- Types of Injuries:
- short leg syndrome: (see
growth deformities of the limbs)
- unequal leg lengths may predispose to injury in shorter leg;
- trochanteric bursitis:
- gluteus medius attaches by a broad insertion into its lateral
aspect;
- below this insertion the bone is covered by the iliotibial tract;
- a bursa is occassionally the site of inflammaion, lies between
the tract and the bone over the
relatively bare portion of the trochanter;
- diff dx:
avascular necrosis:
- AVN often refers pain laterally whereas DJD refers pain
medially;
-
steroid injections can provide dramatic relief;
-
iliotibial band syndrome:
-
semimembranosous
tendonitis:
- predominates in males > 30 yrs of age;
- inflammmation at insertion site of direct head of tendon into area
of posterior tubercle of tibia can
be
detected by increased activity on bone scan;
-
pes anserinus
bursitis;
- pain 6 in below joint line in medial tibia, w/ swelling &
tenderness;
- can be treated w/
NSAIDs and rest;
- this condition should be differentiated w/ stress frx of proximal
tibia;
-
popliteus
tendinitis
- popliteal tendinitis occurs mainly as result of either
hyperpronation or excessive downhill running;
- pain is localized over popliteus tendon just anterior to
LCL;
- refractory cases may benefit from a local injection of steroids;
-
patellar tendonitis (jumper's knee):
-
exertional compartment syndrome:
-
gastrocnemius
rupture
- typically ruptures occur off of the medial origin and may mimic
compartment syndrome;
-
tibial stress frx:
-
medial tibial shin splints:
- exercise related pain in the posterior mid to distal 1/3 of the
tibia can be related to periostitis
at origin of the posterior tibialis;
- exam is notable for local tenderness with pain on resisted
plantar flexion and inversion;;
- x-ray may show periosteal change several wks after onset of
symptoms;
- Foot and Ankle: (
orthotics
for the foot)
-
achilles
tendon contracture:
-
hyperpronation of the foot:
-
heel pain:
-
metatarsalgia:
-
hallux rigidus:
-
Metabolic
-
hyponatremia: