Soft Tissue Disease Flashcards
(17 cards)
Palpation: Biceps Tendinopathy
Extend elbow, flex shoulder
Palpation: Supraspinatus Tendinopathy
Pain on palpation of insertion on greater tubercle, shoulder flexion while elbow flexed
Diagnosis: Shoulder Tendinopathy
X rays (biceps, supra)
US (nonmineralized) and MRI (biceps, supra)
Arthroscopy (only biceps because intra-articular)
Scope and MRI = definitive dx
Treatment: Biceps Tendinopathy
PT/rehab
Medical (5mg triamcinolone)
Surgical (last ditch effort): tenodesis (open), tenotomy (scope/US)
Treatment: Supraspinatus Tendinopathy
PT/rehab
Medical (shock wave, stem cells, PRP)
Surgical: tendon resection, release of transverse humeral ligament, release incisions in supraspinatus
What are the goals of shockwave therapy?
Start/increase inflammatory process
Facilitate proper fiber alignment
Improve extensibility
Strengthen
Alleviate pain
What are the goals of PRP and stem cells?
Enhance tissue architecture
Increase collagen fiber density
Improve biomechanical strength
Diagnosis: Medial Shoulder Instability
Abduction angle measurement
Arthroscopy
MRI
Ultrasound
Treatment: Medial Shoulder Instability
Therapeutic exercise
Orthotics/supportive devices
PT/rehab
Analgesia/anti-inflammatories
Biologics
What are the 2 surgical treatment options for medial shoulder instability?
Radiofrequency shrinkage (controversial)
Prosthetic ligament reconstruction
Tendon transposition (biceps)
What are the 2 types of achilles tendon injuries?
Acute, traumatic
Chronic, degenerative
Treatment: Achilles Tendinopathy
Acute: treat like other tendon laceration
Chronic: surgery
PE Findings: Common Calcaneal Tendinopathy
Firm thickening at insertion, effusion, swelling
Flexibility testing (stifle extended while flexing the tarsus
Assess standing angle of tarsus
Complete rupture of ALL components of the common calcaneal tendon
Common calcaneal tendon rupture, SDF is intact
What are the general guidelines for traumatic achilles tendinopathy repair?
Repair each tendon individually if possible with 3 loop pulley and prolene suture
Hock maintained in extension post-op for 6w max with orthosis
What are the non-surgical treatment options for common calcaneal tendinopathies?
PT
Intralesional injection (PRP, stem cells)
Extracorporeal shockwave therapy
Orthotic
Conservative management
