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Flashcards in Tendon Problems Deck (51):
1

What is tendinosis?

Chronic tendon injury with injury to the tendon at cellular level

2

What is tenosynovitis?

Inflammation of the tendon sheath

3

What is ensinopathy?

inflammation of the tendon origin or the insertion into bone

4

Which mesoderm plate do tendons arise from?

Tendons arise from the lateral plate mesoderm

5

Predominant cells in tendons

Fibroblast (responsible for production and maintenance of collagen)

6

Tendon is composed mainly of which type of collagen?

Type 1 (90%)

7

Drugs that can affect tendons

Antibiotics, steroids

8

Which tendon problems could you treat with injection?

Rotator Cuff, Tennis Elbow
NOT ACHILLES TENDON OR EXTENSOR KNEE MECHANISM

9

What could you use decompression for?

Supraspinatous tendonitis
Subacromial decompression

10

Muscle most commonly affected in rotator cuff pathology?

Supraspinatous

11

Tenderness over which joints in rotator cuff pathology?

Glenohumeral and AC joint

12

Which head of the biceps is predominantly torn in biceps tendinopathy?

The long head

13

What can cause biceps tendinopathy?

Overuse, instability, impingement or trauma

14

Which movements aggravate biceps tendinopathy?

Shoulder flexion
Forearm pronation
Elbow flexion

15

Where is the pain felt in biceps tendinopathy? And where does it radiate to?

Anterior to the shoulder radiating to the elbow

16

When is biceps tendinopathy common?

It is common in occupations where heavy lifting or overhead work is typical

17

Clinical signs of biceps rupture

Clinical signs of a biceps tendon rupture include a popeye sign and extensive bruising

18

Risks of bicep rupture repair surgery

Surgical repair can be carried out but runs a high risk of neurovascular complications especially the distal end

19

What is golfer's elbow?

Inflammation of the flexor forearm muscles

20

Aggravation of Golfer's elbow (medial epicondylitis)

The pain is aggravated by wrist flexion and pronation
Also worse e.g. when grasping jar

21

What is Golfer's elbow associated with?

Ulnar neuropathy/muscle weakness

22

Treatment for Golfer's elbow

rest, physio, modification activities, orthotics, inject or surgical release

23

Main test for Golfer's elbow

Sore upon wrist flexion and pronation
Also when grasping jar

24

When is pain worse in tennis elbow?

When stretched e.g. opening jar

25

Who is De Quervains Tenosynovitis common in and what is it associated with?

Most common in women aged 30-50 and is associated with pregnancy and rheumatoid arthritis

26

What test could you do for De Quervains Tenosynovitis?

Finklesteins test

27

What should you rule out when investigating De Quervains Tenosynovitis?

OA of the CMC joints (do X-ray to rule this out)

28

What kind of patients are more susceptible to achilles tendinopathy?

Rheumatoid arthritis
Those on steroids
Patients with tendonitis

29

Which test could you use to help confirm achilles tendinopathy?

Simmonds test (squeeze calf and leg moves)

30

Clinical findings of achilles tendinopathy

Palpable gap
Unable to stand on tiptoes
Bruising
Simmonds test positive

31

Predominant cell in a tendon

Fibroblast

32

Blood supply to the tendon

Perimysium
Periosteal insertion of the tendon
Paratenon

33

What is paratenon?

The fatty material between a tendon and its sheath

34

Tendon transfer

Tibialis posterior
Extensor pollicis longus

35

Pain in anterior shoulder radiating to elvow

Biceps tendinopathy

36

When is biceps tendinopathy aggravated?

Shoulder flexion
Elbow flexion
Forearm pronation

37

How would you diagnose biceps tendinopathy?

Clinical exam and ultrasound

38

Clinical signs of biceps rupture?

Popeye sign and extensive bruising

39

How do you aggravate medial epicondylitis?

Wrist flexion and forearm pronation

40

Medial epicondyle pain worse on grasping (e.g. opening jar)

Medial epicondylitis
(lateral epicondylitis can also hurt when opening jar)

41

Investigation for medial epicondylitis if diagnosis is uncertain?

MRI or USS

42

Test for lateral epicondylitis?

Mills test

43

Test for De Quervain's tenosynovitis?

Finkelstein's test

44

What is De Quervain's tenosynovitis associated with?

Pregnancy and RA

45

Pain over radial styloid process?

De Quervain's tenosynovitis

46

Finklestein's test?

Patient makes fist over thumb and hand is ulnar deviated to reproduce pain

Can be used in De Quervain's tenosynovitis

47

Drugs which could cause extensor knee problems?

Antibiotics, steroids
Also associated with diabetes

48

What might x-ray show if you have extensor knee problems?

Effusion or the patela sitting in the wrong place :(

49

Treatment for extensor knee problems

Surgery

50

Surgical repair of quadriceps and patellar tendon

Typically done using sutures with bony anchors
-Open approach

51

Clinical findings of achilles tendinopathy

Palpable gap
unable to tiptoe stand
bruising
Simmonds test/thomsons test