Flashcards in Topic 4 - Pathology of Soft Tissue Deck (24):
Features of a muscle contusion
Hematoma from sudden heavy compressive force
Risk factors for myositis ossificans
High injury severity.
Following a rebleed.
Inappropriate Rx (heat, massage ect).
Thigh: effusion present, prone knee flexion <45
Clinical signs myositis ossificans
Increased morning pain, pain with activity.
Improvement cease, then deteriorates.
The difference between a strain and a sprain
Strain - muscular
Sprain - ligament
Which muscles have a higher injury risk?
Two joint muscles
eg. Rectus Femoris, Gastrocnemius, Hamstrings
Mild/1st degree muscle strain - Clinical presentation
No/minimal loss of strength.
No/minimal movement restriction.
Few fibers torn.
Moderate/2nd degree muscle strain - Clinical presentation
Pain on contraction.
Loss of strength.
Restriction of movement.
Significant (more than half) fibers torn.
Severe/3rd degree muscle strain - Clinical presentation
Complete tear of muscle.
Virtually complete loss of muscle function
Stage 1 of skeletal muscle healing
Rupture and necrosis of myofibers.
Formation of haematoma.
Inflammatory cell reaction.
Stage 2 of skeletal muscle healing
Phagocytosis of necrotised tissue.
Regeneration of myofibers and production of connective scar tissue.
Revascularisation by in-growth of capillaries.
Stage 3 of skeletal muscle healing
Maturation of regenerated myofibers.
Retraction and reorganisation of scar tissue,
Recovery of functional capacity of muscle.
Compartment Syndrome - Clinical Signs
Pain during activity, ceases with rest.
Compartment Syndrome - Pathology
Overuse/Exercise raises intracompartmental pressure.
Local tissue swells
Blood supply is decreased
Leads to further tissue swelling, repeats
Muscle soreness that develops 24-48 hours after unaccustomed physical activity.
DOMS Etiology theories
Lactic acid, muscle spasm, torn tissue, Connective tissue, Enzyme efflux, Tissue fluid.
General descriptor for tendon pathology
Collagen degeneration - disarray and separation.
Increased cells and vascular space.
Neovascularization (blood vessels where there shouldn't be).
Increased mucoid ground substance
*ABSENT inflammatory cells*
Pain some time after exercise (next day.
Painful at rest, "warms up" with use, worsens in cool down.
Local tenderness and thickening.
Inflammation of the tendon itself.
Rarely proven, often used incorrectly instead of tendonosis
Inflammation of the outer layer (paratenon).
Occurs where tendon rubs over bony prominence.
Infiltration of inflammatory cells.
Acute odema and hyperaemia.
Difficult to differentiate from tendinosis
Grade 1 ligament sprain
Stretched fibers but normal ROM on stressing ligament
Grade 2 ligament sprain
Considerable proportion of fibers torn.
Stressing of ligament reveals increased laxity, but definite end point.