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Tendons and Swellings Flashcards

(62 cards)

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1
Q

What is tendinopathy

A

Disease of a tendon

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2
Q

What is tendonitis

A

Inflammation

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3
Q

What is tendinosis

A

Chronic tendon injury with damage to extracellular matrix

No inflammation

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4
Q

What is tenosynovitis

A

Inflammation of the tendon sheath

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5
Q

What is enthesopathy

A

Inflammation of the tendon origin or the insertion into bone

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6
Q

What is the function of a tendon

A

Transmit load from muscle to bone

Enables joint function

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7
Q

What is the composition of a tendon

A

Water
Collagen - type 1
Proteoglycans

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8
Q

What do fibroblasts do in tendons

A

Produce collagen and proteoglycan

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9
Q

Do tendons have a good blood supply

A

No

Many watershed areas that are common sites of pathology

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10
Q

Describe the organisation of a tendon

A

Microfibrils organise into sub fibrils which organise into fibrils
The fibrils are organised to fascicles which form the tendon unit

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11
Q

What is the endotendon

A

Layer of connective tissue that surrounds the fascicles

The blood vessels and nerves lie within it

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12
Q

What is the epitenon

A

outer connective Tissue layer which lies within loose areolar tissue or within tendon sheath.

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13
Q

What intrinsic factors can contribute to tendinopathy

A

Age - degeneration
Obesity
Existing disease - RA
Malalignment

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14
Q

What extrinsic factors can contribute to tendinopathy

A

Trauma or injury
Repeated injury
Drugs - steroids and some antibiotics
Sports

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15
Q

List the common treatments for tendon problems

A 
RICE 
Physio 
Analgesics - anti-inflammatories 
Injections 
Splinting 
Surgery
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16
Q

What is meant by RICE treatment

A

Rest
Ice
Compression
Elevation

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17
Q

What soft tissue injuries can you treat with injections

A

Rotator cuff problems

Tennis elbow

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18
Q

What soft tissue injuries can you not treat with injections

A

Achilles tendon injury
Injury to extensor knee mechanism
Due to risk of rupture

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19
Q

What surgical procedures may be performed for soft tissue injury

A

Debridement
Decompression
Synovectomy - prevents rupture
Tendon transfer

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20
Q

What can cause a rotator cuff problem

A

Overuse of muscle - athletes and manual workers

Age

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21
Q

How do you treat a rotator cuff pathology

A

Physio
Injections
Surgery only used in severe cases

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22
Q

How do you treat a biceps rupture

A 
Usually conservative (rest and physio) 
Surgery can be done but is very risky
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23
Q

What is the proper name for tennis elbow

A

lateral epicondylitis

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24
Q

What causes lateral epicondylitis

A

Overuse
Overload at the extensor tendon origin
Common in tennis
Common in dominant arm

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25
How does lateral epicondylitis present
Pain and tenderness over lateral epicondyle | Pain with resisted extension of middle finger
26
How do you treat lateral epicondylitis
Self-limiting Rest, physio Steroid injection can help pain Surgical release in severe cases
27
What is the proper name for Golfer's elbow
medial epicondylitis
28
How does medial epicondylitis present
Medial elbow pain - over origins of wrist flexors Made worse by wrist flexion and pronation Due to repetitive stress
29
How do you treat medial epicondylitis
Self-limiting Rest, physio, activity modification Avoid injections as close to ulnar nerve Surgical debridement is last resort
30
What is cellulitis
Inflammation and infection of soft tissues
31
How does cellulitis present
Generalised swelling Pain Erythema
32
How do you manage cellulitis
``` Rest Elevation Analgesia Splint IV or oral antibiotics - usually flucloxacillin ```
33
What is an abscess
Discreet collection of pus
34
How does an abscess present
Defined swelling Erythema Pain History of trauma
35
How do you treat an abscess
Surgical incision and drainage Rest, elevation, analgesia and splint Antibiotics to follow up
36
What is septic arthritis
Bacterial infection of a joint | Orthopaedic emergency
37
Which organisms are common causes of septic arthritis
Staph aureus Strep E. coli
38
How does septic arthritis present
``` Monoarthropathy Decreased ROM Swelling Systemic upset Raised WCC and inflammatory markers ```
39
How do you treat septic arthritis
Urgent ortho review Aspiration Urgent washout and debridement - arthroscopic or open
40
How do ganglia appear
Discreet round swelling Non-tender Skin mobile
41
Where do ganglia typically appear
wrists feet knees
42
What is a Baker's cyst
Cyst/ganglion in the popliteal fossa | Associated with OA
43
What is bursitis
Inflammation of the synovium lined sacs that protect bony prominences and joints (bursae)
44
How do you differentiate between bursitis and septic arthritis
In bursitis they will still be able to move the joint
45
What causes rheumatoid nodules
Seen around joints in patients with severe RA | Associated with repetitive trauma
46
How do you treat rheumatoid nodules
Leave alone | Excise if problematic
47
What can cause Dupuytren's disease
Genetic predisposition Environmental factors - alcohol, diabetes, trauma Protein expression
48
How does a giant cell tumour of the tendon sheath present
Slow enlarging Firm, discreet swelling May or may not be tendon Usually on volar aspect of digits
49
How do you treat giant cell tumours of the tendon sheaths
Leave alone if no functional issue | Surgical excision if getting in the way
50
What is osteochondroma
Benign bone tumour Usually occurs near the knee Growth usually parallels patient
51
How does osteochondroma present
Painless, hard lump | Symptoms worse with activity
52
How do you treat osteochondroma
Close observation | Surgical excision
53
What is Ewings sarcoma
Malignant primary bone tumour of endothelial cells in marrow Bad prognosis
54
How does Ewing's sarcoma present
Hot, swollen and tender joint | Raised inflammatory markers
55
What does Ewing's sarcoma present like
Infection | Monoarthropathy
56
What is a lipoma
Benign neoplastic proliferation of fat | Often subcutaneous
57
How does a lipoma present
Can be discreet or ill-defined Slow growing Painless Soft movable mass
58
How do you manage a lipoma
Can be left alone | Surgical excision if causing symptoms
59
How do sebaceous cysts present
Slow growing Painless Discreet Mobile
60
Where do sebaceous cysts appear
Face Neck Trunk
61
What is myositis ossificans
Abnormal calcification of a muscle haematoma
62
Describe the typical history of myositis ossificans
Trauma Initial soft swelling Hardness develops over several weeks

MSK (21 decks)

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