Pelvic Fracture

16 Feb 2018

What is a Pelvic Fracture?

A pelvic fracture is a break in the bony structure of the pelvis. This includes the hip bone, sacrum, and coccyx.

A fracture in the pelvis can either be stable or unstable, depending on the extent of hip damage.

In a stable pelvic fracture, there is only one break in the pelvic ring and the broken ends of the bone line up well. On the other hand, an unstable pelvic fracture is the type of fracture with two or more breaks in the pelvic ring. Unlike the stable type, the ends of the broken bone in an unstable fracture do not line up correctly.

Causes of Pelvic Fracture

Pelvic fractures can be caused by high-energy trauma such as a motorcycle collision or fall from a significant height and bone weakness or insufficiency.

Symptoms of a Pelvic Fracture

Pain is the most common symptom of a pelvic fracture. This is usually felt in the hip or groin area and worsens when the hip is moved such as when walking.

Aside from pain, there can also be tenderness in the groin, hip, lower back, or buttocks, swelling and bruising over the pelvic bones, numbness or tingling sensation in the upper thigh or genital area, and in cases of unstable pelvic fracture, heavy bleeding.

Diagnosing a Pelvic Fracture

Diagnosis of a pelvic fracture is made after a thorough physical exam and imaging tests.

During the physical exam, the doctor will assess the pelvis, hips, and legs. He/she will check for possibility of nerve injury or damage by evaluating the movement and sensation on the ankles, feet, and toes.

In most cases, imaging tests are requested in order to determine the complexity of the injury. These tests include x-rays, computed tomography (CT), and magnetic resonance imaging (MRI) scans.

How It Is Treated

Treatment plans for a pelvic fracture depend on several factors. These include the pattern of the fracture, the displacement of the bones, and the overall condition of the patient.

Nonsurgical Treatment

Nonsurgical treatment is usually recommended for stable fractures that are not or minimally displaced.

Some of the nonsurgical treatment options for a pelvic fracture include the use of walking aids to avoid bearing the weight on the affected side and pain medications to relieve the discomfort.

Surgical Treatment

Surgery is typically recommended for cases of unstable pelvic fracture.

Some of the surgical options for a fractured pelvis include the use of external fixation and skeletal traction and open reduction and internal fixation.

Osteoarthritis of the Hip

16 Feb 2018

What is Osteoarthritis of the Hip?

Arthritis is a general term used to pertain to joint inflammation. It’s a condition that causes pain and swelling in the body’s joints.

Osteoarthritis occurs when the inflammation to the joint causes a breakdown of the cartilage tissue, the rubbery material that covers the end of the bones. It can affect any joint of the body including the hips.

The hip is the largest joint of the body and the second most commonly affected joint by osteoarthritis.

Osteoarthritis of the hip is a serious condition. However, it’s not always easy to diagnose as the pain can appear in different locations such as the buttocks, thigh, groin, and knee. The pain can be dull, sharp, or stabbing and can greatly affect one’s ability to move.

The exact cause of osteoarthritis of the hip is unknown but several factors can trigger its development. These include being overweight, inherited defects in the cartilage, and improperly formed joints.

Symptoms of Osteoarthritis of the Hip

Pain around the hip is the most common symptom of osteoarthritis of the hip. This pain develops gradually and usually worsens over time. It can be felt in the groin or thigh area and radiates to other areas like the buttocks and the knees.

Aside from pain, there can also be stiffness, grinding noise (also called crepitus) during movement, “locking” of the hip joint, and decreased range of motion of the hip.

Diagnosing Osteoarthritis of the Hip

A physical exam and at times, some diagnostic tests can help in diagnosing hip osteoarthritis.

During the physical exam, the doctor will look for pain when pressure is applied on the hip, tenderness, problems with the gait, limitations in the range of movement, and any sign of injury to the muscles, tendons, and ligaments surrounding the hip joint.

Diagnostic tests such as x-rays, magnetic resonance imaging (MRI), and computed tomography (CT) scan may be requested to determine the condition of the bones and tissues of the hip.

How It Is Treated

The main goal of the treatment is to help improve the person’s mobility and function of the hip and reduce one’s pain.

Nonsurgical Treatment

During the early stages of the condition, the treatment of choice will be nonsurgical. These include lifestyle modifications, physical therapy, the use of assistive devices such as a walker, and pain medications.

Surgical Treatment

The doctor may recommend surgery if the pain from osteoarthritis is not relieved by nonsurgical treatment methods.

Some of the surgical options for osteoarthritis of the hip include osteotomy, hip resurfacing, and total hip replacement.

Hip Fracture

16 Feb 2018

A hip fracture is a break in the bones of the hip. While anyone can suffer from a hip fracture, older people are at higher risk due to the weakening of the bones as a result of aging. Couple that with poor vision, balance problems, and taking multiple medications, older people are more likely to trip and fall, the most common cause of hip fractures.

Causes and Risk Factors

Falls, especially from a significant height, are the most common causes of a broken hip. Other things that can lead to hip fracture include a blunt trauma to the hip and degenerative bone diseases such as osteoporosis.

There are certain factors that can increase one’s risk of hip fracture. These include obesity, unhealthy habits such as smoking and a sedentary lifestyle and having a medical condition that causes dizziness or loss of balance.

Signs and Symptoms

When one suffers from hip fracture, there can be a significant pain in the outer upper thigh or groin area. Discomfort can also be felt for every hip movement such as flexion or rotation of the hip.

Aside from pain, a hip fracture can also cause bruising, inflammation of the hip, and difficulty in walking. When the bone is completely broken, the injured leg will appear shorter than the non-injured one.

When to See a Doctor

Hip fractures are considered as an orthopaedic emergency. They require immediate medical attention.

A doctor may suspect a hip fracture from obvious signs of a broken hip such as bruising, deformity, and swelling. However, in order to confirm the diagnosis, the doctor may order imaging and other tests such as an X-ray, MRI and CT scans, and a bone scan.

Managing Hip Fractures

Treatment for hip fracture can vary. The doctor usually considers the patient’s age and overall physical health.

Nonsurgical Treatment

Nonsurgical treatment may be considered for patients who are too ill or are confined to a bed before the injury happened.

Patients who qualify for nonsurgical treatment may be placed on traction to keep the affected site immobile. These patients are often recommended for periodic X-rays to make sure that their fracture isn’t getting worse. They are also constantly monitored for possible complications of prolonged immobilization such as infection, formation of blood clots, bed sores, pneumonia, and nutritional wasting.

Surgical Treatment

For patients who are healthy enough to undergo surgery, the procedure is done as soon as the diagnosis of hip fracture is confirmed. The type of surgery depends on the location of the fracture as well as the severity of the patient’s condition.

The two most common surgical treatment for hip fractures are hip repair surgery and hip replacement surgery.

Hip repair surgery (also called internal fixation) is recommended if the bones can still be lined up properly. In this procedure, the doctor uses plates, screws, or rods to hold the bones together while they heal.

If the fractured bones can’t be lined up, the doctor will recommend the hip replacement surgery. It involves replacement of part (partial hip replacement) or all (total hip replacement) of the joint with artificial parts.

Hip Dislocation

16 Feb 2018

What is Hip Dislocation?

A hip dislocation occurs when the ball-shaped head of the thigh bone moves out of its socket in the pelvis. It’s a serious medical injury that requires immediate treatment.

Motor vehicle collisions are common causes of hip dislocation. This injury can also happen during athletic events.

Types of Hip Dislocation

When one suffers from a hip dislocation, the femoral head is either pushed out of the socket in a backward or forward direction.

Posterior Dislocation
This is the most common type of hip dislocation, accounting for about 90% of the cases. In this type of hip dislocation, the femoral head is pushed out of the socket in a backward direction.

Anterior Dislocation
Anterior dislocation occurs when the femoral head is pushed out of the socket in a forward direction. This results in the hip being bent slightly, with the leg rotating out and away from the body’s midline.

Symptoms of Hip Dislocation

Severe pain is the most common complaint of those with dislocated hip. This is usually accompanied by difficulty in moving the leg. In some cases, there can be a loss of feeling in the feet or ankle area. This symptom usually signifies nerve damage.

Diagnosing Hip Dislocation

Most cases of hip dislocation can be easily detected by an orthopaedic surgeon simply by looking at the position of the leg. However, even if it is obvious, many doctors would still do a thorough physical exam to determine other injuries involved.

To determine the exact location of the displaced bone, the doctor may order imaging tests such as x-rays.

How It Is Treated

A hip dislocation needs to be treated immediately. An unmanaged dislocated hip can lead to sciatic nerve damage, recurring dislocation, and inability to perform the closed reduction.

Reduction

If there are no other injuries involved, the doctor may perform the closed reduction. It’s the manual manipulation of the bone fragments without surgical exposure of the fragments. This is usually performed under conscious sedation.

After the reduction, the doctor usually requests additional tests such as x-rays and computed tomography (CT) scan to make sure that the bones are in proper position.

Surgical Intervention

If the closed reduction is unsuccessful or if the joint remains unstable, then surgical intervention is recommended.

Open reduction is commonly performed for a dislocated hip. In this procedure, the bone fragments are exposed surgically for realignment.

Broken Hip

16 Feb 2018

What is a broken hip?

A broken hip or hip fracture refers to a break in the upper quarter of the thigh bone. It’s a serious injury that can lead to life-threatening complications.

Older people are at higher risk to have a broken hip due to weakening of the bones as a result of aging. They are also more prone to falls as a result of problems in vision, balance, and having multiple medications.

Aside from falls, a broken hip may also occur as a result of blunt trauma to the hip, medical conditions such as osteoporosis, and obesity (excessive weight can put too much pressure on the hip bones).

Symptoms of a Broken Hip

Pain in the hip or groin area is the most common symptom of a broken hip. This makes walking very difficult.

Other than pain, there can also be changes in the skin around the affected site. There can be swelling, redness, and bruising. The affected leg may also appear shorter than the unaffected leg.

Diagnosing a Broken Hip

A broken hip is diagnosed after a physical exam and imaging tests.

The physical exam of one with a broken hip may reveal swelling, bruising, or deformity on the affected site.

In order to locate the fracture, the doctor may order imaging tests such as x-rays. If this test doesn’t show any fracture even if the patient is showing hip fracture symptoms, then other imaging tests may be ordered. This can be magnetic resonance imaging (MRI) or computed tomography (CT) scan. These tests often show a hidden fracture.

How It Is Treated

The treatment plan for a broken hip will depend on several factors including the patient’s overall health and medical condition.

Nonsurgical Treatment

Nonsurgical treatment such as the use of pain medications is recommended for those who are too ill to undergo any form of surgical intervention. This is also recommended for those who are unable to walk prior to injury and may have been confined to a bed or wheelchair.

Surgical Treatment

The type of surgery to be done depends on the location and severity of the fracture and whether the fractured or broken bones are displaced (not aligned properly).

Some of the surgical options for a broken hip include internal repair using screws, partial hip replacement, and total hip replacement.

Concussions

16 Feb 2018

What is a Concussion?

A concussion is a type of temporary brain injury that results in temporary loss of normal brain function. In many cases, people who suffer from a concussion don’t show external signs of head trauma. And in many cases, those who suffer from this brain injury never lose consciousness.

Although it’s more common among athletes, anyone can get a concussion through falls, fights, bike accidents, and car crashes. In sports, it’s more common in those who are into football, boxing, soccer, skiing, snowboarding, and hockey.

Symptoms of Concussion

It’s not always easy to know if someone suffers from concussion as mild injuries to the brain are not always observable in routine neurological examinations. Plus, a person who suffers from concussion doesn’t necessarily have to pass out or lose consciousness.

The symptoms of concussion could vary. It can be mild, moderate, or severe. It may last for hours, days, weeks, or months.

Some of the most common symptoms of concussion include:

  • Inability to concentrate or think clearly
  • Difficulty in remembering new information
  • Headache
  • Dizziness
  • Confusion
  • Memory loss
  • Vision problems
  • Nausea and vomiting
  • Sensitivity to light or noise
  • Impaired balance
  • Ringing in the ears
  • Loss of smell or taste

Young children suffering from concussions can have these symptoms too. However, it can be difficult to tell at times.

A child who suffer from any of the following after a fall or accident should be seen by a doctor immediately: crying more than the usual, more temper tantrums, and changes in the way he/she does the usual day-to-day activities such as eating, sleeping, and playing. These could indicate a concussion.

Diagnosing Concussions

A thorough physical examination helps in determining a concussion. When a patient is suspected of having a concussion, the doctor will ask questions to test one’s ability to pay attention and retain memories. He/she may also conduct tests to check on one’s strength, coordination, balance, sensation, and reflexes.

In some cases, the doctor may order tests such as MRI or CT scan to make sure that the brain is neither bleeding or bruising.

How It Is Treated

Rest is the best way to recover from a concussion. Some people may feel normal again for a few hours after the trauma while others may still have the symptoms for weeks or months.

After a concussion, the doctor may advise to avoid activities that are physically or mentally demanding until one feels better. Pain medicines may also be prescribed to help in managing the discomfort.

Trigger Finger

16 Feb 2018

What is a Trigger Finger?

Trigger finger, which is also known as stenosing tenosynovitis, is a painful condition in which the finger gets stuck in a bent position.  It occurs when an inflammation narrows the space within the sheath (the tissue that covers the tendon) that surrounds the tendon of the affected finger.

The condition is common in people who frequently engage in activities that require repetitive gripping action. These include farmers, musicians, and industrial workers. The trigger finger is also seen to be more common in women and in those with diabetes.

Symptoms of a Trigger Finger

Initially, a person develops soreness at the base of the affected finger. This is eventually accompanied by painful clicking or snapping sensation when the finger is bent or straightened. In some cases, the finger can be locked in a bent or straight position.

Diagnosing a Trigger Finger

To diagnose a trigger finger, the doctor has to review one’s medical history and assess the patient’s affected hand. In most cases, there’s no need for imaging tests such as x-rays to confirm the diagnosis.

How It Is Treated

The treatment for trigger finger will depend on the severity of the symptoms. If the symptoms are mild, then the nonsurgical treatment options can suffice.

Nonsurgical Treatment

Some of the nonsurgical treatment options for trigger finger include rest, medications, and steroid injections.

  • Rest
    Mild cases of trigger finger can be managed with rest. The doctor may recommend the use of a splint to keep the finger in a neutral position.
  • Medications
    The pain or discomfort can be alleviated with the use of nonsteroidal anti-inflammatory drugs (NSAIDs).
  • Steroid Injections
    In some cases, the doctor may recommend steroid injections into the tendon sheath. Sometimes, a second injection is needed to improve one’s symptoms.

Surgical Treatment

Although trigger finger is not life-threatening, surgery may be recommended if the symptoms are severe. Surgery may also be suggested to prevent permanent stiffness.

The goal of the surgery for trigger finger is to widen the opening of the tunnel in order for the tendon to slide through it more easily. The procedure is usually done on an outpatient basis.

Thumb Fracture

16 Feb 2018

What is a Thumb Fracture?

A thumb fracture is a common injury that happens when the bones of the thumb break. The break can happen in either of the two bones of the thumb.

There are specific types of thumb fracture. Examples of which are Bennett and Rolando fractures. These thumb fractures occur at the base of the thumb.

Most thumb fractures are a result of direct stress to the thumb. This can be due to a fall from a significant height, an automobile accident, or an injury from high-impact sports.

Symptoms of a Thumb Fracture

The most common symptoms of a thumb fracture include severe pain, noticeable deformity of the thumb, a tender sensation when touched, numbness or coldness, and limited range of motion of the thumb.

Diagnosing a Thumb Fracture

To diagnose a thumb fracture, the doctor has to assess the injured site. He/she will look into noticeable deformities, contusions, and swelling within the thumb. The patient’s medical history will also be reviewed to determine the cause and nature of injury.

In most cases, x-rays will be ordered to confirm the diagnosis. It also helps in evaluating further the fracture especially if it is displaced (the pieces of the cracked bone have separated). It will help identify the exact location of the fracture as well as determine the extent of the injury.

How It Is Treated

The treatment options for a thumb fracture will depend on several factors, which include the type of fracture and the severity of the break in the bone.

Nonsurgical Treatment

A thumb fracture can be treated nonsurgically if the bone fragments are not displaced or if the break happens in the shaft (middle part of the bone).

To hold the bone fragments in the place, the doctor will use a specially designed cast. This has to be worn in 4-6 weeks. X-rays may be taken on a regular basis to make sure that the bone is healing well and has not slipped out of alignment.

Nonsteroidal anti-inflammatory drugs (NSAIDs) and antibiotics may also be prescribed to reduce the pain, swelling, and risk of infection.

Surgical Treatment

Surgery will only be done if the bone fragments can’t be put back in place through the use of a cast. It may also be recommended if there is a lot of movement between the broken fragments of the bone.

A common surgical option for treating a thumb fracture is open reduction internal fixation (ORIF). This procedure aims to realign the fractured bone to its original position. The surgeon will use screws, rods, or plates to stabilize the fractured bone under the skin.

Hand Fracture

16 Feb 2018

What is a Hand Fracture?

The 27 bones of the hand serve as its framework, supporting the muscles that make the fingers and wrist move. When one of these bones is broken or fractured, it can be hard for one to use his/her hand, wrist, and fingers.

There are different causes of a hand fracture. The most common causes are workplace injuries such as improper use of tools. Bones in the hand can also get broken as a result of falls, crush injuries, and sports injuries.

Symptoms of a Hand Fracture

The signs and symptoms of a broken hand include swelling, bruising, pain, deformity, shortened finger, depressed knuckle, reduced range of motion of the fingers, and inability to grasp.

Diagnosing a Hand Fracture

The hands are one of the most important parts of the body and are essential for certain functions. Hence, when a hand fracture is suspected, medical help should be sought immediately.

A physical examination is needed to diagnose a hand fracture. During the physical exam, the doctor will check the position of the fingers and the condition of the skin. The range of motion of the fingers, as well as their sensation, will also be assessed.

In most cases, x-rays will be ordered to confirm the diagnosis as well as to determine the location and extent of the fracture.

How It Is Treated

There are nonsurgical and surgical methods of treating a hand fracture.

Nonsurgical Treatment

Most of the time, the broken bones can be realigned without the need for surgery. This can be done with the use of a cast, splint, or fracture-brace. Any of these can be used to immobilize the site while it’s healing.

While the cast, splint, or fracture-brace is worn, x-rays of the injured site will be taken a week later to make sure that it is healing well.

Surgical Treatment

In some cases, surgery is needed to realign the fractured bones. This is usually the case of hand fractures that result from a crushing injury.

The surgical treatment for a hand fracture usually involves the use of wires, screws, or plates to hold the broken bones in place.

Fingertip Injuries

16 Feb 2018

What are Fingertip Injuries?

Fingertip injuries are one of the most common injuries of the hand. This can be a crushing injury, tearing injury, a sharp cut, or a combination of these.

There are several possible causes of fingertip injuries, most of which are caused by accidents at home, school, or work.

Symptoms of Fingertip Injuries

The most common symptoms of fingertip injuries include pain, bleeding, swelling, deformity, and swelling of the injured site. Aside from that, there can also be some redness, pus, and fever especially if the injured site is not treated immediately.

Diagnosing Fingertip Injuries

Taking the patient’s medical history and doing a thorough physical exam are needed to diagnose fingertip injuries.

Medical History
As part of taking the medical history, the doctor may ask of the nature and circumstance of the injury. He/she may ask questions as to how and when the injury occurs. The doctor may also ask about other conditions the patient has as well as the medications that he/she is taking.

Physical Exam
The injured finger will be assessed thoroughly. The doctor will look for missing tissues, any exposed bone, and injury to the nail and nail bed.

If the doctor suspects of broken bones, he/she may recommend the patient for x-rays.

Treatment for Fingertip Injuries

Treatment for fingertip injuries would vary, depending on the type of injury the patient has. The doctor will also consider the patient’s general health, lifestyle, and preference.

For Injuries Without Exposed Bone
Small fingertip injuries without exposed bone may heal on their own. The doctor may just place a protective covering over it. After 1-2 days, the doctor may recommend the injured finger to be soaked daily in warm solution or saline solution with peroxide. Range of motion finger exercises can be started after 48 hours to prevent stiffness.

For Injuries With Exposed Bone
A surgical procedure may be needed for injuries with exposed bone. The type of surgery to perform will depend on the extent of injury.

Reconstructive flap surgery and replantation are some of the surgical options for fingertip injuries with exposed bone.

Finger Fracture

16 Feb 2018

What is a Finger Fracture?

A broken or fractured finger can occur when any of the phalanges (the bones in the fingers) break. This is usually brought by a hand injury, which can be a result of a fall, slamming the fingers in a door, or carelessness in using tools like drills and power saws.

Symptoms of a Finger Fracture

Pain, swelling, tenderness, and limited range of motion are the most common symptoms of a finger fracture. There can also be deformity of the injured finger and bruising at the fractured site.

Diagnosing a Finger Fracture

A fractured finger requires medical attention.

To diagnose a broken finger, the doctor has to review one’s medical history which includes reviewing the nature of injury. He/she will also do a physical exam on the injured site.

During the physical exam, the doctor may ask the patient to extend the hand or make a fist. This is to see if the injured finger angles in the wrong direction or appears too short.

Usually after the physical exam, the doctor orders additional tests to confirm the diagnosis. This includes x-rays of both hands for comparing the uninjured and injured sites.

How It Is Treated

There are nonsurgical and surgical treatment options for a broken finger.

Nonsurgical Treatment

A broken bone can be put back in place without surgery. This is by using a splint or cast to protect it and keep it straight while it’s healing. In some cases, the doctor may splint the fingers next to the fractured site for added support.

The splint is usually worn for about 3 weeks. X-rays of the injured site are done on a regular basis to monitor its healing.

Surgical Treatment

Surgery is recommended for severe cases of finger fracture. That is, a broken finger that can’t be put back in place with splint or cast alone.

Surgery for a finger fracture usually involves the use of small devices such as pins, wires, or screws for holding the fractured bones together.

Carpal Tunnel

16 Feb 2018

What is Carpal Tunnel Syndrome?

Carpal tunnel syndrome is a condition that can cause numbness, tingling sensation, weakness, and other symptoms in the hand. It occurs when the median nerve, one of the major nerves to the hand, is compressed or squeezed. This can be a result of conditions such as rheumatoid arthritis and diabetes, pregnancy, and repetitive movements of the same hand especially if the wrist is bent.

Most people get carpal tunnel syndrome as a result of different factors. It can be a combination of heredity, certain medical conditions, and repetitive hand use.

Symptoms of Carpal Tunnel Syndrome

The symptoms of carpal tunnel syndrome develop gradually. Initially, there will be numbness or tingling sensation of the thumb, index, and middle fingers. This numbness usually come and go.

The tingling sensation may travel from the wrist up to the arm. Hence, people with the carpal tunnel syndrome usually “shake out” their hands to relieve them of these symptoms.

There can also be weakness of the hand, making one drop objects. This can be brought about by either the numbness of the hand or the weakness of the thumb’s pinching muscles.

Diagnosing Carpal Tunnel Syndrome

A review of one’s medical history and a thorough physical exam are needed to diagnose carpal tunnel syndrome.

During the physical exam, the doctor may press down the median nerve inside the wrist to find out if it causes numbness. He/she may also test for numbness or tingling by bending and holding the wrist in a flexed position. Sensitivity in the fingers and hands may also be tested as well as muscle strength around the base of the thumb.

Additional tests may be required to confirm the diagnosis and determine the severity of the condition. Some of these tests may include electrophysiological tests, x-rays, ultrasound, and magnetic resonance imaging (MRI) scan.

How It Is Treated

Although the symptoms of carpal tunnel syndrome develop gradually, they can get worse when the condition is left unmanaged. Hence, it’s very important to treat the condition as soon as it is diagnosed.

Nonsurgical Treatment

During the early stages of the condition, nonsurgical methods may be recommended for managing the symptoms. Some of the nonsurgical treatment options include the use of brace or splint at night for keeping the wrist in a neutral position, the use of nonsteroidal anti-inflammatory drugs (NSAIDs), steroid injections, and nerve gliding exercises.

Surgical Treatment

Surgery is only recommended if the nonsurgical treatment options are tried and there is still no relief from the symptoms.

The surgical procedure for carpal tunnel syndrome is called carpal tunnel release. In this procedure, the surgeon cuts through the ligament that is pressing down or causing pressure on the carpal tunnel. This creates more room for the median nerve and tendons passing through the tunnel. This procedure usually improves pain and restores hand function.

Bursitis

16 Feb 2018

What is bursitis?

Bursitis is the inflammation of the fluid-filled sac called bursa. This sac cushions the area between tissues such as bones and tendons, reducing the friction between the moving parts of the body.

The bursa can get inflamed as a result of repetitive motions, infection, trauma, and preexisting rheumatoid conditions.

The most common areas affected by bursitis are the shoulder, elbow, and hip. However, it can also affect the knee and the Achilles tendon.

Symptoms of Bursitis

Although the symptoms of bursitis could vary, depending on the affected site, pain and tenderness are the most common complaints of those who have it. The inflammation of the bursa may also cause limitations in movement.

Shoulder Bursitis

A person with shoulder bursitis usually complains of pain which often worsens at night, tender spots, and decreased range of active motion (overhead lifting and reaching causes discomfort).

Elbow Bursitis

In elbow bursitis, the pain increases when the elbow is bent. Infection is also common in this type of bursitis.

Hip Bursitis

The pain that occurs in hip bursitis worsens when the hip is extended and rotated. It usually radiates to the front and middle parts of the thigh to the knee.

There can also be tenderness in the groin area and at times, there can be a mass felt that resembles a hernia.

Knee Bursitis

The pain in knee bursitis is felt when the knee is bent. This can be troublesome for many people especially at night. In some cases, the pain radiates to the inner thigh and mid-calf.

Ankle Bursitis

With ankle bursitis, the pain is usually felt at the back of the heel and worsens with resistive flexion or passive extension.

Diagnosing Bursitis

Bursitis can be infectious. Hence, medical care should be sought if the symptoms are felt.

Doctors diagnose bursitis based on one’s medical history and result of physical exam and diagnostic tests.

In order to determine the cause of bursitis, the doctor may remove fluid from the bursa and send it to the laboratory for analysis.

Other tests that may be recommended include blood tests and magnetic resonance imaging (MRI) and computed tomography (CT) scans. These tests help in ruling out other conditions.

How It Is Treated

Most cases of bursitis get better on their own. The discomfort is usually managed through rest, application of cold compress, and taking of pain reliever. However, if the symptoms are not relieved through conservative measures, the doctor may prescribe antibiotics, physical therapy, or corticosteroid injections.

Although it happens rarely, an inflamed bursa may be surgically drained.

Bunions

16 Feb 2018

A bunion is a bony, often painful bump that develops at the base of the big toe. Also known as hallux valgus, bunions often develop slowly.

What causes bunions?

Bunions develop when the bones that make up the metatarsophalangeal joint or MTP (the largest joint of the big toe) move out of alignment.

There are several theories on how bunions develop but the exact cause is still unknown. There are some factors though that can increase one’s risk of developing bunions. These include having an inherited foot type, congenital foot deformities, and foot injuries.

In some cases, bunions are associated with certain types of inflammatory arthritis such as rheumatoid arthritis.

Signs and Symptoms

The most common signs and symptoms of bunions include a bulging bump on the outside of the base of the big toe, pain or soreness around the big toe joint, a burning sensation, inflammation, redness, and in some cases, numbness.

Corns or calluses may develop with bunions especially when the first and second toes overlap.

When to See a Doctor

In many cases, bunions don’t require medical treatment. However, seeing a doctor is advised if there is persistent pain on the big toe, a visible bump on the big toe joint, difficulty walking in flat shoes, and a decreased in the movement of the big toe or the foot.

Bunions can be easily detected through one’s medical history and physical assessment. To confirm the diagnosis and determine the degree of deformity, the doctor may order an X-ray.

Since the alignment of the bones changes with one’s position, the doctor will take an X-ray while the patient is standing. This provides better images on the misalignment of the bones on the foot.

Managing Bunions

Nonsurgical Treatment

Most cases of bunions can be managed through different nonsurgical methods. While they can help alleviate the pain, these methods cannot reverse the deformity itself.

Wearing the right kind of shoes, applying pads over the area of the bunion, application of cold compress, and taking of oral nonsteroidal anti-inflammatory drugs (NSAIDs) are just some of the ways to manage the discomfort associated with bunions.

Surgical Treatment

Surgery is only recommended if pain persists even with nonsurgical treatments and when the pain interferes with day-to-day activities.

Surgical treatment for bunions usually involves removal of the bump in the bone and correcting the changes in the bony structure as well as changes in the soft tissues. The goal of these surgeries is to reduce the pain and deformity.

Tennis Elbow

16 Feb 2018

What is a Tennis Elbow?

Also known as lateral epicondylitis, tennis elbow is a condition that occurs when the tendons of the elbows are overused. It’s a painful condition that usually occurs as a result of repetitive motions of the wrist and the arm.

This condition is very common among tennis players and other athletes who play sports that require repetitive and vigorous use of the forearm muscles. It’s also common in those who work in certain jobs such as carpentry, cooking, and plumbing.

Symptoms of a Tennis Elbow

The symptoms of a tennis elbow develop gradually. It usually begins with mild pain that worsens over weeks or months. This pain may radiate from the outside of the elbow into the forearm and wrist.

Aside from the pain, there can also be arm weakness. As a result, the patient finds it hard to do things with his/her hands such as gripping an object, holding a cup, and even turning a doorknob.

Diagnosing a Tennis Elbow

There are several areas that the doctor will look into before making a diagnosis. These include one’s symptoms and how they developed and any existing occupational or sports risk factors.

Aside from reviewing the medical history, the doctor will also run a thorough physical exam. He/she may ask the patient to straighten his/her arm against resistance to see if it causes pain. The occurrence of pain will tell the doctor that those muscles are not healthy.

Additional tests may be required to rule out other possible causes of the symptoms. These tests may include magnetic resonance imaging (MRI) scan, electromyography (EMG), and x-rays.

How It Is Treated

Most cases of tennis elbow (about 80 to 95%) are successfully treated through nonsurgical methods.

Nonsurgical Treatment

Rest, which includes cessation of participation in activities that require heavy work, is usually part of the treatment plan for patients with tennis elbow. If he/she is active in certain sports, he/she may be recommended to stop his/her participation in them for several weeks in order to give the arms the rest they need.

Other nonsurgical treatment options for tennis elbow include the use of non-steroidal anti-inflammatory drugs (NSAIDs), physical therapy, use of a brace centered over the back of the forearm, steroid injections, and extracorporeal shock wave therapy.

Surgical Treatment Options

If symptoms are still felt after 6 to 12 months of nonsurgical intervention, the doctor may recommend surgery.

Most surgical procedures for the tennis elbow involved the removal of the diseased muscle and then re-attaching the healthy muscle back to the bone. The surgery can either be an open or arthroscopic procedure.

Osteoarthritis of the Elbow

16 Feb 2018

What is Osteoarthritis of the Elbow?

Osteoarthritis of the elbow is a degenerative condition that results from the wear and tear of the cartilage surface of the elbow.

Types and Causes of Elbow Osteoarthritis

There are two types of elbow osteoarthritis: the primary and the post-traumatic osteoarthritis. In primary elbow osteoarthritis, the degenerative changes in the joint occur without a specific cause. It’s different with the post-traumatic type wherein arthritis occurs as a result of injury, which may have happened years ago.

Elbow injuries such as dislocation or fracture can lead to osteoarthritis as these can damage the cartilage directly. Pieces of cartilage can be ripped away from the bone and may float around the joint, causing pain.

The Least Affected Joints

Osteoarthritis usually affects the weight-bearing joints of the body such as the hips and the knees. The elbows are the least affected because of their stabilizing ligaments and well-matched joint surfaces.

Symptoms of Osteoarthritis of the Elbow

Like other cases of osteoarthritis, pain and stiffness are the most common symptoms of elbow osteoarthritis. Initially, the pain is related to activity. There is usually less pain and stiffness with activity. When one stops to take a break, the pain and stiffness increase or worsen.

As the condition progresses, the pain is felt even when one is at rest. There can also be swelling around the elbow and a squeaking noise and crepitus (creaking sensation) when the joints are moved.

All these symptoms can affect one’s movement. Those with elbow osteoarthritis initially find it hard to completely straighten their arms. As it progresses, they find it hard to bend until they experience arm weakness and decrease in function.

Diagnosing Osteoarthritis of the Elbow

Doctors can easily diagnose elbow osteoarthritis based on the patient’s symptoms and the result of standard x-rays, which usually show arthritic changes.

How It Is Treated

Treatment for elbow osteoarthritis depends on several factors include the severity of the patient’s condition, his/her medical history, his/her overall health condition, and the results of x-ray and other tests.

Nonsurgical Treatment

Nonsurgical treatment is recommended for early stages of the disease. This usually includes oral injections to reduce the pain, physical therapy, and making changes or modifications in one’s usual activities. In some cases, corticosteroid injections are recommended for pain relief.

Surgical Treatment

Surgery is only recommended when there is no relief from the nonsurgical treatment options. Arthroscopy and joint replacement are the common surgical options.

Arthroscopy, which involves the removal of any loose cartilage or degenerative tissue in the joint, is shown to provide pain relief and improvement in movement. Joint replacement, on the other hand, is only recommended when the joint surface has worn out completely.

Elbow Fracture

16 Feb 2018

What is Elbow Fracture?

An elbow fracture or a broken elbow is a common injury in both adults and children. It may occur as a result of overuse (a common cause among athletes), high-energy trauma such as a motorcycle collision, a sideswipe injury, or any other direct injury to the elbow, shoulder, hand, or wrist.

An elbow fracture is a serious elbow injury that requires medical attention. Early diagnosis and treatment can help in preventing complications and later disability.

Symptoms of Elbow Fracture

A common symptom of elbow fracture is a sudden and often intense pain in the elbow and forearm. Other symptoms include swelling of the elbow or of the area immediately above or below it, deformity of the elbow or areas near it, discoloration or bruising, difficulty in moving the elbow, and numbness or decreased sensation on the forearm, hand, or fingers. Some people with elbow fracture also complain of a feeling of tightness in the area of the elbow or forearm.

Diagnosing Elbow Fracture

An elbow fracture requires immediate medical help as it can lead to serious complications and disability.

If an elbow fracture is suspected, the doctor will review one’s medical history including the nature and cause of injury. There will also be a thorough physical exam, focusing on the affected area/arm. He/she will look for the swelling, tenderness, change in color in the hand, bruising, and any limitation in movement.

X-rays are often required to see clear images of the affected site. It can help the doctor determine what kind of fracture it is and whether the bones have moved out of alignment.

How It Is Treated

Treatment for elbow fracture depends on several factors including the type of fracture and the degree of the displacement.

Nonsurgical Treatment

Nonsurgical treatment is recommended for those with stable fracture (a type of fracture on which the bones line up and are barely out of place).

The use of a splint or cast for immobilization is an example of nonsurgical treatment. In some cases, the application of splint or cast is done only after closed reduction.

Surgical Treatment

Surgery is recommended if the bone fragments are displaced. Surgical options for elbow fracture include closed reduction and percutaneous pinning and open reduction and internal fixation.

Scoliosis

16 Feb 2018

What is Scoliosis?

Scoliosis is a condition characterized by curvature of the spine. It usually occurs during growth spurt years, just before the puberty.

Scoliosis can be caused by certain conditions like muscular dystrophy and cerebral palsy but the majority of the cases have unknown causes.

Symptoms of Scoliosis

During the early stages of scoliosis, there is a lateral, or side, curvature of the spine of at least 10 degrees. A curve as small as this will not show any signs or symptoms.

As the curve progresses to 20 degrees and more, signs and symptoms like uneven shoulders, waist, and hips (one hip higher than the other) become more obvious.

The progression of the curve may cause other issues like trunk imbalances, muscle spasms, and pain.

Diagnosing Scoliosis

To diagnose scoliosis, the doctor has to take a detailed medical history including questions about recent growth. He/she will also do a thorough physical exam which includes the Adam’s forward bend test. In this test, the doctor will ask the patient to bend forward at the waist, with arms hanging loosely. This position allows the doctor to see the asymmetry of the shoulders, waist, and hips. This forward bend test is highly useful for scoliosis in the upper or mid back.

As part of the forward bend test, the doctor may use a special tool called a scoliometer (also known as inclinometer). This tool is placed flat on the back of the patient where the asymmetry looks at its greatest. It helps in estimating the angle of trunk rotation (ATR).

Plain X-rays are often recommended to help confirm the diagnosis. If the doctor suspects of a tumor, additional tests such as MRI scan will be recommended.

How It Is Treated

Most children have mild scoliosis but usually don’t need any treatment. However, they may be required for regular checkups every 4 to 6 months to see if there are changes in the spine.

If the child has moderate scoliosis, he/she may be recommended to wear a brace. Its use won’t cure or reverse the curve but can help in preventing further progression of the curve.

For severe scoliosis, the doctor may recommend surgery to reduce the severity of the spinal curve.

Spinal fusion is the most common surgery for scoliosis. In this procedure, the surgeon connects two or more bones in the spine so they can’t move independently.

Sciatica

16 Feb 2018

What is Sciatica?

Sciatica refers to pain felt in the lower extremity resulting from irritation of the sciatic nerve. The sciatic nerve is the largest nerve in the body, running from each side of the lower spine down the back of each leg.

The pain of sciatica is felt from the lower back to behind the thigh. It can also radiate down below the knee.

Most cases of sciatica result from a lumbar disk herniation, which presses on the nerve and causing inflammation or irritation of the sciatic nerve. Aside from herniated disk, the sciatic nerve may also be irritated as a result of tumors, internal bleeding, injury, and infection in or around the lumbar spine. Sciatica may also occur during pregnancy.

Symptoms of Sciatica

Sciatica can cause pain that begins in the back or buttock, radiating down the back of the thigh and into the lower leg or foot. The pain, which is usually described as sharp or searing, is alleviated through movements that extend the spine. These include walking and lying down.

Aside from the pain, there can also be weakness or numbness when moving the leg or foot, “pins-and-needles” sensation, and numbness down the leg.

Diagnosing Sciatica

A review of the patient’s medical history as well as a thorough physical exam can help in diagnosing sciatica. In some cases, additional tests are needed to determine the underlying cause of it. These tests include X-rays, electromyogram, MRI scan, and CT scan.

How It Is Treated

Most cases of sciatica improve through nonsurgical methods. These include the application of heat/ice compress, medications such as muscle relaxants, anti-inflammatory drugs, and narcotics, physical therapy, and steroid injections.

If nonsurgical methods don’t work and the compressed nerve causes significant weakness, progressive pain, or loss of bowel or bladder control, then surgery is recommended. The surgery usually involves removal of the portion of the herniated disk or bone spur that’s pressing on the pinched nerve.

Lumbar Spinal Stenosis

16 Feb 2018

What is Lumbar Spinal Stenosis?

Lumbar spinal stenosis is the narrowing of the spaces within the lumbar spine (lower back). It’s the most common form of spinal stenosis.

Spinal stenosis, in general, is usually caused by degenerative conditions such as osteoarthritis. Aside from these conditions, other possible causes of spinal stenosis include herniated disks, abnormal growths inside the spinal cord, thickened ligaments that bulge into the spinal canal, and spinal injuries.

Although anyone can have spinal stenosis, this condition is more common in people over the age of 50.

Symptoms of Lumbar Spinal Stenosis

Not all people with lumbar spinal stenosis have symptoms. There are those who have evidence of the condition but are not experiencing any symptom. For those who have, the symptoms usually start gradually and worsen over time.

Some of the common symptoms of lumbar spinal stenosis include weakness in a foot or leg, back pain, numbness or tingling sensation in a foot or leg, and pain or cramping in one or both legs especially when standing for prolonged periods of time and when walking.

Diagnosing Lumbar Spinal Stenosis

A review of the patient’s medical history and a physical examination are needed to diagnose lumbar spinal stenosis. As part of the physical exam, the doctor will examine the back and push on different areas to assess the location and quality of pain. The doctor may also ask the patient to bend forward, backward, and side-to-side to look for limitations in movement.

Additional tests may be required to help in diagnosing the condition. These may include X-rays, magnetic resonance imaging (MRI), and computed tomography (CT) scans.

How It Is Treated

Treatment for lumbar spinal stenosis depends on the severity of the symptoms. If there is only mild pain, the doctor may require regular follow-up appointments to monitor the patient’s condition. Self-care tips may also be given to help in alleviating the pain.

If self-care tips don’t work, the doctor may recommend other ways of relieving pain and other associated symptoms. These may include pain relievers, physical therapy, steroid injections, or a decompression procedure.

Lumbar spinal stenosis can be debilitating. For those whose quality of life is greatly compromised with the condition, surgery may be recommended.

Laminectomy and spinal fusion are some of the surgical options for lumbar spinal stenosis.

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