• Clinical science

Collection of orthopedic conditions

Popliteal (Baker) cyst

Rupture of a popliteal cyst may mimic a deep vein thrombosis!

References:[1][2]

Bursitis

References:[3][4][5]

Meniscal cyst

  • Definition: a collection of synovial fluid in or around the meniscus
  • Etiology: secondary to a meniscal tear synovial fluid becomes encysted
  • Clinical features
    • Pain and swelling
    • Decreased range of motion of the knee
    • Chronic meniscal tears → locking (decreased extension of the knee) and popping (knee joint laxity)
  • Diagnosis
    • Clinical diagnosis
    • MRI can aid in management if surgical intervention is indicated.
  • Treatment
    • Conservative management with rest, pain control, and crutches
    • Surgical intervention is indicated in refractory cases that do not respond to conservative management, or if there are mechanical symptoms (locking, popping) or tears in an avascular zone.

References:[6][7]

Stress fracture

  • Definition: complete bone fracture caused by repetitive stress without underlying bone pathology or disease affecting the bone
  • Etiology: Increased load or frequency of physical activity can facilitate bone resorption.
  • Risk factors
    • Repetitive high-intensity physical activity
    • Improper technique during physical activity
    • Ill-fitting footwear
    • Caloric restriction; , especially in patients with anorexia nervosa
    • Decreased bone density (e.g., bisphosphonates use)
    • Calcium deficiencies
    • Female sex
  • Clinical features:
  • Diagnosis
    • Clinical diagnosis
    • Conventional x-rays can appear normal in the first 2–3 weeks.
    • MRI for definitive diagnosis: detects fracture line , surrounding tissue damage, and edema
  • Treatment

References:[8][9]

Genu valgum

  • Definition: valgus (lateral) misalignment of the knee, resulting in a knocked knee deformity
  • Etiology
  • Clinical features of pathological valgus
    • Unilateral valgus that is progressive (after 4–5 years of age) or persistent (after 7 years of age)
    • Severe valgus
    • Gait abnormalities and congenital flat feet
    • Features suggestive of an underlying disease (e.g., unilateral deformity, short stature, fever, knee or foot pain, abnormal swelling)
  • Diagnosis: : if pathological valgus is suspected, imaging and/or metabolic evaluation to determine underlying disease
  • Treatment
    • Physiological valgus may improve by the age of 7 and should be managed with close observation and reassurance.
    • Medical treatment of the underlying pathology
    • For persistent symptoms in patients older than 10, surgery is indicated.

References:[10][11]

Genu varum

  • Definition: varus (medial) misalignment of the knee, resulting in a bow leg deformity; common in children
  • Etiology
    • Physiological: normal at birth; associated with normal stature, bilateral symmetry, and no clinical symptoms
    • Pathologic varus: : result of Blount disease, metabolic disorders (e.g., rickets; ), skeletal dysplasias, or neoplasms
  • Clinical features of pathological varus
    • Bowing that is progressive or persistant (after 3 years of age)
    • Severe bowing
    • Gait abnormalities
    • Features suggestive of an underlying disease (e.g., unilateral deformity, short stature, fever, knee or foot pain, abnormal swelling)
  • Diagnosis: if pathological varus is suspected, imaging and/or metabolic evaluation to determine underlying disease
  • Treatment
    • Physiological varus usually improves by 24 months and should be followed by close observation.
    • Treatment of the underlying pathology
    • For persistent symptoms; that do not respond to medical management, surgery is indicated.

References:[12]

Greater trochanteric pain syndrome

References:[13][14]

Forearm fractures

Colles and smith fractures

See distal radius fractures.

Monteggia fracture

Galeazzi fracture

Other forearm fractures

References:[15][16][17][18][19]

Ganglion cyst

  • Definition: benign mucin-filled cyst that develops along tendons or joints and has no true epithelial lining; most common type of hand mass
  • Location: : wrist and fingers; most common at the dorsal wrist
  • Pathophysiology: : herniation of connective tissue; associated with repetitive trauma and mucoid degeneration of periarticular structures; sac that is lined with synovial cells and contains paucicellular connective tissue (typically mucin)
  • Clinical features
    • Usually asymptomatic but can occasionally cause joint pain
    • Fluctuant, transilluminant swelling
    • Can lead to nerve compression, which may cause numbness, weakness, or tingling (e.g., Guyon tunnel syndrome)
  • Differential diagnoses: epidermoid cysts, lipoma, rheumatoid nodules, infectious tenosynovitis, soft tissue tophus
  • Treatment

References:[20]