pain - Modalities like ES, TENS and HCP is helpful to reduce
pain.
4. To improve mobility of joint - Passive ROM exercises (Flexion,extension
& Abduction) and Active ROM exercises in pain free range.
5. To prevent reflex inhibition of muscle – Activation exercises for
hamstrings, glutes and core muscle.
26. Do’s and Don’ts
Do’s
• Do keep the leg facing forward
• Do keep the affected leg in front as you
sit or stand
• Do use a high kitchen or barstool in the
kitchen
• Do kneel on the knee on the operated
leg (the bad side)
• Do use ice to reduce pain and swelling,
but remember that ice will diminish
sensation.
Don’ts
• Don't cross your legs at the knees
for at least 8 weeks.
• Don't bring your knee up higher
than your hip.
• Don't lean forward while sitting or
as you sit down.
• Don't try to pick up something on
the floor while you are sitting.
27. Do’s
• Do apply heat before exercising to
assist with range of motion.
• Use a heating pad or hot, damp
towel for 15 to 20 minutes.
• Do cut back on your exercises if
your muscles begin to ache, but
don't stop doing them.
Don’ts
• Don't turn your feet excessively
inward or outward when you bend
down.
• Don't bend at the waist beyond 90°
• Don't kneel on the knee on the
non-operated leg (the good side)
• Avoid toe-standing
28. References
1. S. Brent Broadzman &Robert C. Manske, PT “Clinical Orthopaedic
Rehabilitation”- 3rd edition.
2. Jayant Joshi & Prakash Kotwal “ Orthopaedics and applied
Physiotherapy”- 3rd edition.
3. Moya-Angeler J, Gianakos AL, Villa JC, Ni A, Lane JM. Current concepts
on osteonecrosis of the femoral head. World J Orthop 2015; 6(8): 590-601
[PMID: 26396935 DOI: 10.5312/wjo.v6.i8.590].
4. American Academy of Orthopedic Surgeons: http://orthoinfo.aaos.org