Urgent Cases and Foreign Bodies

Size: px
Start display at page:

Download "Urgent Cases and Foreign Bodies"

Transcription

1 Urgent Cases and Foreign Bodies Catherine J. Brandon, MD, MS University of Michigan Ann Arbor, MI, USA

2 Introduction: Patients added on to the schedule from the emergency department or as urgent add-on from the clinics can be grouped into several categories: Suspected septic joint Acute pain with trauma, pre-operative evaluation Acute pain in post-operative setting New or suspicious mass For these patients and their referring physicians, the ultrasound study can be critical to appropriate clinical management.

3 Ultrasound evaluation for foreign bodies also can guide clinical and pre-operative evaluation. Not only should the foreign body be detected and described but any potential complication to its removal should also be communicated to the referring physicians. Marking the skin to show site of entry and size and direction of the foreign body can aid in its surgical removal.

4 Suspected Abscess/ Septic Joint History: Dorsal hand swelling and tenderness after human bite during fist fight. US: Dorsal hand abscess. Classic appearance of purulent material with multiple echogenic foci.

5 Suspected Septic Joint: History: Hemophilia arthropathy and AIDS US: Septic ankle effusion with US guided aspiration (arrows). Hyperemia seen with synovitis. Marnix von Holsbeeck

6 Suspected Septic Joint: History: Two patients with posterior knee pain and mass US: Leaking Bakers cyst, fluid plus synovium in cyst. US: Infected Baker s cyst in septic knee, gas in cyst (star)

7 Suspected Septic Joint: History: Swollen knee US: Pre-patellar bursa effusion, trace knee joint effusion History: Posterior elbow pain and swelling. US: Tendinosis of triceps with reparative hyperemia

8 Suspected Septic Joint: Olecranon longitudinal Olecranon longitudinal History: Left: diabetic with gout. Right: triceps tendon rupture with hematoma and swelling US: Left: Olecranon bursitis with hyperemia from soft tissue infection. Right: Soft tissue swelling as reaction to triceps rupture. TX: Conservative non-operative

9 Suspected septic joint/tendon sheath needle History: Painful swollen wrist in patient with rheumatoid arthritis. Question infection on MR US: Inflammatory response of extensor carpi ulnaris tendon. Fluid within sheath. TX: US guided aspiration to document no infection.

10 Acute Pain with trauma panoramic longitudinal History: Direct trauma US: Fractured patella longitudinal History: Severe pain during basketball US: Complete patellar tendon rupture panoramic transverse History : Traumatic patella dislocation with fracture US: Lipohemarthrosis

11 Acute pain with trauma History: Varsity athlete with sudden onset pain during game. US: Avulsion fracture of the ankle capsule with effusion and fracture fragment. Normal for comparison.

12 Acute pain with trauma History: 70 yo felt pop in lateral foot while lifting luggage out of the car. US: Rupture of the peroneus longus tendon with fracture of the peroneal ossicle (os peronaeum). TX: Conservative treatment.

13 Acute pain with trauma History: Thumb trauma skiing US: Torn UCL: loss of fibrillar structure, fluid, and retraction: Sterner lesion (balled up UCL) US: Torn UCL not retracted US: Normal UCL

14 Acute pain with trauma History: Severe pain catching falling box. US: Distal biceps tendon rupture with proximally retracted tiny bone avulsion fragment producing shadowing in the torn stump.

15 A panoramic longitudinal Normal longitudinal History: Severe pain catching falling box. US: Distal biceps tendon (arrows) after complete tendon tear from radial tuberosity (star). Typical fibrillar tendon pattern is absent. Tendon stump is retracted proximally (double headed arrow) 13 cm with shadowing from the torn fibers (arrowhead).

16 distal biceps, torn distal biceps, intact US: Since the distal biceps insertion on the radial tuberosity is difficult to see, scanning the elbow in 90 degree of flexion helps in ultrasound and MR.

17 Acute pain with trauma History: Pain in Achilles US: Achilles tendon thickening from tendinosis US: Achilles tendon proximal tear dorsiflexion plantar flexion US: Dynamic: gap between stumps decreases plantar flexion plantar flexion

18 Post-operative pain transverse longitudinal History: Lateral ankle pain, with dorsiflexion, after plate and screw fixation of distal fibular fracture. US: Plate and elevated screw (star). Peroneal longus tendon subluxes over screw with dorsiflexion (yellow arrow). TX: Hardware removed.

19 Post-operative pain peroneal longus tendon longitudinal transverse History: Post ORIF continued pain over peroneal tubercle of calcaneus. US : retained fracture fragment (yellow arrow) cutting into the peroneal longus tendon. TX: Operative removal

20 Post-operative pain History: Inguinal hernia repair with mesh. Patient now feels some pain and irritation in groin. US: Color flow demonstrates artifact associated with mesh and reassures the patient of intact repair.

21 Post-operative pain longitudinal History: Flexor tendon of the ring finger cut in industrial accident. Has undergone repair but sudden onset of pain after playing catch ball US: Intact flexor tendon without tear at the repair site.

22 Post-operative pain transverse longitudinal History: New pain and swelling at volar wrist distal radial plate operative site. US: Fluid collection (arrow) from incision to plate (star) with debris. US guided aspiration demonstrated infection. TX: Operative removal of plate and treatment.

23 Suspicious Mass History: New (?) mass on the ankle, decreased range of motion. US: Mass with blood flow within the anterior ankle joint. Focal PVNS on US guided biopsy.

24 Suspicious mass longitudinal transverse History: New palpable mass along the anterior abdominal wall in diabetic. US: Palpable mass is pump tubing connector for newly implanted pump and tubing placed deep in the subcutaneous tissues. Note posterior shadowing.

25 Foreign body History: Wooden toothpick stuck into hand during party. Fragments remain. US: Small hypoechoic halo of granulation tissue around the wooden fragment aids identification. TX: Removed surgically.

26 Foreign body longitudinal transverse History: Injuries while gardening US: Thorn adjacent to a flexor tendon ( ) (left). Wood fragment with granulation tissue entering transverse flexor tendon sheath (right)

27 Foreign body History: Hit in the mouth during car accident. Fragments of tooth seen on film. Laceration in lower lip. US: Tooth fragment as hyperechoic linear structure identified just within the laceration. TX: Surgical removal and repair of lip.

28 Foreign body History: Injury during metal work at factory US: (Clip) Metallic fragments adjacent to median nerve. Unsuspected partial cut of the nerve demonstrated TX: Damage to nerve confirmed and repaired surgically.

29 Summary: Ultrasound in the emergent, urgent and just need to know setting can provide a wide range of critical diagnoses for clinical management, pre- and postoperative evaluation and patient reassurance as the above cases have demonstrated.

Ultrasound of Mid and Hindfoot Pathology

Ultrasound of Mid and Hindfoot Pathology Ultrasound of Mid and Hindfoot Pathology Levon N. Nazarian, M.D. Professor of Radiology Thomas Jefferson University Hospital Disclosures None relevant to this presentation Educational Objective Following

More information

ELENI ANDIPA General Hospital of Athens G. Gennimatas

ELENI ANDIPA General Hospital of Athens G. Gennimatas ELENI ANDIPA General Hospital of Athens G. Gennimatas Technological advances over the last years have caused a dramatic improvement in ultrasound quality and resolution An established imaging modality

More information

Ultrasound Evaluation of Masses

Ultrasound Evaluation of Masses Ultrasound Evaluation of Masses Jon A. Jacobson, M.D. Professor of Radiology Director, Division of Musculoskeletal Radiology University of Michigan Disclosures: Consultant: Bioclinica Advisory Panel: GE,

More information

Why? Ultrasound of the Foot. Ultrasound of the Foot. General Rules. Plantar Fascia. Plantar Fasciitis 18/09/2018

Why? Ultrasound of the Foot. Ultrasound of the Foot. General Rules. Plantar Fascia. Plantar Fasciitis 18/09/2018 Ultrasound of the Foot Why? Ultrasound of the Foot Plantar fasciitis Plantar fascia fibromatosis Morton s neuroma Intermetatarsal bursitis Adventitial bursitis Plantar plate tears MTP joint synovitis Ganglia

More information

Introduction to Ultrasound Examination of the Hand and upper

Introduction to Ultrasound Examination of the Hand and upper Introduction to Ultrasound Examination of the Hand and upper Emil Dionysian, M.D. Ultrasound of upper ext. Upside Convenient Opens another exam dimension Can be like a stethoscope Helps 3-D D visualization

More information

Sonography of Knee and Calf Pain: the differential considerations

Sonography of Knee and Calf Pain: the differential considerations Sonography of Knee and Calf Pain: the differential considerations Dr. Lisa L. S.Wong Consultant Radiologist St Paul s Hospital Outline Ultrasound techniques Common pathologies in calf and posterior knee

More information

Knee, Ankle, and Foot: Normal and Abnormal Features with MRI and Ultrasound Correlation. Disclosures. Outline. Joint Effusion. Suprapatellar recess

Knee, Ankle, and Foot: Normal and Abnormal Features with MRI and Ultrasound Correlation. Disclosures. Outline. Joint Effusion. Suprapatellar recess Knee, Ankle, and Foot: Normal and Abnormal Features with MRI and Ultrasound Correlation Jon A. Jacobson, M.D. Professor of Radiology Director, Division of Musculoskeletal Radiology University of Michigan

More information

Original Report. Sonography of Ankle Tendon Impingement with Surgical Correlation

Original Report. Sonography of Ankle Tendon Impingement with Surgical Correlation Downloaded from www.ajronline.org by 162.158.89.91 on 08/23/18 from IP address 162.158.89.91. Copyright RRS. For personal use only; all rights reserved Monisha Shetty 1 David P. Fessell 1 John E. Femino

More information

The Elbow 3/5/2015. The Elbow Scanning Sequence. * Anterior Joint (The anterior Pyramid ) * Lateral Epicondyle * Medial Epicondyle * Posterior Joint

The Elbow 3/5/2015. The Elbow Scanning Sequence. * Anterior Joint (The anterior Pyramid ) * Lateral Epicondyle * Medial Epicondyle * Posterior Joint Scanning Sequence * Anterior Joint (The anterior Pyramid ) * Lateral Epicondyle * Medial Epicondyle * Posterior Joint Anterior Elbow Pyramid Courtesy of Jay Smith, MD. Vice chair PMR Mayo Clinic Rochester,

More information

Elbow. Chapter 2 LISTEN. Mechanism of Injury (If Applicable) Pain

Elbow. Chapter 2 LISTEN. Mechanism of Injury (If Applicable) Pain Chapter 2 Elbow LISTEN Mechanism of Injury (If Applicable) Patient usually remembers their position at the time of injury Certain mechanisms of injury result in characteristic patterns Fall on outstretched

More information

Peripheral Nerve Ultrasound

Peripheral Nerve Ultrasound Peripheral Nerve Ultrasound Jon A. Jacobson, M.D. Professor of Radiology Director, Division of Musculoskeletal Radiology University of Michigan Normal Peripheral Nerve Ultrasound appearance: Hypoechoic

More information

ORTHOPAEDIC INJECTION AND ASPIRATION TECHNIQUES

ORTHOPAEDIC INJECTION AND ASPIRATION TECHNIQUES ORTHOPAEDIC INJECTION AND ASPIRATION TECHNIQUES OAAPN October 20, 2016 David H. Sohn, JD MD Chief, Shoulder and Sports Medicine University of Toledo Medical Center When to aspirate? To rule out infection

More information

KAPA 2017 Musculoskeletal Aspiration and Injection Workshop. W. Scott Black, MD Physician Assistant Studies Program University of Kentucky

KAPA 2017 Musculoskeletal Aspiration and Injection Workshop. W. Scott Black, MD Physician Assistant Studies Program University of Kentucky KAPA 2017 Musculoskeletal Aspiration and Injection Workshop W. Scott Black, MD Physician Assistant Studies Program University of Kentucky Aspiration Relatively quick and inexpensive Can be performed in

More information

Prevention and Treatment of Injuries. Anatomy. Anatomy. Tibia: the second longest bone in the body

Prevention and Treatment of Injuries. Anatomy. Anatomy. Tibia: the second longest bone in the body Prevention and Treatment of Injuries The Ankle and Lower Leg Westfield High School Houston, Texas Anatomy Tibia: the second longest bone in the body Serves as the principle weight-bearing bone of the leg.

More information

Pediatric Musculoskeletal Ultrasound: Cases reviewed and lessons learned

Pediatric Musculoskeletal Ultrasound: Cases reviewed and lessons learned Pediatric Musculoskeletal Ultrasound: Cases reviewed and lessons learned Jessica Leschied, MD Sections of Pediatric and Musculoskeletal Radiology C.S. Mott Children s Hospital University of Michigan Ann

More information

Point of Care Ultrasound on the Field of Play K AT I E N ANOS, MD

Point of Care Ultrasound on the Field of Play K AT I E N ANOS, MD Point of Care Ultrasound on the Field of Play K AT I E N ANOS, MD H I GH P ERFORMANCE S PORTS MEDICINE P HYSI ATRIST, P R ACTICING S PORTS MEDI CINE No disclosures No disclosures Who am I? Objectives Over

More information

Lateral Elbow Pathology

Lateral Elbow Pathology Lateral Elbow Pathology Jon A. Jacobson, M.D. Professor of adiology Director, Division of Musculoskeletal adiology University of Michigan Disclosures: Consultant: Bioclinica Advisory Board: GE, Philips

More information

Ultrasound of the Knee

Ultrasound of the Knee Ultrasound of the Knee Jon A. Jacobson, M.D. Professor of Radiology Director, Division of Musculoskeletal Radiology University of Michigan Disclosures: Consultant: Bioclinica Book Royalties: Elsevier Advisory

More information

The Painful Elbow, Wrist, and Hand. Jennifer R Marks, MD

The Painful Elbow, Wrist, and Hand. Jennifer R Marks, MD The Painful Elbow, Wrist, and Hand Jennifer R Marks, MD The Painful Elbow A 44 yo M presents to clinic complaining of a sore elbow What further questions do you have for this patient? What is on your differential

More information

The Elbow Scanning Protocol

The Elbow Scanning Protocol The Elbow Scanning Protocol Diagnostic Imaging of the Elbow: Introduction The elbow maybe considered as consisting of four quadrants, anterior, medial, lateral and posterior. Ultrasound would normally

More information

Sports Medicine Unit 16 Elbow

Sports Medicine Unit 16 Elbow Sports Medicine Unit 16 Elbow I. Bones a. b. c. II. What movements does the elbow perform? a. Flexion b. c. Pronation d. III. Muscles in motion a. FLEXION (supinated) i Brachialis (pronated) ii (neutral)

More information

Pragmatic ultrasound in the diagnosis of soft tissue rheumatic pain. Plamen Todorov

Pragmatic ultrasound in the diagnosis of soft tissue rheumatic pain. Plamen Todorov Pragmatic ultrasound in the diagnosis of soft tissue rheumatic pain Plamen Todorov INTRODUCTION Soft tissue rheumatism: nonsystemic, focal pathological syndromes involving the periarticular structures.

More information

Ultrasonography of Peripheral Nerve -upper extremity

Ultrasonography of Peripheral Nerve -upper extremity Ultrasonography of Peripheral Nerve -upper extremity Department of Physical Medicine and Rehabilitation Korea University Guro Hospital Korea University College of Medicine Yoon Joon Shik Normal median

More information

Ultrasound and MRI Findings of Tennis Leg with Differential Diagnosis.

Ultrasound and MRI Findings of Tennis Leg with Differential Diagnosis. Ultrasound and MRI Findings of Tennis Leg with Differential Diagnosis. Poster No.: R-0057 Congress: 2015 ASM Type: Educational Exhibit Authors: M. George, A. Thomas, R. Dutta, K. Gummalla; Singapore/SG

More information

Top 10 Ortho Urgent Care Injuries. J.C. Clark, M.D. ORA Orthopedics

Top 10 Ortho Urgent Care Injuries. J.C. Clark, M.D. ORA Orthopedics Top 10 Ortho Urgent Care Injuries J.C. Clark, M.D. ORA Orthopedics 10. Proximal Humerus Fractures Treatment Simple sling ICE, pain meds Button-down shirts Recliner to sleep in It will be up to the surgeon

More information

HKCEM JCM OSCE. 06 March 3013 AED POH

HKCEM JCM OSCE. 06 March 3013 AED POH HKCEM JCM OSCE 06 March 3013 AED POH 1 Case 1 M/52 Walk unaided to AED c/o left foot sprain few days ago during working P/E swelling, tender over dorsum of foot 2 3 Questions What were the X ray findings

More information

Fractures and dislocations of the fingers

Fractures and dislocations of the fingers Chapter 1 Fractures and dislocations of the fingers Felix S. Chew, M.D., and Catherine Maldjian, M.D. Case 1 1 Phalangeal tuft avulsion fracture 31-year-old woman injured in a ground-level fall. Lateral

More information

CLINICAL PRESENTATION AND RADIOLOGY QUIZ QUESTION

CLINICAL PRESENTATION AND RADIOLOGY QUIZ QUESTION Donald L. Renfrew, MD Radiology Associates of the Fox Valley, 333 N. Commercial Street, Suite 100, Neenah, WI 54956 10/13/2012 Radiology Quiz of the Week # 94 Page 1 CLINICAL PRESENTATION AND RADIOLOGY

More information

Management of Brachial Plexus & Peripheral Nerves Blast Injuries. First Global Conflict Medicine Congress

Management of Brachial Plexus & Peripheral Nerves Blast Injuries. First Global Conflict Medicine Congress Management of Brachial Plexus & Peripheral Nerves Blast Injuries Joseph BAKHACH First Global Conflict Medicine Congress Hand & Microsurgery Department American University of Beirut Medical Centre Brachial

More information

Longitudinal Split of the Peroneus Longus and Peroneus Brevis Tendons with Disruption of the Superior Peroneal Retinaculum

Longitudinal Split of the Peroneus Longus and Peroneus Brevis Tendons with Disruption of the Superior Peroneal Retinaculum Longitudinal Split of the Peroneus Longus and Peroneus Brevis Tendons with Disruption of the Superior Peroneal Retinaculum Gregory C. Diaz, MD, Marnix van Holsbeeck, MD, Jon A. Jacobson, MD Longitudinal

More information

Index. Note: Page numbers of article titles are in boldface type.

Index. Note: Page numbers of article titles are in boldface type. Note: Page numbers of article titles are in boldface type. A ACJ. See Acromioclavicular joint (ACJ) Acromioclavicular joint (ACJ) procedures of, 557 559 Ankle and foot procedures of, 649 671 (See also

More information

Ultrasound Evaluation of Posteromedial Ankle Pathology. Andrew C Cordle, M.D., Ph.D. 9/21/2018

Ultrasound Evaluation of Posteromedial Ankle Pathology. Andrew C Cordle, M.D., Ph.D. 9/21/2018 Ultrasound Evaluation of Posteromedial Ankle Pathology Andrew C Cordle, M.D., Ph.D. 9/21/2018 Overview: Pathology of the Posteromedial Ankle Flexor Tendon Pathology Accessory Navicular Bone Pathology Tarsal

More information

Elbow. Chapter 2 LISTEN. Mechanism of Injury (If Applicable) Pain

Elbow. Chapter 2 LISTEN. Mechanism of Injury (If Applicable) Pain Preface The first decade of the twenty-first century has witnessed the continuation of an explosion in our knowledge and understanding of all aspects of disease. Accompanying this has been the increasing

More information

Benefits of Aspiration and Injection JOINT INJECTIONS. Injection Indications. Mechanism of Action 1/11/2016

Benefits of Aspiration and Injection JOINT INJECTIONS. Injection Indications. Mechanism of Action 1/11/2016 Benefits of Aspiration and Injection JOINT INJECTIONS Mark Niedfeldt, M.D. Medical College of Wisconsin Decrease or resolution of pain Decrease or resolution of inflammation Decrease or resolution of effusion

More information

Review relevant anatomy of the foot and ankle. Learn the approach to examining the foot and ankle

Review relevant anatomy of the foot and ankle. Learn the approach to examining the foot and ankle Objectives Review relevant anatomy of the foot and ankle Learn the approach to examining the foot and ankle Learn the basics of diagnosis and treatment of ankle sprains Overview of other common causes

More information

CASE ONE CASE ONE. RADIAL HEAD FRACTURE Mason Classification. RADIAL HEAD FRACTURE Mechanism of Injury. RADIAL HEAD FRACTURE Imaging

CASE ONE CASE ONE. RADIAL HEAD FRACTURE Mason Classification. RADIAL HEAD FRACTURE Mechanism of Injury. RADIAL HEAD FRACTURE Imaging CASE ONE An eighteen year old female falls during a basketball game, striking her elbow on the court. She presents to your office that day with a painful, swollen elbow that she is unable to flex or extend

More information

Superficial Lumps and Bumps: Ultrasound Assessment

Superficial Lumps and Bumps: Ultrasound Assessment Posterior knee Superficial Lumps and Bumps: Ultrasound Assessment Walter Mak, MD Department of Medical Imaging St. Michael s Hospital SM SM MGas MGas MGas MGas Synovial lined Synovial cyst: extrusion of

More information

The Elbow and the cubital fossa. Prof Oluwadiya Kehinde

The Elbow and the cubital fossa. Prof Oluwadiya Kehinde The Elbow and the cubital fossa Prof Oluwadiya Kehinde www.oluwadiya.com Elbow and Forearm Anatomy The elbow joint is formed by the humerus, radius, and the ulna Bony anatomy of the elbow Distal Humerus

More information

Office Orthopedics. No conflict of interest No financial disclosures 1/31/2018

Office Orthopedics. No conflict of interest No financial disclosures 1/31/2018 Office Orthopedics Amin Afsari DO Orthopedic Hand and Upper Extremity Surgery Orthopedic Institute of Wisconsin Midwest Orthopedic Specialty Hospital 1 No conflict of interest No financial disclosures

More information

Hand injuries. The metacarpal bones may fracture through the base, shaft or the neck.

Hand injuries. The metacarpal bones may fracture through the base, shaft or the neck. Hand injuries Metacarpal injuries The metacarpal bones may fracture through the base, shaft or the neck. Shaft fractures; these are caused by direct trauma which may cause transverse # of one or more metacarpal

More information

When Pads of Fat are a Welcome Sight: Fat Pads in Acute Musculoskeletal Imaging

When Pads of Fat are a Welcome Sight: Fat Pads in Acute Musculoskeletal Imaging When Pads of Fat are a Welcome Sight: Fat Pads in Acute Musculoskeletal Imaging Poster No.: C-2444 Congress: ECR 2013 Type: Authors: Keywords: DOI: Educational Exhibit M. Zakhary 1, M. Adix 2, C. Yablon

More information

ASPEN MEDICAL SURGERY REGINA

ASPEN MEDICAL SURGERY REGINA It is hereby certified that ASPEN MEDICAL SURGERY REGINA Has successfully completed an inspection as is required under the College s Bylaw 26.1 and is therefore approved as a Non Hospital Treatment Facility

More information

How to Triage Orthopaedic Care. David W. Gray, M.D.

How to Triage Orthopaedic Care. David W. Gray, M.D. How to Triage Orthopaedic Care David W. Gray, M.D. OBJECTIVES: Define basic assessments skills needed to identify orthopedic injuries Differentiate when an orthopedic injury is a medical emergency Determine

More information

Rheumatology & Immunology. Regional pain syndromes to be covered today. Some definitions. Tendinitis. Bursitis. History. History. Exam.

Rheumatology & Immunology. Regional pain syndromes to be covered today. Some definitions. Tendinitis. Bursitis. History. History. Exam. Rheumatology & Immunology Some problems are difficult, but diagnosing and treating soft tissue syndromes are not! Soft tissue syndromes one of the most common reasons patients present to their doctor.

More information

The Foot. Dr. Wegdan Moh.Mustafa Medicine Faculty Assistant Professor Mob:

The Foot. Dr. Wegdan Moh.Mustafa Medicine Faculty Assistant Professor Mob: The Foot Dr. Wegdan Moh.Mustafa Medicine Faculty Assistant Professor Mob: 0127155717 The skeleton of the foot Cutaneous innervations Sole of foot layers of muscles First layer -Abductor hallucis -Flexor

More information

Salisbury Foundation Trust Radiology Department Referral Guidelines for Primary Care: Musculoskeletal Imaging

Salisbury Foundation Trust Radiology Department Referral Guidelines for Primary Care: Musculoskeletal Imaging Salisbury Foundation Trust Radiology Department Referral Guidelines for Primary Care: Musculoskeletal Imaging These guidelines have been issued in conjunction with the Royal College of Radiology referral

More information

UNUSUAL ACL CASE: Tibial Eminence Fracture in a Female Collegiate Basketball Player

UNUSUAL ACL CASE: Tibial Eminence Fracture in a Female Collegiate Basketball Player UNUSUAL ACL CASE: Tibial Eminence Fracture in a Female Collegiate Basketball Player Cheri Drysdale, MEd,, ATC Margot Putukian,, MD Jeffery Bechler,, MD Princeton University How many of you have done an

More information

Arm Injuries and Disorders

Arm Injuries and Disorders Arm Injuries and Disorders Introduction Your arms are made up of muscles, joints, tendons and other connective tissue. There are many injuries and disorders that can affect the arm. Some arm injuries and

More information

BLUE SKY SCHOOL OF PROFESSIONAL MASSAGE AND THERAPEUTIC BODYWORK Musculoskeletal Anatomy & Kinesiology KNEE & ANKLE MUSCLES

BLUE SKY SCHOOL OF PROFESSIONAL MASSAGE AND THERAPEUTIC BODYWORK Musculoskeletal Anatomy & Kinesiology KNEE & ANKLE MUSCLES BLUE SKY SCHOOL OF PROFESSIONAL MASSAGE AND THERAPEUTIC BODYWORK Musculoskeletal Anatomy & Kinesiology KNEE & ANKLE MUSCLES MSAK201-I Session 3 1) REVIEW a) THIGH, LEG, ANKLE & FOOT i) Tibia Medial Malleolus

More information

THE LOWER EXTREMITY EXAM FOR THE FAMILY PRACTITIONER

THE LOWER EXTREMITY EXAM FOR THE FAMILY PRACTITIONER THE LOWER EXTREMITY EXAM FOR THE FAMILY PRACTITIONER Melinda A. Scott, D.O. Orthopedic Associates of Dayton Board Certified in Primary Care Sports Medicine GOALS Identify landmarks necessary for exam of

More information

CLINICAL PRESENTATION AND RADIOLOGY QUIZ QUESTION

CLINICAL PRESENTATION AND RADIOLOGY QUIZ QUESTION Donald L. Renfrew, MD Radiology Associates of the Fox Valley, 333 N. Commercial Street, Suite 100, Neenah, WI 54956 11/24/2012 Radiology Quiz of the Week # 100 Page 1 CLINICAL PRESENTATION AND RADIOLOGY

More information

Clinical Orthopaedic Rehabilitation Volume 1 and 2

Clinical Orthopaedic Rehabilitation Volume 1 and 2 Clinical Orthopaedic Rehabilitation Volume 1 and 2 COURSE DESCRIPTION This program is a practical, clinical guide that provides guidance on the evaluation, differential diagnosis, treatment, and rehabilitation

More information

31yo M with chronic basilar thumb and wrist pain that started after cross-country bicycle ride 5 yrs ago.

31yo M with chronic basilar thumb and wrist pain that started after cross-country bicycle ride 5 yrs ago. 31yo M with chronic basilar thumb and wrist pain that started after cross-country bicycle ride 5 yrs ago. EPL EPB APL Full-thickness tear involving the dorsal deltoid ligament of the first carpometacarpal

More information

THE WRIST. At a glance. 1. Introduction

THE WRIST. At a glance. 1. Introduction THE WRIST At a glance The wrist is possibly the most important of all joints in everyday and professional life. It is under strain not only in many blue collar trades, but also in sports and is therefore

More information

Practical Reporting of Musculoskeletal Imaging Studies: MRI Elbow

Practical Reporting of Musculoskeletal Imaging Studies: MRI Elbow Practical Reporting of Musculoskeletal Imaging Studies: MRI Elbow James F Griffith History Where is pain located? For how long? Trauma if so, what and when Radiographers can get this info Grade. Don t

More information

Soft Tissue Rheumatism. Elinor Mody, MD Chief, Division of Rheumatology Reliant Medical Group

Soft Tissue Rheumatism. Elinor Mody, MD Chief, Division of Rheumatology Reliant Medical Group Soft Tissue Rheumatism Elinor Mody, MD Chief, Division of Rheumatology Reliant Medical Group Some problems are difficult, but diagnosing and treating most causes of joint pain are not! Common areas of

More information

Wrist Ganglion. Did not notice Suddenly. Over several hours Over several days Over several weeks Over several months

Wrist Ganglion. Did not notice Suddenly. Over several hours Over several days Over several weeks Over several months Onset, Duration and Frequency Are you left handed or right handed? Left Right Both Which side of your body is affected? Left Right Both If both, which side is more severe? Left Right Varies About the same

More information

Ankle Tendons in Athletes. Laura W. Bancroft, M.D.

Ankle Tendons in Athletes. Laura W. Bancroft, M.D. Ankle Tendons in Athletes Laura W. Bancroft, M.D. Outline Protocols Normal Anatomy Tendinopathy, partial and complete tears Posterior tibial, Flexor Hallucis Longus, Achilles, Peroneal and Anterior Tibial

More information

Ligaments of Elbow hinge: sagittal plane so need lateral and medial ligaments

Ligaments of Elbow hinge: sagittal plane so need lateral and medial ligaments Ligaments of Elbow hinge: sagittal plane so need lateral and medial ligaments Ulnar Collateral ligament on medial side; arising from medial epicondyle and stops excess valgus movement (lateral movement)

More information

MR: Finger and Thumb Injuries

MR: Finger and Thumb Injuries MR: Finger and Thumb Injuries Laura W. Bancroft, M.D. Professor of Radiology University of Central Florida Florida State University Outline Normal anatomy of the fingers and thumb MR imaging protocols

More information

Surgical Care at the District Hospital. EMERGENCY & ESSENTIAL SURGICAL CARE

Surgical Care at the District Hospital. EMERGENCY & ESSENTIAL SURGICAL CARE Surgical Care at the District Hospital 1 18 Orthopedic Trauma Key Points 2 18.1 Upper Extremity Injuries Clavicle Fractures Diagnose fractures from the history and by physical examination Treat with a

More information

8 Recovering From HAND FRACTURE SURGERY

8 Recovering From HAND FRACTURE SURGERY 8 Recovering From HAND FRACTURE SURGERY Hand fractures are caused by trauma and result in breaking (fracturing) the phalanges or metacarpals. Surgery involves achieving acceptable alignment and providing

More information

Other Elbow Concerns in Overhead Athletes

Other Elbow Concerns in Overhead Athletes Other Elbow Concerns in Overhead Athletes John A. Steubs, M.D. Team Physician, Minnesota Twins TRIA Orthopaedic Center Disclosures None relevant to this presentation. Other Elbow Problems Valgus extension

More information

Overuse Injuries & special skeletal injuries Dr M.Taghavi Director of sport medicine center of olympic academy

Overuse Injuries & special skeletal injuries Dr M.Taghavi Director of sport medicine center of olympic academy Overuse Injuries & special skeletal injuries Dr M.Taghavi Director of sport medicine center of olympic academy Prevalence of Overuse Injuries 30 to 50% of all sport injuries are from overuse In some sports

More information

Index. radiologic.theclinics.com. Note: Page numbers of article titles are in boldface type.

Index. radiologic.theclinics.com. Note: Page numbers of article titles are in boldface type. Index Note: Page numbers of article titles are in boldface type. A Acromioclavicular joint injuries in football players, 318, 319 ALPSA. See Anterior labroligamentous periosteal sleeve avulsion. Anterior

More information

4/28/2010. Fractures. Normal Bone and Normal Ossification Bone Terms. Epiphysis Epiphyseal Plate (physis) Metaphysis

4/28/2010. Fractures. Normal Bone and Normal Ossification Bone Terms. Epiphysis Epiphyseal Plate (physis) Metaphysis Fractures Normal Bone and Normal Ossification Bone Terms Epiphysis Epiphyseal Plate (physis) Metaphysis Diaphysis 1 Fracture Classifications A. Longitudinal B. Transverse C. Oblique D. Spiral E. Incomplete

More information

The Muscular System. Chapter 10 Part C. PowerPoint Lecture Slides prepared by Karen Dunbar Kareiva Ivy Tech Community College

The Muscular System. Chapter 10 Part C. PowerPoint Lecture Slides prepared by Karen Dunbar Kareiva Ivy Tech Community College Chapter 10 Part C The Muscular System Annie Leibovitz/Contact Press Images PowerPoint Lecture Slides prepared by Karen Dunbar Kareiva Ivy Tech Community College Table 10.9: Muscles Crossing the Shoulder

More information

Acute Ankle Injuries, Part 1: Office Evaluation and Management

Acute Ankle Injuries, Part 1: Office Evaluation and Management t June 08, 2009 Obesity [1] Each acute ankle injury commonly seen in the office has associated with it a mechanism by which it can be injured, trademark symptoms that the patient experiences during the

More information

CLINICAL PRESENTATION AND RADIOLOGY QUIZ QUESTION

CLINICAL PRESENTATION AND RADIOLOGY QUIZ QUESTION Donald L. Renfrew, MD Radiology Associates of the Fox Valley, 333 N. Commercial Street, Suite 100, Neenah, WI 54956 12/01/2012 Radiology Quiz of the Week # 101 Page 1 CLINICAL PRESENTATION AND RADIOLOGY

More information

emoryhealthcare.org/ortho

emoryhealthcare.org/ortho COMMON SOCCER INJURIES Oluseun A. Olufade, MD Assistant Professor, Department of Orthopedics and PM&R 1/7/18 GOALS Discuss top soccer injuries and treatment strategies Simplify hip and groin injuries in

More information

MR IMAGING OF THE WRIST

MR IMAGING OF THE WRIST MR IMAGING OF THE WRIST Wrist Instability Dissociative Pattern apparent on routine radiographs Non-dissociative Stress / positional radiographs Dynamic fluoroscopy during stress Arthrography MRI / MR arthrography

More information

Alberta Health Care Insurance Plan. Schedule Of Anaesthetic Rates Applicable To Podiatry. Procedure List. As Of. 01 April Government of Alberta

Alberta Health Care Insurance Plan. Schedule Of Anaesthetic Rates Applicable To Podiatry. Procedure List. As Of. 01 April Government of Alberta Alberta Health Care Insurance Plan Procedure List As Of 01 April 2017 Alberta Health Care Insurance Plan Page i Generated 2017/03/14 TABLE OF CONTENTS As of 2017/04/01 II. OPERATIONS ON THE NERVOUS SYSTEM.......................

More information

Ultrasound of the Knee Joint. Jun Sung Park,M.D. Bundang General Hospital Dept. of Rehabilitation Medicine

Ultrasound of the Knee Joint. Jun Sung Park,M.D. Bundang General Hospital Dept. of Rehabilitation Medicine Ultrasound of the Knee Joint Jun Sung Park,M.D. Bundang General Hospital Dept. of Rehabilitation Medicine Clinical History and P/E Chronic or Acute Symptoms Chronic Sx. : possible of systemic articular

More information

Alberta Health Care Insurance Plan. Schedule Of Anaesthetic Rates Applicable To Podiatric Surgery. Procedure List. As Of.

Alberta Health Care Insurance Plan. Schedule Of Anaesthetic Rates Applicable To Podiatric Surgery. Procedure List. As Of. Alberta Health Care Insurance Plan Procedure List As Of 01 April 2016 Alberta Health Care Insurance Plan Page i Generated 2016/03/22 TABLE OF CONTENTS As of 2016/04/01 07 PHYSICAL MEDICINE, REHABILITATION,

More information

Fractures and dislocations around elbow in adult

Fractures and dislocations around elbow in adult Lec: 3 Fractures and dislocations around elbow in adult These include fractures of distal humerus, fracture of the capitulum, fracture of the radial head, fracture of the olecranon & dislocation of the

More information

Case study #11 Rt. knee

Case study #11 Rt. knee The patient is a 55 year old female who presents with bilateral knee pain. Patient is a collegiate softball coach and has a very active lifestyle and career that is hampered by her chronic knee pain. She

More information

MIDFOOT INJURIES-ARE WE UNDERTREATING IT? Mr Rajiv Limaye Mr Prasad Karpe University Hospital of North Tees 3 rd Foot and Ankle Symposium

MIDFOOT INJURIES-ARE WE UNDERTREATING IT? Mr Rajiv Limaye Mr Prasad Karpe University Hospital of North Tees 3 rd Foot and Ankle Symposium MIDFOOT INJURIES-ARE WE UNDERTREATING IT? Mr Rajiv Limaye Mr Prasad Karpe University Hospital of North Tees 3 rd Foot and Ankle Symposium Introduction Increasing sports injuries RTA and traumatic injuries

More information

Lever system. Rigid bar. Fulcrum. Force (effort) Resistance (load)

Lever system. Rigid bar. Fulcrum. Force (effort) Resistance (load) Lever system lever is any elongated, rigid (bar) object that move or rotates around a fixed point called the fulcrum when force is applied to overcome resistance. Force (effort) Resistance (load) R Rigid

More information

The Rheumatoid Hand Deformities & Management. Dr. Anirudh Sharma Resident Department of Orthopedics

The Rheumatoid Hand Deformities & Management. Dr. Anirudh Sharma Resident Department of Orthopedics + The Rheumatoid Hand Deformities & Management Dr. Anirudh Sharma Resident Department of Orthopedics + Why is Rheumatoid Arthritis important? + RA is a very debilitating disease median life expectancy

More information

OBJECTIVES: Define basic assessments skills needed to identify orthopedic injuries. Differentiate when an orthopedic injury is a medical emergency

OBJECTIVES: Define basic assessments skills needed to identify orthopedic injuries. Differentiate when an orthopedic injury is a medical emergency 1 2 How to Triage Orthopaedic Care David W. Gray, M.D. OBJECTIVES: Define basic assessments skills needed to identify orthopedic injuries Differentiate when an orthopedic injury is a medical emergency

More information

Shane A. Shapiro, M.D. Assistant Professor, Orthopedic Surgery Mayo Clinic 2012 MFMER slide MFMER slide-3

Shane A. Shapiro, M.D. Assistant Professor, Orthopedic Surgery Mayo Clinic 2012 MFMER slide MFMER slide-3 Ultrasound Foot and Ankle Pathology Disclosures None relevant Shane A. Shapiro, M.D. Assistant Professor, Orthopedic Surgery Mayo Clinic Florida @ShaneShapiroMD 2012 MFMER slide-2 Foot and Ankle Fundamentals

More information

Resolving the Top Three Boot Camp Injuries. Ryan Matthiesen DO

Resolving the Top Three Boot Camp Injuries. Ryan Matthiesen DO Resolving the Top Three Boot Camp Injuries Ryan Matthiesen DO About Me Oklahoma State College of Osteopathic Medicine Family Medicine Residency Plaza Medical Center Sports Medicine Fellowship Texas Tech

More information

Chapter 4: Forearm 4.3 Forearm shaft fractures, transverse (12-D/4)

Chapter 4: Forearm 4.3 Forearm shaft fractures, transverse (12-D/4) AO Manual of ESIN in children s fractures Chapter 4: Forearm 4.3 Forearm shaft fractures, transverse (12-D/4) Title AO Manual of ESIN in children Subtitle Elastic stable intramedullary nailing (ESIN) Author

More information

The Forearm, Wrist, Hand and Fingers. Contusion Injuries to the Forearm. Forearm Fractures 12/11/2017. Oak Ridge High School Conroe, Texas

The Forearm, Wrist, Hand and Fingers. Contusion Injuries to the Forearm. Forearm Fractures 12/11/2017. Oak Ridge High School Conroe, Texas The Forearm, Wrist, Hand and Fingers Oak Ridge High School Conroe, Texas Contusion Injuries to the Forearm The forearm is constantly exposed to bruising and contusions in contact sports. The ulna receives

More information

A 24 year old male patient presented with a swelling on the dorsal aspect of left foot since 3 years. He was operated thrice before, outside, for

A 24 year old male patient presented with a swelling on the dorsal aspect of left foot since 3 years. He was operated thrice before, outside, for A 24 year old male patient presented with a swelling on the dorsal aspect of left foot since 3 years. He was operated thrice before, outside, for same. Came to us with recurrence since last one year with

More information

Lecture 09. Popliteal Fossa. BY Dr Farooq Khan Aurakzai

Lecture 09. Popliteal Fossa. BY Dr Farooq Khan Aurakzai Lecture 09 Popliteal Fossa BY Dr Farooq Khan Aurakzai Dated: 14.02.2018 What is popliteus? Introduction Anything relating to, or near the part of the leg behind the knee. From New Latin popliteus the muscle

More information

Servers Disease (Calcaneal Apophysitis ) 101

Servers Disease (Calcaneal Apophysitis ) 101 Servers Disease (Calcaneal Apophysitis ) 101 Servers Disease Causes a disturbance to the growing area at the back of the heel bone (calcaneus) where the strong Achilles tendon attaches to it. It is most

More information

A Patient s Guide to Ulnar Collateral Ligament Injuries

A Patient s Guide to Ulnar Collateral Ligament Injuries A Patient s Guide to Ulnar Collateral Ligament Injuries 20295 NE 29th Place, Ste 300 Aventura, FL 33180 Phone: (786) 629-0910 Fax: (786) 629-0920 admin@instituteofsports.com DISCLAIMER: The information

More information

Ultrasound of the elbow, what the radiologist should know.

Ultrasound of the elbow, what the radiologist should know. Ultrasound of the elbow, what the radiologist should know. Poster No.: C-1679 Congress: ECR 2012 Type: Educational Exhibit Authors: P. Gamo Villegas, J. García Yavar, S. Allodi de la Hoz, J. 1 1 3 2 1

More information

Ultrasound in Rheumatology

Ultrasound in Rheumatology Arthritis Research UK Primary Care Centre Winner of a Queen s Anniversary Prize For Higher and Further Education 2009 Ultrasound in Rheumatology Alison Hall Consultant MSK Sonographer/Research Fellow Primary

More information

Index. Note: Page numbers of article titles are in boldface type.

Index. Note: Page numbers of article titles are in boldface type. Note: Page numbers of article titles are in boldface type. A Abscess, epidural, 822 824 Achilles tendon rupture, 894 895, 981 982 Acromioclavicular separations, shoulder pain in, 751 753 Adhesive capsulitis,

More information

Sports Medicine in your office: What not to miss!

Sports Medicine in your office: What not to miss! Sports Medicine in your office: What not to miss! 2018 Primary Care Approach to Treating the Injured Athlete May 4, 2018 John H. Wilckens, MD Associate Professor, Dept of Orthopaedic Surgery Disclosures

More information

CLINICAL PRESENTATION AND RADIOLOGY QUIZ QUESTION

CLINICAL PRESENTATION AND RADIOLOGY QUIZ QUESTION Donald L. Renfrew, MD Radiology Associates of the Fox Valley, 333 N. Commercial Street, Suite 100, Neenah, WI 54956 10/6/2012 Radiology Quiz of the Week # 93 Page 1 CLINICAL PRESENTATION AND RADIOLOGY

More information

Index. orthopedic.theclinics.com. Note: Page numbers of article titles are in boldface type.

Index. orthopedic.theclinics.com. Note: Page numbers of article titles are in boldface type. Index Note: Page numbers of article titles are in boldface type. A Acetabular fractures thromboembolic disease after, 341 Achilles tendon rupture ACL. See Anterior cruciate ligament (ACL) Adolescent idiopathic

More information

Hand Injuries in Baseball

Hand Injuries in Baseball Hand Injuries in Baseball Steven S. Shin, MD, MMSc Director of Hand Surgery, Kerlan-Jobe Orthopaedic Clinic Co-Director of Hand Surgery, Cedars-Sinai Health System Los Angeles, California Hand Consultant

More information

Joints Outline 8.1 Joints are classified into three structural and three functional categories (p. 251; Table 8.1) A. Joints are classified by

Joints Outline 8.1 Joints are classified into three structural and three functional categories (p. 251; Table 8.1) A. Joints are classified by Joints Outline 8.1 Joints are classified into three structural and three functional categories (p. 251; Table 8.1) A. Joints are classified by structure and by function: Structural classification focuses

More information

Emile N. Brown, MD, and Scott D. Lifchez, MD

Emile N. Brown, MD, and Scott D. Lifchez, MD Flexor Pollicis Longus Tendon Rupture After Volar Plating of a Distal Radius Fracture: Pronator Quadratus Plate Coverage May Not Adequately Protect Tendons Emile N. Brown, MD, and Scott D. Lifchez, MD

More information

The Elbow. The Elbow. The Elbow 12/11/2017. Oak Ridge High School Conroe, Texas. Compose of three bones. Ligaments of the Elbow

The Elbow. The Elbow. The Elbow 12/11/2017. Oak Ridge High School Conroe, Texas. Compose of three bones. Ligaments of the Elbow Oak Ridge High School Conroe, Texas Compose of three bones The humerus The radius The ulna Ligaments of the Elbow Ulnar collateral ligament Radial collateral ligament Annular ligament 1 The elbow is considered

More information

Leg. Dr. Heba Kalbouneh Associate Professor of Anatomy and Histology

Leg. Dr. Heba Kalbouneh Associate Professor of Anatomy and Histology Leg Dr. Heba Kalbouneh Associate Professor of Anatomy and Histology Skin of the Leg Cutaneous Nerves Medially: The saphenous nerve, a branch of the femoral nerve supplies the skin on the medial surface

More information