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Flashcards in Tendon problems Deck (71):
1

What is the definition of tendinopathy?

Disease of a tendon

2

What is the definition of tendinitis?

Inflammation of a tendon

3

What is the definition of tendinosis?

Chronic tendon injury with cellular damage

4

What is the definition of tenosynovitis?

Inflammation of the tendon sheath

5

What is the definition of enthesopathy?

Inflammation of the tendon origin/insertion into bone

6

What is a tendon?

Structure which anchors muscle to bone

7

What type of collagen composes a tendon?

Type 1

8

What is the predominant cell type of a tendon?

Fibroblast

9

What is the structure of a tendon?

Microfibrils >
Subfibrils >
Fibrils >
Fascicle >
Endotendon >
Epitendon

10

Which three sources does the blood supply of a tendon come from?

Perimyseum
Periosteal insertion
Paratendon

11

Which intrinsic factors contribute to the development of tendinopathy?

Age
Gender
Rheumatoid arthritis
Leg length discrepancy
Mal-alignment
Obesity
Pes cavus

12

Which extrinsic factors contribute to the development of tendinopathy?

Trauma
Injury
Steroids
Antibiotics
Sports

13

What is the principle management for most tendinopathies?

Rest
Analgesia
Anti-inflammatories

14

Which tendinopathies might warrant injections? What type of injection?

Tennis elbow (lateral epicondylitis)
Golfer's elbow (medial epicondylitis)
Rotator cuff injuries

Local anaesthetic and cortisone

15

Which tendinopathy might warrant splinting?

Achillies tendinopathy

16

On which tendinopathies must injections not be used? Why?

Extensor knee mechanism problems
Achillies tendinopathy

Risk of rupture too high

17

What are the types of surgical management that may be indicated for certain tendinopathies?

Debridement
Decompression
Synovectomy
Tendon transfer

18

For which pathologies might decompression surgery be indicated?

Supraspinatus tendonitis
Subacromial depression

19

What does synovectomy prevent?

Rupture

20

For which pathologies might synovectomy be useful?

Extensor tendons of the wrist in rheumatoid arthritis
Tibialis posterior

21

For which pathologies might tendon transfer be useful?

Tibialis posterior
Extensor pollicus longus

22

Which types of people tend to develop rotator cuff pathology?

Athletes (throwing events)
Manual workers (painters)

23

How does rotator cuff pathology present?

Gradually developing achy pain of the shoulder
Difficulty sleeping on affected side
Pain when reaching overhead
Pain when lifting items
Shoulder tenderness (glenohumeral and AC joint)

24

What are the clinical findings with rotator cuff impingement?

Painful arc
Weakness on resistance tests
Positive impingement tests

25

What are the four muscles of the rotator cuff?

Supraspinatus
Infraspinatus
Teres minor
Subscapularis

26

Which is the most common muscle to be affected in rotator cuff pathology?

Supraspinatus

27

How can rotator cuff pathology be managed conservatively?

Rest
Physiotherapy
Steroid & local anaesthetic injections

28

How can rotator cuff pathology be managed surgically?

Subacromial decompression
Rotator cuff repair

29

What imaging is used in suspected rotator cuff pathology?

USS
MRI

30

What are the mechanisms of biceps tendinopathy?

Overuse
Impingement
Instability
Trauma

31

How does biceps tendinopathy present?

Pain anterior to shoulder radiating to elbow
Pain on shoulder and elbow flexion
Pain forearm pronation
Snapping with shoulder movements

32

What imaging modality is preferred for biceps tendinopathy?

USS

33

Which type of people get biceps tendinopathy?

Athletes (throwing events)
Manual workers (painters)

34

How can biceps tendinopathy be managed?

Conservative
Surgical

35

What are the clinical signs of biceps tendon rupture?

Popeye sign
Extensive bruising

36

What is the biggest risk with biceps tendinopathy?

Neurovascular injury

37

20% of lateral epicondylitis' are bilateral. T/F

True

38

What is the presentation of lateral epicondylitis?

Pain and tenderness over the lateral epicondyle at origin of forearm extensors
Pain worse when stretching muscles

39

What are the investigations used in lateral epicondylitis?

USS
MRI
Nerve conduction study

40

How is lateral epicondylitis managed?

Rest
Physiotherapy
Activity modification
Orthotics
Injection
Surgery

41

What test is positive in lateral epicondylitis?

Mill's test

42

How does medial epicondylitis present?

Medial elbow pain at origin of wrist flexors

43

What is the underlying mechanism which causes epicondylitis?

Repetitive strain

44

Is medial epicondylitis self limiting?

Yes

45

What is medial epicondylitis associated with?

Ulnar neuropathy
Muscle weakness

46

How is medial epicondylitis investigated?

X-ray
MRI
Nerve conduction study

47

How is medial epicondylitis managed?

Rest
Physiotherapy
Modify activity
Orthotics
Injection
Surgical release

48

Which muscles does de quervians tenosynovitis effect?

Abductor pollicus longus
Extensor pollicus brevis

49

How does de quervians tenosynovitis present?

Pain over radial styloid process

50

Which test is positive in de quervians tenosynovitis?

Finklestein's

51

Which imaging modalities are used to identify de quervians tenosynovitis?

USS
X-ray to rule out CMC osteoarthritis

52

How is de quervians tenosynovitis managed?

Splinting
Rest
Physiotherapy
Analgesia
Injections
Surgical decompression

53

Who gets de quervians tenosynovitis?

Commonly women over 30

54

What is de quervians tenosynovitis associated with?

Pregnancy
Rheumatoid arthritis

55

Is an extensor knee mechanism rupture partial or complete?

Either

56

What is extensor knee mechanism rupture associated with?

Trauma (running/jumping sports)
Antibiotics
Steroids
Diabetes mellitus

57

What is found on examination with a knee extensor mechanism?

Palpable gap
Inability to straight leg raise

58

What imaging modalities are used to investigate knee extensor mechanism problems?

X-ray
USS
MRI

59

How are knee extensor mechanisms treated?

Surgical + physiotherapy
Immobilisation + physiotherapy (small tears only)

60

What may be seen on the x-ray of someone with a knee extensor mechanism problem?

Effusion
Patella in the wrong place

61

What is osgood schlatter's disease?

Inflammation of tendon at insertion of patellar tendon into anterior tibial tuberosity

62

Who gets osgood schlatter's disease?

Adolescent active boys

63

What is Sever's disease?

Traction apophysitis at insertion of tibialis anterior into os calcis (tarsal bone)

64

What is traction apophysitis

Inflammation of where tendon attaches to bone due to traction

65

Is calaneal tendon rupture common?

Yes

66

What is the mechanism behind calcaneal tendon rupture?

Sudden force (running, jumping)

67

What is calcaneal tendon rupture associated with?

Rheumatoid arthritis
Steroids
Tendonitis

68

What are the clinical findings with calcaneal tendon rupture?

Palpable gap
Unable to tiptoe stand
Bruising

69

Which test is positive in calcaneal tendon rupture?

Simmond's

70

Which imaging modalities are used in calcaneal tendon rupture?

USS
MRI

71

How are calcaneal tendons treated?

Plaster cast
Surgery

Decks in Year 2 Class (72):