What's your diagnosis? #3
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The document discusses Hunter's Bump, which is a sacroiliac luxation where the sacrum moves out of proper position relative to the ilium. This causes a prominence of the tuber sacrale bone. A Hunter's Bump indicates underlying sacroiliac disease. Diagnosis involves musculoskeletal examination, gait analysis, and potentially a bone scan to detect inflammation before visible changes occur. Treatment typically involves rest, controlled rehabilitation, and steroid injections into the sacroiliac joint.
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Action:
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Places one hand on the ASIS and
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uppermost hip
Action:
Examiner applies a gentle
posterior shear force while
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Positive finding:
Unilateral pain at SI joint
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posterior-to-anterior shear force
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Unilateral pain at SI joint
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This document discusses spinal anatomy, trauma, and injury. It covers the epidemiology, mechanisms, classifications, diagnosis, and management of spinal cord injuries. Some key points include:
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5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
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What's your diagnosis? #3
- 2. Hunter’s Bump = Sacroiliac Luxation
- 3. Sacroiliac Joint ✤ Attachment of the hind legs to the spine ✤ Non-mobile joint ✤ Transfers hind limb propulsive forces to the vertebral column ✤ Prominence of the tuber sacrale occurs when muscles/ligaments holding the SI in place are torn
- 5. Diagnosis of SI Subluxation ✤ Musculoskeletal examination and gait analysis to determine if painful ✤ Hunter’s Bump can be chronic or acute: ✤ If the luxation is chronic but stable, the horse may not be painful. ✤ If the luxation is acute and unstable, hind end lameness is usually evident ✤ A Hunter’s Bump is evidence of SI disease.
- 6. Diagnosis of SI Subluxation ✤ Subluxation and pain can occur prior to visible development of Hunter’s Bump ✤ lack of Bump does not rule out SI pain ✤ Ideally we would like to identify SI strain prior to full luxation and visible changes to the pelvis ✤ Nuclear Scintigraphy(Bone Scan) - intravenous injection of radioactive material and detection of "hot spots" by use of a gamma camera.
- 7. Treatment for SI Subluxation ✤ Rest and controlled rehabilitation typical for any soft tissue injury ✤ Ultrasound guided injection of Steroids into SI joint to reduce inflammation and pain
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