examination,impingement syndrome,rotator cuff injury,shoulder,shoulder instability
All about orthopaedic shoulder examination. comprehensive ppt with all tests arranged symptom wise
The presentation investigates the following characteristics of the meniscus;
Role of the Meniscus
Material Properties
Structural Limitations / Failure Limits
Mechanism & Treatment of Injuries
Sacroiliac(SI) Joint Dysfunction,Evaluation and Treatment Dr.Md.Monsur Rahman
Dr.MD.Monsur Rahman,PT
MPT-Musculoskeletal Disorders
Maharishi Markandeshwar Institute Of Physiotherapy And Rehabilitation, Maharishi Markandeshwar (Deemed to be University), Mullana - Ambala,133-207 (Haryana)
Monteggia fractures and neglected cases
A simple presentation to understand the fracture and its classifications and answer some coomonly asked questions regarding the neglected cases managment
examination,impingement syndrome,rotator cuff injury,shoulder,shoulder instability
All about orthopaedic shoulder examination. comprehensive ppt with all tests arranged symptom wise
The presentation investigates the following characteristics of the meniscus;
Role of the Meniscus
Material Properties
Structural Limitations / Failure Limits
Mechanism & Treatment of Injuries
Sacroiliac(SI) Joint Dysfunction,Evaluation and Treatment Dr.Md.Monsur Rahman
Dr.MD.Monsur Rahman,PT
MPT-Musculoskeletal Disorders
Maharishi Markandeshwar Institute Of Physiotherapy And Rehabilitation, Maharishi Markandeshwar (Deemed to be University), Mullana - Ambala,133-207 (Haryana)
Monteggia fractures and neglected cases
A simple presentation to understand the fracture and its classifications and answer some coomonly asked questions regarding the neglected cases managment
Traitement médical de la pubalgie - Dr Alain Simon - 1ère journée européenn...VitamineB
Traitement médical de la pubalgie -
Par le Docteur Alain Simon
Lors de la 1ère journée européenne de la pubalgie.
Clinique du sport bordeaux mérignac
Andrew Wolfe,LMP of Harmony Licensed Massage Therapy presents power point presentation, he created to illustrate massage therapy as a medical modality of natural and effective means to rehabilitation of medical injury care and recovery from soft tissue care and disfunction. His private practice,is based in Arlington Washington. He has over 23 years clinical advanced training and experience;since 1987.
VIMG's Condition of the Week - Ilio-Tibial Band Syndrome.
Learn more about ilio-tibial band syndrome including ideas for treatment and prevention.
www.markjpitcher.com
www.vailhealth.com
A number of periarticular disorders have become increasingly common over the past two to three decades, due in part to greater participation in recreational sports by individuals of a wide range of ages. Periarticular disorders most commonly affect the knee or shoulder. With the exception of bursitis, hip pain is most often articular or is being referred from disease affecting another structure.
Conservative Management of Severe OA Knees with the V-VAS OrthosisDerek Jones
This presentation won best paper award at BAPO (British Association of Prosthetics & Orthotics) Conference in 2008. The focus is on conservative management of severe OA knee pain and deformity using the V-VAS Knee orthosis from Anatomical Concepts
a painful knee can be classified into arthritic and non-arthatic. Many doctor forget non-arthic knee pain. This non-arthritic pain affect many pat.. younger more affected than old pat.,
definition of Femoroacetabular impingement.pptxHome
definition of hip impingement,
femoroacetabular impingement complete definition, signs and symptoms of hip impingement,
diagnosis of hip impingement,
treatment for hip impingement
pictures of hip impingement,
classification of hip impingement.
complete Knee joint assessment from physiotherapeutic point of view. Includes observation , palpation , assessment, special test, differential diagnosis of knee joint .
Knee injuries in sports medicine & arthroscopydocortho Patel
knee ligaments injuries are so incresing in sports persons & even in accidental trauma.here providing you basic knowledge of these injuries & arthroscopy treatment
How to Split Bills in the Odoo 17 POS ModuleCeline George
Bills have a main role in point of sale procedure. It will help to track sales, handling payments and giving receipts to customers. Bill splitting also has an important role in POS. For example, If some friends come together for dinner and if they want to divide the bill then it is possible by POS bill splitting. This slide will show how to split bills in odoo 17 POS.
The Indian economy is classified into different sectors to simplify the analysis and understanding of economic activities. For Class 10, it's essential to grasp the sectors of the Indian economy, understand their characteristics, and recognize their importance. This guide will provide detailed notes on the Sectors of the Indian Economy Class 10, using specific long-tail keywords to enhance comprehension.
For more information, visit-www.vavaclasses.com
Welcome to TechSoup New Member Orientation and Q&A (May 2024).pdfTechSoup
In this webinar you will learn how your organization can access TechSoup's wide variety of product discount and donation programs. From hardware to software, we'll give you a tour of the tools available to help your nonprofit with productivity, collaboration, financial management, donor tracking, security, and more.
This is a presentation by Dada Robert in a Your Skill Boost masterclass organised by the Excellence Foundation for South Sudan (EFSS) on Saturday, the 25th and Sunday, the 26th of May 2024.
He discussed the concept of quality improvement, emphasizing its applicability to various aspects of life, including personal, project, and program improvements. He defined quality as doing the right thing at the right time in the right way to achieve the best possible results and discussed the concept of the "gap" between what we know and what we do, and how this gap represents the areas we need to improve. He explained the scientific approach to quality improvement, which involves systematic performance analysis, testing and learning, and implementing change ideas. He also highlighted the importance of client focus and a team approach to quality improvement.
2024.06.01 Introducing a competency framework for languag learning materials ...Sandy Millin
http://sandymillin.wordpress.com/iateflwebinar2024
Published classroom materials form the basis of syllabuses, drive teacher professional development, and have a potentially huge influence on learners, teachers and education systems. All teachers also create their own materials, whether a few sentences on a blackboard, a highly-structured fully-realised online course, or anything in between. Despite this, the knowledge and skills needed to create effective language learning materials are rarely part of teacher training, and are mostly learnt by trial and error.
Knowledge and skills frameworks, generally called competency frameworks, for ELT teachers, trainers and managers have existed for a few years now. However, until I created one for my MA dissertation, there wasn’t one drawing together what we need to know and do to be able to effectively produce language learning materials.
This webinar will introduce you to my framework, highlighting the key competencies I identified from my research. It will also show how anybody involved in language teaching (any language, not just English!), teacher training, managing schools or developing language learning materials can benefit from using the framework.
Palestine last event orientationfvgnh .pptxRaedMohamed3
An EFL lesson about the current events in Palestine. It is intended to be for intermediate students who wish to increase their listening skills through a short lesson in power point.
How to Make a Field invisible in Odoo 17Celine George
It is possible to hide or invisible some fields in odoo. Commonly using “invisible” attribute in the field definition to invisible the fields. This slide will show how to make a field invisible in odoo 17.
Ethnobotany and Ethnopharmacology:
Ethnobotany in herbal drug evaluation,
Impact of Ethnobotany in traditional medicine,
New development in herbals,
Bio-prospecting tools for drug discovery,
Role of Ethnopharmacology in drug evaluation,
Reverse Pharmacology.
4. HISTORY OF PRESENT ILLNESS:
• 17-year-old gentleman who complains of left
hip pain for the last 6 months.
• He denies any incident or fall that caused the
injury.
• He describes multiple groin pulls that he had
in the past, as well as hip flexor injuries that
he thought was the cause of this.
5. Sport
• He plays basketball and football, and recently
received a full scholarship to Santa Clara
University for baseball. He is really hoping
that he will get drafted over this next year
into the NLB draft, and he would like to fix
this problem before that.
6. Pain Hx
• He states that pain is worse with
running, squatting, stretching and lifting
weights.
• He has tried Advil and icing which have been
somewhat helpful. He has not tried any
physical therapy. He has never had an
injection in the hip.
• He does report some clicking and popping in
the hip.
7. Back and Radiation Hx
• He denies any history of low back pain.
Denies any numbness or tingling in the legs.
Denies any radiating pain.
8. Summary
Age and Gender 17y male Sport Basketball
Duration of Pain 6 months Football
Unilateral Pain Yes Baseball (on scholarship)
Onset of pain Insidious
Pain ↑ running, squatting,
Traumatic Injury No stretching and lifting
weights
Physical Therapy No
Pain ↓ Advil and ice were
Medications None
somewhat helpful
Previous Injection No
Clicking and Popping Yes - Unilateral
Back Pain No
Pain Radiation No
10. PHYSICAL EXAMINATION
Right Left (painful side)
Trendelenburg N N
Psoas Strength 5 4+
ROM - Flexion 110 100
Internal Rotation 15 5
External Rotation 20 40
Impingement Test + +
Labral Stress Test + + w/ click
FABER 2¼ 2+
Internal Snapping N N
Trochanteric Pain / Ober N N
12. Trendelenburg Test
• Described by German
surgeon Friedrich
Trendelenburg in 1895.
• Positive result may
indicate weakness of
the abductors – mainly
the gluteus medius and
but also glut. minimus
and TFL
27. 1. Make sure it’s a good quality XR
2. Measurements
I. Joint space and arthritic changes
II. Cross-over sign
III. Os-acetabulum
IV. Profunda, protrosio
V. Center-edge angle and acetabular inclination
28. 34˚
X
90˚
1. Make sure it’s a good quality XR
2. Measurements
I. Joint space and arthritic changes
II. Cross-over sign
III. Os-acetabulum
IV. Profunda, protrosio
V. Center-edge angle and acetabular inclination
32. Reasons to do MRI
• To confirm the diagnosis
• Local anesthetics delivery
• Quantify pathology and morphology
• See peri-articular structures
– gluteus medius, iliopsoas tendon, peripheral compartment
• See areas that are hard to fully visualize during surgery
– Inferior acetabulum, Inferior/central femoral
head, Posterior and medial femoral neck
• See the bony pathologies –
– edema, AVN, sub-chondral cysts, tumors
37. Labral Tear Types
Seldes et al. (2001)
has recognized two
types of acetabular
labral tears:
Type 1 – Tear at the
base of the
chondro-labral
junction
Type 2 – Intra-
substance tear
43. Iliopsoas Tendinitis
• Sagittal MR
imaging of a
professional male
tennis player
demonstrating
iliopsoas tendinitis
(white arrow) and
a posterior
perilabral cyst
(black arrow)
44. Sacral Stress Fracture
• MR imaging of a 21-
year-old female
collegiate volleyball
player presenting with
posterior hip pain and
negative radiographs.
MR imaging
demonstrates sacral
stress fracture (black
arrow) with
associated marrow
edema (white arrows)
45. Synovial Chondromatosis
• Coronal MR
imaging of a male
patient with cam
type FAI, and
multiple loose
bodies (arrows) of
synovial
chondromatosis.
53. Intra-Articular Injection
• 43% of patients, extra-articular structures may
be a major source of pain even though a labral
tear is suggested on MRI arthrogram
Intra-articular injection should be a
routine procedure
55. What is Dysplasia?
• Wiberg described the lateral CE angle
• Defined thresholds:
– >25˚ as normal
– 25˚ to 20˚ as borderline normal
– <20˚ as dysplastic and pathologic
56. Dysplasia: Natural History
Lack of bony support
Increased load on hypertrophic labrum
Labral tearing
Antero-superior migration/subluxation
Eccentric loading of acetabular cartilage ARTHRITIS
57.
58. Parvizi 2009
• 34 arthroscopic labral debridements in
dysplastic hips
• Failed to relieve pain in 24 patients
• Accelerated arthritis in 14 patients
• Migration of the femoral head in 13 patients
• 16 patients underwent further surgery
– periacetabular osteotomy [6 patients]
– femoroacetabular osteoplasty [7 patients]
– total hip arthroplasty [3 patients]
59. Peri-Acetabular Osteotomy (PAO)
• Currently the ONLY surgical solution which
corrects the deformity
• Arthroscopic treatment should be considered
only if PAO is not an option
62. 22 yo F, 2 years of R hip pain, MRI: Ant-sup labral tear
18˚
3˚
X X
63. 22 yo F, 2 years of R hip pain – Hip Arthroscopy
64. Labral Tears In Dysplasia
DO NOT RESECT THE LABRUM
Unless planning a labral reconstruction
The Labrum is important in:
– Absorption of loading forces
– Prevention of subluxation
– Risk in increasing instability and
subluxation after labrum resection
65. The Capsule in Dysplasia
• In dysplasia, instability is
the problem
• ALWAYS PRESERVE or
PLICATE THE CAPSULE
• Capsular plication may
allow improved
stability, diminish likelihood
of lateral migration
Hip internal rotation is correlated to radiographic findings of cam femoroacetabular impingement in collegiate football players.Kapron AL, Anderson AE, Peters CL, Phillips LG, Stoddard GJ, Petron DJ, Toth R, Aoki SK.Arthroscopy. 2012 Nov;28(11):1661-70. doi: 10.1016/j.arthro.2012.04.153. Epub 2012 Sep 19.Department of Bioengineering, University of Utah, Salt Lake City, USA
Very sensitive test, may elicit pain in a subtle hip pathology. Not specific for impingement!
May be painful in posterior impingement or adhesive capsulitis (and restricted). May be minimal with anterior capsule laxity.
Cause compressive forces multiple times the body weight in the hip joint (Byrd). When compared to intra-articular injection, was found to be the most specific test for internal hip pain, FABER and labral stress test were found to be the most sensitive [PM&R 2010 http://www.ncbi.nlm.nih.gov/pubmed/20359681]
The limb is supported, as it is moved back and forth an external snap may be elicited. In Ober test - lowering the knee towards the table can assess ITB tightness.
* Inclusion and jamming of a proximal femoral deformity into the acetabulum (Cam type)*chondral and labral damage at the transitional zone
Direct impaction of the femoral neck against the acetabular rim (Pincer type)
Herniation pits were first described by Pitt in 1982, and were believed to be inclusion cysts that were normal variants and of no significance. Subsequently, Leunig and colleagues showed that 33% of patients undergoing surgery for FAI demonstrated herniations pits, and these occurred in the location of the impingement
Axial MR imaging demonstrating edema of the quadratus femoris muscle (arrow), consistent with the diagnosis of ischiofemoral impingement.
Axial MR imaging of a 19-year-old competitive soccer player who sustained a dislocation to his hip 3 years prior and continues to complain of hip instability without recurrent dislocation. Thickening and scarring of the iliofemoral ligament (arrows) is seen on MR imaging
More than 50% relieve of less.
Arthrsocopy 2008This study found that in 43% of individuals, extra-articular structures may be a major source of pain even though a labral tear is suggested on MRI arthrogram. Labral tear on MRI may not be the main source of pain, intra-articular injection should be a routine procedure.
