Bone Spurs (Osteophytes) – an Overview | Orthopaedics

What are bone spurs?

Bone spurs (also known as osteophytes) are hard and soft lumps of excess bone that form at the ends of bones. They often appear in the joints, the places where the two bones meet. They are also formed in the spine.

The main cause of bone spurs is the joint damage associated with osteoarthritis. Most bone spurs do not cause symptoms and have not been recognized for years. They may not need treatment. Whether treatment is needed depends on where the spurs are and how they affect your health.

Bone spurs form in many parts of your body, including:

  • Hands
  • Back
  • Neck
  • Spine
  • Fruits
  • Knees
  • Feet (heels)

Most bone spurs do not cause problems. But if they rub against other bones or press against nerves, you may experience pain and stiffness.

Symptoms of bone spurs

Most bone spurs cause no signs or symptoms. You may not realize you have bone spurs until an X-ray reveals an increase in another condition. In some cases, bone spurs can cause joint pain and movement.

The most common problem areas for bone spurs are:

  • Knee: Over time, bone spurs cause pain, stiffness, and limited mobility (how much the joint can move).
  • Hip: Spurs can reduce pain and range of motion.
  • Spine: Bony spurs in the spine can be a factor in the development of spinal stenosis, reducing the spine in the lower back. It pinches the nerves, causing pain, numbness, and weakness in the legs.
  • Shoulder: Shoulder movement is affected by rubbing the bone spurs against the tendons and muscles of the shoulder rotor cuff. This can lead to tendonitis (inflammation or irritation of the tendon) and a torn rotator cuff.
  • Hands: Bony spurs form in the finger joints. Loses mobility and gives the fingers a navel-like appearance.
  • Foot and Ankle: Bone spurs can form on the back or bottom of the heel (heel spurs). They can be painful and may require shoe inserts, stretching, or, as a last resort, surgery. Bone spurs are also common on the middle foot and big toe. Shoe insertion and modification before surgical consideration.

Causes of bone spurs

The most common cause of bone spurs is joint damage from osteoarthritis or degenerative joint disease. The cushioning between the joints and the spine can wear out with age. Rheumatoid arthritis, lupus, and gout can also damage the joints.

Bone spurs also often occur after a joint or tendon injury. When your body feels that your bone is damaged, it tries to fix it by attaching the bone to the injured area.

Other causes of bone spurs:

  • Overuse: for example, if you run or dance for a long time
  • Genes
  • Food
  • Ob arrears
  • Bone problems you were born with
  • Narrowing of the spine (spinal stenosis)

Risk factors for bone spurs

Aging is the biggest risk factor for bone spurs. Over time, all of your joints will suffer at least some wear and tear. This is true even if you have no obvious injuries. If you were born with structural problems like scoliosis (curved spine), your risk is even higher. Poor posture also increases the risk of osteophytes.

There may also be a hereditary factor. If you have parents who have osteophytes, they are more likely to have them.

Diagnosis of bone spurs

Oftentimes, osteophytes are first evaluated by your regular doctor, who will refer you to a specialist. You will probably need to see a rheumatologist or orthopedic doctor. Rheumatologists specialize in joint problems. Orthopedic doctors focus on the musculoskeletal system. Your doctor will feel the joint to look for a lump. You can also order an X-ray to help you see the bone marrow better.

Other tests your doctor may use to diagnose osteophytes:

  • Computed tomography: It is a powerful X-ray that produces detailed images of the inside of your body.
  • Magnetic resonance: It uses powerful magnets and radio waves to create images of organs and structures within your body.
  • Electroconductive tests: These tests measure how fast your nerves send electrical signals. They can show damage caused by osteophytes to the nerves in your spinal canal.

Bone spurs treatments and home care

To reduce pain and inflammation, you can try one of these over-the-counter pain relievers:

  • Acetaminophen (Tylenol)
  • Ibuprofen (Advil, Motrin)
  • Naproxen sodium (olive)

These can cause side effects, especially if you take them in large doses or for a long time. If you take them for more than a month, ask your doctor if you can try a different treatment.

Other treatments for osteophytes:

  • Chill out
  • Steroid injections to reduce inflammation and reduce joint pain.
  • Physiotherapy to improve joint strength and increase mobility.
  • If these treatments don’t work or the bone spur affects your mobility, you may need surgery to remove the excess bone.

Prevention of bone spurs

Osteophytes are often the result of the wear and tear of arthritis and cannot be prevented. But there are other things you can do to prevent osteophytes:

  • Wear shoes with a wide toe box, good arch support, and enough cushion to cushion you with every step. Have your shoes professionally adjusted so that your feet don’t rub when you walk. Wear thick socks to prevent your shoes from rubbing.
  • Eat a diet rich in calcium and vitamin D to protect your bones.
  • Do weight loss exercises, like walking or climbing stairs, to keep your bones strong.
  • Try to keep the extra pounds off.
  • See your doctor if you have joint problems such as pain, swelling, or stiffness. By catching and treating arthritis early, you can prevent damage that can lead to osteophytes.

Tips for pain management

Take the following steps to manage your bone pain:

  • To reduce the load on your joints, lose weight if you are overweight or balanced.
  • Wear good foot-support shoes to cushion your feet and other joints as you walk.
  • Start physical therapy to learn exercises that strengthen the muscles around the joint and stabilize it.
  • Maintain correct posture while standing or sitting to help maintain back strength and position your spine correctly.
  • Use over-the-counter pain relievers like ibuprofen when inflammation and pain are caused by a bone spur. Ask your doctor before taking anti-inflammatory medications.

Rotator Cuff Injury – Everything You Need To Know | Orthopaedics

What is a rotator cuff injury?

A rotator cuff injury is a group of muscles and ligaments that surround the shoulder joint, holding the head of the upper arm bone firmly within the shallow socket of the shoulder. Rotator cuff injury causes a dull pain in the shoulder, which is often aggravated by using the hand away from the body.

Rotator cuff injuries are common and increase with age. These can occur earlier in people who have jobs that require them to perform aerial movements repeatedly. Examples are painters and carpenters. Most people with rotator cuff injury can manage their symptoms and return to activity with physical therapy exercises that improve the flexibility and strength of the muscles around the shoulder joints.

Sometimes rotator cuff tears can occur as a result of a single injury. In those situations, a medical evaluation should be provided as soon as possible to discuss the role of surgery. Extensive rotator cuff tears may not resolve and replacement or replacement of the replacement ligament may be possible.

There are two types of rotator cuff tears. Partial tear when one of the muscles that make up the rotator cuff is fried or damaged. The other was a full tear. It passes through the tendon or pulls the tendon from the bone.

Rotator cuff injury is a common injury, especially in sports like baseball or tennis, or in jobs like painting or cleaning windows. Rotator cuff injury usually happens over time from normal wear and tears, or if you repeat the same arm motion over and over. But rotator cuff injury also can happen suddenly if you fall on your arm or lift something heavy.

Symptoms of rotator cuff injury

Pain associated with rotator cuff injury:

  • Describe it as a deep, dull ache in your shoulder.
  • Interrupt sleep
  • Comb your hair or make it harder to reach your back
  • Being with arm weakness

Rotator cuff injuries can cause pain in the shoulder and upper arm. Pain is most noticeable when stretching or stretching. When you lift your arm and twist it, the tendons are likely to rub against the surrounding structures. Because of this, your shoulder symptoms may get worse when you try to comb your hair or slide your hand up your sleeve. You may also have aching and lethargic shoulder pain at night.

Rotator cuff tears that affect a significant part of the tendon can cause shoulder weakness, limiting the hand’s ability to hold to the side or lift an object. The difficulty in using the shoulder due to pain is not that there are always tears. Rotator cuff injuries can cause pain in the shoulder and upper arm. Pain is most noticeable when stretching or stretching. When you lift your arm, the tendons are likely to rub against the surrounding structures. Because of this, your shoulder symptoms may get worse when you try to comb your hair or slide your hand up your sleeve. You may also feel lethargic and have shoulder pain at night.

Rotator cuff tears that affect a significant part of the tendon can cause shoulder weakness, limiting the hand’s ability to hold to the side or lift an object. The difficulty in using the shoulder due to pain is not that there are always tears.

What causes rotator cuff injury?

  • Rotator cuff injuries range from mild to severe. They fall into one of three categories.
  • Tendonitis is an injury caused by overuse of the rotator cuff. This caused it to flare up. Tennis players who use the overhand serve and painters who have to climb to do their job often suffer from this injury.
  • Bursitis is another common rotator cuff injury. It is caused by inflammation of the bursa. These are fluid-filled sacs that sit between the rotator cuff ligaments and the underlying bone.
  • Rotator cuff strains or tears can be caused by overuse or serious injury. The tendons that connect muscles to bones are partially or completely fractured (stressed) or torn.
  • The rotator cuff can become strained or torn even after a fall, a car accident, or another accidental injury. These injuries usually cause immediate and severe pain.

Risk factors for rotator cuff injury

The following factors can increase your risk of rotator cuff injury:

  • Years: As you get older, your risk of rotator cuff injury increases. Rotator cuff tears are more common in people over the age of 60.
  • Construction work: Professions such as carpentry or home painting require repetitive hand movements, often on the head, which can damage the rotator cuff over time.
  • Family history: There may be a genetic component associated with rotator cuff injuries because they are more common in some families.

Diagnosis of rotator cuff injury

To find out if you have a torn rotator cuff, your doctor will start with a history of injuries and a physical exam of the shoulder. During the test, they will check your mobility and muscle strength. They will also see movements that hurt your shoulder.

Also, your doctor may use one of the following:

  • An MRI that uses radio waves and a powerful magnet to create detailed images of your shoulder.
  • X-rays to see if the upper part of your arm bone (humeral head) is pushing towards the rotator cuff area
  • Ultrasound to view the soft tissues (tendons, muscles, and bursa) in your shoulder.

Rotator cuff injury treatment

Conservative treatments, such as rest, ice, and physical therapy, are sometimes necessary to recover from a rotator cuff injury. If your injury is severe, you may need surgery.


If conventional therapies do not relieve your pain, your doctor may recommend an injection of steroids into your shoulder joint, especially if the pain interferes with your sleep, daily activities, or physical therapy. These injections often help temporarily but should be used sparingly as they can contribute to tendon weakness and ultimately reduce the success of surgery if necessary.


Physical therapy is usually one of the first treatments prescribed by your doctor. Exercises tailored to the specific location of your rotator cuff injury can help restore flexibility and strength to your shoulder. Physical therapy is also an important part of the recovery process after rotator cuff surgery.


There are several types of surgery available for rotator cuff injuries, including:

  • Arthroscopic tendon repair: In this procedure, surgeons insert small incisions (arthroscope) and instruments through small incisions to reattach the damaged tendon to the bone.
  • Open tendon repair: In some cases, an open tendon repair is a good option. In these types of surgeries, your surgeon works through a large incision to reattach the damaged tendon to the bone.
  • Tendon transfer: If the damaged ligament is severely damaged and does not reattach to the arm bone, surgeons may decide to use a nearby ligament as an alternative.
  • Shoulder replacement: Severe rotator cuff injuries may require shoulder replacement surgery. To improve the stability of the artificial joint, an innovative procedure (reverse shoulder arthroplasty) places the ball part of the artificial joint on the shoulder blade and the part of the socket on the arm bone.

Complications of rotator cuff injury

Without treatment, rotator cuff problems can lead to permanent loss of mobility or weakness and progressive deterioration of the shoulder joint. While your shoulder may need to rest to recover, prolonged stabilization can cause the joint to thicken and tighten (frozen shoulder).

Prevention of rotator cuff injury

If you are at risk for rotator cuff injuries or have had a rotator cuff injury in the past, daily shoulder strengthening exercises can help prevent future injuries.

Most people exercise the front chest, shoulder, and upper arm muscles, but it is important to strengthen the muscles behind the shoulder and around the shoulder blade. Your doctor or physical therapist will help you plan your exercise routine.


Treatment and Types of Bone Fracture | Orthopaedics

What is a bone fracture?

A bone fracture is a medical condition in which the continuation of the bone is broken. A significant percentage of bone fractures occur due to high-energy impact or stress.

However, fractures can also be the result of certain medical conditions that weaken the bones, for example, osteoporosis, some cancers, or osteogenesis imperfecta (also known as brittle bone diseases).

Fractures are common (there are millions in the United States each year) and can be caused by several factors. People can break bones in sports injuries, car accidents, falls, or osteoporosis (weakening of the bones due to aging). Although most fractures are caused by injury, they can still be “pathological” (due to an underlying disease such as cancer or severe osteoporosis). There are more than a million “brittle” fractures each year due to osteoporosis. A broken bone requires immediate medical attention.

Symptoms of bone fracture

The signs and symptoms of a fracture vary depending on the bone effect, the age and general health of the patient, as well as the severity of the injury. However, they often have some of the following:

  • Pain
  • Inflammation
  • Injuries
  • Skin color around the affected area
  • Angulation – the affected area may bend at an unusual angle
  • The patient cannot put weight on the injured area
  • The patient cannot move the affected area
  • The affected bone or joint may have a rubbing sensation
  • If it is an open fracture, there may be bleeding
  • When a large bone like the pelvis or thigh is affected
  • The victim appears pale and flat.
  • May cause dizziness (feeling faint)
  • Feelings of sickness and nausea

If possible, do not move a person with a broken bone while a healthcare professional can assess the condition and, if necessary, place a splint. If the patient is in a dangerous location, such as in the middle of a busy road, action may need to be taken before emergency services arrive.

Types of bone fracture

Fractures generally describe their location, how the bones align, whether there are problems with blood and nerve function and whether the skin at the injury site is intact.

The terms and definitions used in medicine to describe fractures allow healthcare professionals to describe where the fracture is in the bone. For the reference point, the heart is considered central to the body and anatomical descriptions are based on its position as a reference to the heart. When describing a body or body position, stand with your hands slightly apart from your sides, imagine yourself standing and holding your palms forward.

There are some types of fractures, including:

Avulsion Fracture: A muscle or ligament that pulls on a bone and breaks it.

Reported Fracture: The bone is broken into many pieces.

Compression fracture (crush): Usually occurs in the soft bone of the spine. For example, osteoporosis can cause the front of the spine to collapse.

Fracture dislocation: A joint is displaced and one of the bones in the joint is broken.

Greenwood Fracture: The bone is partially fractured on one side, but not completely broken because the rest of the bone is bent. It is more common in children whose bones are softer and more elastic.

Hairline Fracture: A partial fracture of the bone. Sometimes this type of fracture is difficult to detect with routine x-rays.

Affected fracture: When a bone is broken, one part of the bone moves to another.

Intracellular fracture: Where the break extends to the surface of the joint.

Longitudinal fracture: The fracture occurs along the bone.

Inclined fracture: A fracture diagonal to the long axis of the bone.

Symptomatic Fracture: A fracture occurs when an underlying disease or condition has already weakened the bone (bone fracture due to an underlying disease or condition of the weak bone).

Spiral fracture: A fracture that distorts at least part of the bone.

Stress fracture: More common in athletes. Bone fractures due to repeated strains and strains.

Bull fracture: The bone is deformed but does not crack. More common in children. It is painful but constant.

Inverted fracture: Break directly through the bone.

Causes of bone fracture

Most cracks are caused by a bad fall or a car accident. Healthy bones are very hard and tough and can withstand surprisingly powerful impacts. As people age, two factors increase the risk of fracture, weak bones and an increased risk of falls.

Children who have a more physically active lifestyle than adults are also more likely to suffer fractures.

People with underlying diseases and conditions that weaken the bones are at risk for fractures. Examples of osteoporosis, infection, or tumor. As mentioned earlier, this type of fracture is called an asymptomatic fracture.

Frequent stresses and stress breaks as a result of running commonly found in professional athletes are also common causes of fractures.

Risk factors of bone fracture

Anyone can feel the crack. If you have brittle bones or low bone density, you are more likely to develop one. You are more likely to develop brittle bones:

  • Old
  • Have osteoporosis
  • There are endocrine or intestinal disorders.
  • Taking corticosteroids
  • They are physically inactive
  • Drinking alcohol
  • Smoke

Diagnosis of bone fracture

If you suspect you have a fracture, seek medical help immediately. Your doctor will ask about your symptoms and perform a visual exam of the injured area. You may be asked to move this area in some way to look for other signs of pain or injury.

If they think you have a fracture, your doctor will order X-rays. According to the American Academy of Orthopedic Surgeons, X-rays are the most common method for diagnosing fractures. They can create images of your bone and reveal signs of breaks or other damage. X-rays can also help determine the type and location of the fracture.

In some cases, your doctor may also order a magnetic resonance imaging (MRI) or computed tomography (CT or CAT) scan to examine your bones or surrounding tissues.

Treatment for bone fracture

Treatment also focuses on providing the injured bone with the best conditions for optimal healing (stabilization). For the natural healing process to begin, it is necessary to align the ends of the broken bone; This is called fracture reduction.

The patient usually falls asleep under general anesthesia when the reduction of the fracture occurs. Fracture reduction can be done by manipulation, closed reduction (removal of bone fragments), or surgery.

Stabilization: As soon as the bones are aligned, they should be stable while they heal. These may include:

Cast or functional plastic braces: These hold the bone in place until it heals.

Metal plates and screws: Current procedures may use minimally invasive methods.

Intramedullary nails: Internal metal rods placed between long bones. Flexible cables can be used for children.

External fixators: External fixators are made of metal or carbon fiber. They have steel pins that go directly to the bone through the skin. They are a kind of scaffolding outside the body.

Usually, the area of ​​the fractured bone remains stable for 2-8 weeks. The duration depends on the bone affected and if there are any problems, such as a blood supply problem or an infection.

Healing: If the fractured bone is properly aligned and stable, the healing process is usually straightforward.

Osteoporosis (bone cells) absorb old and damaged bone, while hollow bones (other bone cells) are used to create new bone.

The callus is the new bone that forms around the fracture. It forms on both sides of the crack and grows on each side until the crack space is filled. Eventually, the extra bone will soften and the bone will remain as before.

The patient’s age, the affected bone, the type of fracture, and the patient’s general health are factors that affect how quickly the bone heals. If the patient smokes regularly, the healing process will take longer.

Physiotherapy: After the bone has healed, it is necessary to restore muscle strength, as well as mobility in the affected area. If the fracture occurs near the joint, there is a risk of permanent stiffness or arthritis. The person may not bend the joint as well as the front.

Surgery: If there is damage to the skin and soft tissues around the affected bone or joint, plastic surgery may be necessary.

Backward unions and non-unions: Fractures that do not heal nonunion, delayed unions take longer to heal.

Ultrasound treatment: A low-intensity ultrasound is applied daily to the affected area. It was found to heal the fracture. Studies in this area are still ongoing.

Bone graft: If the fracture does not heal, natural or synthetic bone is transplanted to stimulate the broken bone.

Stem cell therapy: Studies are currently underway to determine if stem cells can be used to treat untreated fractures.

Complications of bone fracture

Cure in the wrong condition: This is called a Malonian. The fracture heals in the wrong place or changes (the fracture also changes).

Disruption of bone growth: If a childhood fracture affects the growth plate, there is a risk that the normal development of that bone will be affected, increasing the risk of a subsequent deformity.

Persistent infection of the bones or bone marrow: If the skin is broken, the compound can crack and cause bacteria to enter and infect the bone or bone marrow, which can develop into a chronic infection (chronic osteomyelitis).

Patients must be hospitalized and treated with antibiotics. Sometimes surgical drainage and curettage are required.

Bone death (avascular necrosis): The bone can die if it loses the necessary blood supply.

Prevention of bone fracture

Nutrition and sunlight: The human body needs an adequate supply of calcium for healthy bones. Milk, cheese, yogurt, and dark green leafy vegetables are good sources of calcium.

  • Our body needs vitamin D to absorb calcium; Exposure to sunlight, as well as eating eggs and oily fish are good ways to get vitamin D.
  • Vitamin D plays an important role in maintaining healthy bones.
  • Physical Activity: The more you exercise with the weight, the stronger and denser your bones will be.
  • Some examples are jumping, walking, running, and dancing, any exercise such as the body on the skeleton.
  • Aging is not the only cause of weak bones, often with less physical activity, further increasing the risk of weak bones. People of all ages need to be physically active.

Menopause: Estrogen, which regulates a woman’s calcium, drops during menopause, making calcium regulation much more difficult. Consequently, women need to be especially careful about the density and strength of their bones during and after menopause.

The following steps may help reduce post-menopausal osteoporosis risk:

  • Do several short weight-bearing exercise sessions each week
  • Do not smoke
  • Consume only moderate quantities of alcohol, or don’t drink it
  • Get adequate exposure to daylight

Make sure your diet has plenty of calcium-rich foods. For those who find this difficult, a doctor may recommend calcium supplements.


Causes and Treatment Options of Ganglion Cyst | Orthopaedics

What is a ganglion cyst?

A ganglion cyst is a small sac of fluid that procedures over a joint or tendon (tissue that connects muscle to bone). Inside the cyst is a thick, sticky, transparent, colourless, and gelatinous material. Depending on the size, the cysts may feel firm or soft.

Ganglion cysts, also known as biblical cysts, most commonly appear on the back of the hand at the wrist joint, but can also develop on the palm side of the wrist. They can appear in other areas as well, but these are less common:

  • The base of the fingers on the palm, where they appear as small pea-sized bumps.
  • The fingertip, fair below the cuticle, where they are called mucous cysts.
  • The outside of the knee and ankle.
  • Top of foot

Causes of a ganglion cyst

It is not known what triggers the creation of a ganglion. They are more common in younger people between the ages of 15 and 40, and women are more likely to be affected than men. These cysts are also common among gymnasts, who repeatedly apply tension to the wrist.

Ganglion cysts that develop at the end of a finger joint, also known as mucous cysts, are generally associated with arthritis in the finger joint and are most common in women between the ages of 40 and 70.

Symptoms of a ganglion cyst

The most common symptoms of a ganglion cyst comprise a visible lump, distress, and pain. If the cyst is on your foot or ankle, you may feel discomfort when ambulatory or wearing shoes. If it is near a nerve, a ganglion cyst can sometimes cause:

  • A loss of mobility
  • Numbness
  • Pain
  • A tingling sensation
  • Some ganglion cysts can get larger or smaller over time.

Diagnosis of a ganglion cyst

A doctor usually illuminates the cyst to see if its contents are transparent or opaque. In a ganglion cyst, the fluid will be clear and thick.

Imaging scans, such as an X-ray, ultrasound, or MRI scan, can help your doctor determine the cause of the nodule and rule out other problems.

Ganglion cyst treatment

Treatment for this disease can frequently be non-surgical. In many cases, these cysts can simply be seen, especially if they are painless. It usually disappears spontaneously. If the cyst becomes painful, limits activity, or is unacceptable, there are several treatment options available, including:

  • Splints and anti-inflammatory medications to decrease pain associated with activities.
  • The aspiration to remove fluid from the cyst and decompress it (this requires placing a needle into the cyst, which can be done in most office settings. Aspiration is a very humble procedure, but recurrence of the cyst is shared).
  • If nonsurgical options do not provide relief, or if the cyst recurs, there are surgical alternatives available. Surgery involves the removal of the cyst and may include the removal of a part of the joint capsule or tendon sheath. For wrist ganglion cysts, both traditional open and arthroscopic techniques often work well. Surgical treatment is generally successful, although cysts can recur. Your hand surgeon will discuss the greatest treatment options for you.

Risk factors for a ganglion cyst

Factors that can increase your risk of this disease may include:

  • Your gender and age: Ganglion cysts can develop in anyone, but they occur most often in women between the ages of 20 and 40.
  • Osteoarthritis: People who have wasting arthritis in the finger joints closest to the nails are at higher risk of developing ganglion cysts near those joints.
  • Joint or tendon injury: Joints or tendons that have been injured in the previous are more likely to develop this disease.


The prevention is not possible as the cause is unknown. The complications can be prevented through early diagnosis and treatment.


These are usually painless. But if cyst journalists on a nerve, even if the cyst is too small to form an obvious lump, it can cause pain, tingling, numbness, or muscle weakness.


Causes and Treatments of Medial Epicondylitis | Orthopaedics

What is medial epicondylitis (golfer’s or baseball elbow)?

Medial epicondylitis, also known as golfer’s elbow, baseball elbow, suitcase elbow, or right tennis elbow, is branded by discomfort from the elbow to the wrist on the inside (medial side) of the elbow. The pain is caused by damage to the tendons that curve the wrist to the palm. A tendon is a cord of robust tissue that attaches muscles to bones.

Causes of medial epicondylitis

Medial epicondylitis is caused by excessive force used to bend the wrist into the palm, such as swinging a golf club or throwing a baseball. Other likely causes of medial epicondylitis comprise the following:

  • Serving very hard in tennis or using a spin serve
  • Weak shoulder and wrist muscles
  • Using a tennis racket that is too short, too strung, or too heavy
  • Throw a javelin
  • Carrying a heavy suitcase
  • Chopping wood with an axe
  • Operating a chainsaw
  • Frequent use of other hand tools continuously.

Symptoms of medial epicondylitis

These are the most common symptoms of golf and baseball elbow (medial epicondylitis):

  • Pain and tenderness along the palm side of the forearm, from the elbow to the wrist, on the same side as the little finger; may appear suddenly or gradually
  • Pain can be felt when bending the wrist into the palm against resistance or when squeezing a rubber ball. Clenching your fist can also hurt.
  • Weakness in your hands and wrists.
  • Stiffness in your elbow
  • Numbness or tingling that may radiate to the fingers (usually the ring and little fingers)

Treatment of medial epicondylitis

Treatment for medial epicondylitis includes stopping the activity that causes the symptoms. It is important to avoid the movement that caused the condition in the first place. Treatment may include:

  • Application of ice packs (to reduce inflammation)
  • Strengthening exercises
  • Anti-inflammatory medicine
  • Bracing
  • Corticosteroid injections
  • Surgery (rare)

Medial epicondylitis diagnosis

If elbow pain does not improve, see a doctor. Your doctor may ask you questions about your symptoms, pain level, medical history, and any recent injuries. You will also need to provide information about your daily activities, including your job duties, hobbies, and recreational activities.

Your physician may whole a physical exam, which may include applying pressure to the elbow, wrist, and fingers to check for stiffness or discomfort.

Golfer’s elbow test:

A common way for a doctor to diagnose medial epicondylitis is by the following test:

Before diagnosing medial epicondylitis, your physician may order an X-ray of the inside of your elbow, arm, or wrist to rule out other likely causes of pain, such as a fracture or arthritis.

Complications of golfer’s elbow

Complications of this disease are rare. If a person stops doing the activity that caused the condition or does it less often, they will usually recover.

Only those who continue the problem activity, despite the pain, tend to experience more problems. In these cases, a person may require surgery to correct the condition.

Prevention of golfer’s elbow

There are several ways to prevent this disease. One way is to strengthen related muscles by doing exercises, such as those mentioned above.

Other steps include:

  • Use proper form during activities such as golf or tennis
  • Stretching before and after activity
  • Stop any activity that begins to cause pain

Risk factors for golfer’s elbow

You could be at a higher risk of developing a golfer’s elbow if:

  • 40 years or more
  • Do repetitive activity at least two hours a day.
  • Obese
  • A smoker

Symptoms and Types of Dislocated Shoulder | Orthopaedics

What is a dislocated shoulder?

A partial dislocation (subluxation) income that the skull of the arm bone (humerus) is partially out of the socket (glenoid). A Dislocated shoulder means that it is completely out of the hole. Both partial and complete dislocations cause pain and instability in the shoulder.

The shoulder joint is the most moveable in the body. It can alternate in many directions, but this advantage also makes the shoulder an informal joint to dislocate.

Symptoms of a dislocated shoulder

Symptoms of a dislocated shoulder include:

  • Deformity
  • Swelling
  • Numbness
  • Weakness
  • Bruises
  • Sometimes a dislocation can tear the ligaments or tendons in the shoulder or damage the nerves

The shoulder joint can be disrupted forward, backward, or downward. A common type of shoulder dislocation is when the shoulder slides forward (anterior instability). This means that the upper arm bone has moved forward and out of its socket. It can happen when the arm is placed in the launch position.

Types of a dislocated shoulder

There are 3 different types of shoulder dislocation:

  • Previous (forward): The head of the arm bone (humerus) moves forward, in front of the socket (glenoid)
  • Rear (behind): The head of the arm bone moves behind and above the socket
  • Lower (bottom)

Causes of a dislocated shoulder

The shoulder joint is the most moveable in the body and lets the arm move in many directions. This aptitude to move makes the joint integrally unstable and also makes the shoulder the most frequently dislocated joint in the body.

At the shoulder joint, the head of the humerus (upper arm bone) is located in the glenoid fossa, an extension of the scapula, or shoulder blade. Because the glenoid fossa is shallow, other structures are needed in and around the shoulder joint to maintain its stability.

Within the joint, the labrum (a fibrous ring of cartilage) spreads from the glenoid fossa and delivers a deeper receptacle for the humeral head. The capsule tissue that surrounds the joint also helps maintain stability. The rotator cuff muscles and tendons that move the shoulder provide a significant amount of protection and stability for the shoulder joint.

A dislocated shoulder occurs when the head of the humerus is forcibly removed from its socket in the glenoid fossa. It is likely to dislocate the shoulder in many different directions, and a dislocated shoulder is described by the site where the humeral head ends after it has been dislocated.

Ninety-five percent or more of shoulder displacements are anterior dislocations, meaning that the humeral head has moved to a location in front of the joint. Posterior dislocations are those in which the head of the humerus has moved back toward the shoulder blade. Other rare kinds of dislocations include luxation erecta, a lower dislocation below the joint, and intrathoracic, in which the humeral head develops stuck between the ribs.

Dislocations in younger people tend to arise from trauma and are often associated with sports (soccer, basketball, and volleyball) or falls. Older patients are prone to dislocations due to the gradual weakening of the ligaments and cartilage that support the shoulder. However, even in these cases, it is necessary to apply some force to the shoulder joint to dislocate it.

Forward dislocations often occur when the shoulder is in a vulnerable position. A common example is when the arm is held above the head with the elbow bent and a force is applied that pushes the elbow back and removes the humeral head from the glenoid fossa.

This scenario can occur when throwing a ball or hitting a volleyball. Anterior dislocations also occur during outstretched falls. An anterior dislocation includes external rotation of the shoulder; that is, the shoulder rotates absent from the body.

Posterior dislocations are rare and are often associated with specific injuries such as lightning, electrical injuries, and seizures. Occasionally, this type of dislocation can occur with minimal injury in the elderly, and because radiographs may not readily show a posterior dislocation, the diagnosis is often overlooked if the patient presents for evaluation of pain in the elderly. shoulder and/or decreased range of motion. of the shoulder joint.

A shoulder separation is a totally different injury and does not affect the glenohumeral joint of the shoulder. Instead, the acromioclavicular joint is affected. This is where the clavicle (clavicle) and the acromion (part of the shoulder blade) meet at the front of the shoulder.

A direct blow laterally, often from landing directly on the outside of the shoulder, damages the joint, the inner cartilage, and the many ligaments that maintain stability. While there may be pain and swelling at the end of the clavicle, the patient can usually move the shoulder a little.

Risk factors of a dislocated shoulder

Men in their teens or twenties, a group that tends to be physically active, are at higher risk for shoulder dislocation.

Diagnosis of a dislocated shoulder

To make a diagnosis, your healthcare provider will take a medical history and examine your shoulder. Your provider may also ask you to have an X-ray to confirm the diagnosis.

Treatment for a dislocated shoulder

Once your doctor has a clear understanding of your injury or a dislocated shoulder, your treatment will begin. To start, your physician will try a closed decrease on your shoulder.

Closed reduction: This means that your doctor will push your shoulder back into your joint. Your doctor may give you a mild sedative or muscle relaxant beforehand to help reduce any discomfort.

An X-ray will be done after the reduction to confirm that the shoulder is in the correct position. As soon as your shoulder lodges back in your joint, your pain should go away.

Immobilization: Once your shoulder has been restored, your physician may wear a splint or sling to keep your shoulder from moving while it heals. Your physician will tell you how long to keep your shoulder stable. Depending on your injury, it can be anywhere from a few days to three weeks.

Medicine: As you continue to heal and regain strength in your shoulder, you may need medicine to relieve pain. Your doctor may suggest ibuprofen (Motrin) or acetaminophen (Tylenol). You can also apply an ice pack to relieve pain and swelling.

If your doctor thinks you need something stronger, he or she may prescribe ibuprofen or acetaminophen, which you can get from a pharmacist. They can also refer to hydrocodone or tramadol.

Surgery: In severe cases, surgical intervention may be necessary. This method is a last resort and is only used if a closed discount has failed or if there is extensive damage to the surrounding blood vessels and muscles. In rare cases, a dislocation may have an associated vascular injury, either in a main vein or artery. This may require urgent surgery. Surgery on the capsule or other soft tissues may be essential, but usually at a later date.

Rehabilitation: A dislocated shoulder can be treated through physical rehabilitation can help you regain your strength and improve your range of motion. Rehabilitation generally includes supervised or guided exercise in a physical therapy center.

Your doctor will commend a physical therapist and advise you on your next steps. The type and duration of your rehabilitation will depend on the extent of your injury. You could take a few appointments a week for a month or more.

Your physical therapist can also give you exercises to do at home. There may be certain positions that you need to avoid to avoid another dislocation, or they may recommend certain exercises based on the type of dislocation you had. It is important to do them regularly and follow the instructions given by the therapist.

You should not participate in sports or any strenuous activity until your doctor considers it safe enough to do so. Doing these activities before your doctor says it can damage your shoulder even more.

Home care: You can cover your shoulder with ice or cold compresses to relieve pain and swelling. Apply a cold pack to your shoulder for 15 to 20 minutes at a time every two hours for the first 2 days.

You can also try a warm compress on your shoulder. The heat will help relax the muscles. You can try this method for 20 minutes whenever you feel the need.

Complications of a dislocated shoulder

Complications of a dislocated shoulder can include:

  • Tearing of the muscles, ligaments, and tendons that strengthen the shoulder joint
  • Damage to the nerves or blood vessels in or about the shoulder joint
  • Instability of the shoulder, especially if you have a severe dislocation or repeated dislocations, making you more prone to re-injury

If you stretch or tear the ligaments or tendons in your shoulder or injury the nerves or blood vessels around the shoulder joint, you may need surgery to overhaul these tissues.

Prevention of a dislocated shoulder

To help prevent a dislocated shoulder:

  • Take care to avoid falls
  • Wear protective gear when playing contact sports
  • Exercise frequently to maintain strength and suppleness in your joints and muscles

Once the shoulder joint has been dislocated, it may be more susceptible to future shoulder dislocations. To avoid a recurrence, shadow the specific strength and stability exercises that you and your doctor have deliberated for your injury.


Symptoms and Causes of Rheumatoid Arthritis | Orthopaedics

What is rheumatoid arthritis (RA)?

Rheumatoid arthritis is a chronic inflammatory disorder that can impact more than just your joints. In some people, the precondition can harm a variety of body systems, including the skin, eyes, lungs, and heart, and blood vessels. An immune system issue, rheumatoid arthritis inflammation happen when your invulnerable framework erroneously assaults your body’s tissues.

In contrast to the mileage from osteoporosis, rheumatoid arthritis inflammation impacts the covering of your joints, causing agonizing expansion that can at long last prompt bone erosion and joint deformation.

The aggravation related to rheumatoid arthritis inflammation is the thing that can harm different pieces of the body too. While new kinds of drugs have greatly improved treatment options, acute rheumatoid arthritis can cause physical disabilities.

Symptoms of rheumatoid arthritis

Rheumatoid arthritis is a chronic disease characterized by symptoms of inflammation and pain in the joints. These indications and signs happen during periods known as flares or intensifications. Other times are known as periods of remission when symptoms completely disappear.

While symptoms of rheumatoid arthritis can affect several organs in the body, symptoms of rheumatoid arthritis include:

  • Joint pain
  • Joint swelling
  • Joint stiffness
  • Loss of joint function and deformities

Symptoms can vary from mild to severe. It’s significant not to disregard your manifestations, regardless of whether they travel every which way. Knowing the early signs of rheumatoid arthritis will help you and your healthcare provider better treat and manage it.

Causes of rheumatoid arthritis

RA is an autoimmune disease. Your immune system, like bacteria and viruses, is supposed to attack foreign bodies in your body by causing inflammation. In autoimmune disease, the immune system mistakenly sends inflammation to healthy tissues. The immune system causes a lot of inflammation to be sent to your joints causing joint pain and swelling.

If the inflammation persists for an extended period of time, it can damage the joint. Usually, this damage cannot be reversed once it has occurred. The cause of rheumatoid arthritis is unknown. There is evidence that autoimmune diseases run in families. For example, some of the genes you were born with may make you more likely to develop rheumatoid arthritis.

Risk factors of rheumatoid arthritis

According to the Arthritis Foundation, women get rheumatoid arthritis two to three times more often than men. In women, symptoms tend to appear between the ages of 30 and 60, while men often develop symptoms later in life. There may also be a genetic basis for the disease. Cigarette smoking and periodontitis are also risk factors.

Diagnosis of rheumatoid arthritis

In its early stages, rheumatoid arthritis can be difficult for a doctor to diagnose because it can resemble other conditions. However, early diagnosis and treatment are essential to slow disease progression. The CDC recommends an effective diagnosis and treatment strategy to begin within 6 months of symptoms appearing.

The doctor will look at the person’s clinical signs of inflammation and ask how long they have been there and how severe the symptoms are. They will also perform a physical examination to check for any swelling, functional limitations, or deformity. They might recommend some tests.

Blood tests:

  • Erythrocyte sedimentation rate (ESR or sed rate): This test measures levels of inflammation in the body. It measures how quickly red blood cells in a test tube separate from blood serum over a specified period. If the red blood cells rapidly settle into deposits, levels of inflammation are elevated. This test is not specific to RA and is a useful test for inflammatory conditions or other infections.
  • C-reactive protein (CRP): The liver produces C-reactive protein. A high CRP level indicates inflammation in the body. This test is not specific to RA and CRP can occur in inflammatory conditions or other infections.
  • Anemia: Many people with rheumatoid arthritis also have anemia. Anemia happens when there are too scarcely any red platelets in the blood. Red platelets convey oxygen to the tissues and organs of the body.
  • Rheumatoid factor: If an antibody known as a rheumatoid factor is present in the blood, it can indicate the presence of rheumatoid arthritis. However, not everyone with rheumatoid arthritis is positive for this factor.

Imaging scans and X-rays: An X-ray or MRI of the joint can help the doctor determine the type of arthritis present and monitor the progression of rheumatoid arthritis over time.

Diagnostic criteria: In 2010, the American College of Rheumatology recommended the following criteria for diagnosing rheumatoid arthritis:

  • Swelling is present in at least one joint, and it has no other cause
  • Results of at least one blood test indicate rheumatoid arthritis
  • Symptoms have been present for at least 6 weeks

Treatment for rheumatoid arthritis

The goals of treating rheumatoid arthritis are:

  • Control of patient signs and symptoms
  • Prevent joint damage
  • Maintaining the patient’s quality of life and ability to function

Joint harm, by and large, happens inside the initial two years of determination, so it is critical to analyze and treat rheumatoid joint pain in a “window of opportunity” to forestall long-haul outcomes.

Treatments for rheumatoid arthritis include medication, rest, exercise, physical therapy / occupational therapy, and surgery to correct the damage to the joint.

The type of treatment depends on many factors, including the person’s age, general health, medical history, and the severity of arthritis.

Non-pharmacologic therapies

Non-drug therapy is the first step in treatment for all people with rheumatoid arthritis. Non-drug treatments include the following:

Rest: When joints become inflamed, the risk of injuring the joint and nearby soft tissue structures (such as tendons and ligaments) is high. This is why sore joints should be relieved. However, fitness should be maintained as much as possible. Maintaining a good range of motion in your joints and good overall fitness is important in dealing with the general features of the disease.

Exercise: Pain and stiffness often cause people with rheumatoid arthritis to become lethargic. However, inactivity can lead to loss of joint mobility, cramps, and loss of muscle strength. These, in turn, reduce joint stability and increase fatigue.

Regular exercise, especially in a controlled way with the help of physical therapists and occupational therapists, can help prevent and reverse these effects. Useful exercises include a range of motion exercises to maintain and restore joint mobility; Exercises to increase strength, and; Exercises to increase endurance (walking, swimming, cycling).

Physical and occupational therapy: Physical and occupational therapy can relieve pain, reduce inflammation, and help maintain joint structure and function for rheumatoid arthritis sufferers. Certain types of treatment are used to treat specific problems of rheumatoid arthritis:

  • Heat or cold can relieve pain or stiffness
  • Ultrasound can help reduce inflammation of the sheaths surrounding the tendons (tendinitis)
  • It can improve exercise and maintain joint range of motion
  • Resting and splinting can help reduce joint pain and improve joint function
  • Finger bracing and other assistive gadgets can forestall deformations and improve handwork
  • Relaxation techniques can relieve secondary muscle spasms

Occupational therapists also focus on helping people with rheumatoid arthritis to continue to actively participate in work and leisure activities, with special attention to maintaining the good function of the hands and arms.

Nutrition and dietary therapy: Weight reduction might be prescribed for overweight and hefty individuals to diminish weight on aroused joints. People with rheumatoid arthritis are more likely to have coronary artery disease. High blood cholesterol (a danger factor for coronary supply route malady) can react to changes in diet. A nutritionist can recommend specific foods to eat or avoid in order to reach your desired cholesterol level.

Diet changes have been investigated as treatments for rheumatoid arthritis, but no diet has been proven to treat it. There are no herbal or nutritional supplements, such as cartilage or collagen, that can treat rheumatoid arthritis. These treatments can be dangerous and are not usually recommended.


There are many medications to reduce joint pain, swelling, and inflammation and prevent or slow the disease. The type of medication your doctor recommends will depend on the severity of your arthritis and how well you respond to the medications.

These include medicines:

  • Non-steroidal anti-inflammatory drugs (NSAIDs), such as aspirin, ibuprofen, or naproxen
  • Corticosteroids (oral and injection forms)
  • COX-2 inhibitor (celecoxib [Celebrex®])
  • Disease-modifying antirheumatic drugs (DMARDs) such as hydroxychloroquine (Plaquenil), methotrexate (Rheumatrex, Trexall), sulfasalazine, and leflunomide

It may take four to six weeks of treatment with methotrexate, one to two months with sulfasalazine, and two to three months with hydroxychloroquine to see improvement in symptoms.

  • Biological agents, such as infliximab (Remicade), etanercept (Enbrel), adalimumab (Humira), certolizumab (Cimzia), golimumab (Simponi), tocilizumab (Actemra), rituximab (Rituxan), abatacept (Orencia) ), anakinra (Kineret), tofacitinib (Xeljanz)

Biology tends to work quickly, within two weeks for some drugs and within four to six weeks for others. Biopharmaceuticals may be used alone or in combination with other disease-modifying drugs. It is usually intended for patients who do not respond adequately to DMDs, or if a patient’s disease prognosis (outlook) is a problem.

Other precautions to be noted with these medications:

  • Cancer-modifying medications and biological agents interfere with the immune system’s ability to fight infection and should not be used by people with serious infections.
  • Anti-TNF agents such as infliximab, etanercept, adalimumab, certolizumab, and golimumab are not recommended for people with lymphoma or who have been treated for lymphoma. People with rheumatoid arthritis – especially those who are very ill – have an increased risk of developing lymphoma, regardless of the treatment used. Anti-TNF agents were associated with a further increase in the risk of developing lymphoma in some studies but not in others. More research is needed to determine this risk.
  • Tuberculosis (TB) test is required before starting anti-TNF treatment. People with evidence of TB should be treated earlier than TB because there is an increased risk of developing active TB while receiving anti-TNF treatment.

Some of these medicines are traditionally used to treat other conditions, such as cancer, inflammatory bowel disease, and malaria. When these medications are used to treat rheumatoid arthritis, doses are much lower and the risks of side effects tend to be much lower. However, the risks of side effects from treatment must be weighed against the benefits on an individual basis.

Whenever you have prescribed any medication, it is important to meet your doctor regularly so that he can monitor for any side effects.


When bone damage from arthritis becomes severe or pain is not controlled with medications, surgery is an option to restore function to the damaged joint.

Complications of rheumatoid arthritis

Since rheumatoid arthritis is a systemic disease, its inflammation can impact organs and areas of the body other than the joints.

  • The inflammation of the eye and mouth glands associated with arthritis can cause dryness in these areas and is referred to as Sjogren’s syndrome. Dry eyes can erode the cornea.
  • Inflammation of the white parts of the eye (sclera) is referred to as scleritis and can be very dangerous to the eye.
  • Rheumatoid inflammation of the lining of the lung (pleuritis) causes chest pain accompanied by deep breathing, shortness of breath, or coughing. The lung tissue itself can become inflamed and scarred, and sometimes inflammatory nodules (rheumatic nodules) develop inside the lungs.
  • Inflammation of the tissue (pericardium) surrounding the heart, called pericarditis, can cause chest pain that usually changes in intensity when lying down or bending forward.
  • Rheumatoid arthritis is associated with an increased risk of a heart attack.
  • Rheumatoid disease can decrease the number of red blood cells (anemia) and white blood cells.
  • Decreased white cells can be associated with an enlarged spleen (referred to as Felty’s syndrome) and can increase the risk of developing infections.
  • The risk of developing lymphoma (lymphoma) is higher in patients with rheumatoid arthritis, especially those with persistent active arthritis.
  • Hard lumps or hard bumps under the skin (subcutaneous nodules called rheumatic nodules) can occur around the elbows and fingers where there is repeated pressure. Although these nodules usually do not cause symptoms, they can sometimes become infected.
  • Nerves in the wrists can become pinched to cause carpal tunnel syndrome.
  • Inflammation of the blood vessels (vasculitis) is a rare serious complication, usually with chronic rheumatoid disease. Vasculitis can impair blood flow to tissues and lead to tissue death (necrosis). This often appears initially as small black areas around the nail bed or as leg sores.

Legg-Calve-Perthes Disease – an Overview | Orthopaedics

What is Perthes disease?

Perthes disease is a rare childhood disorder that affects the hip. It happens when the blood supply to the round head of the femur (thigh bone) is temporarily interrupted. Without an adequate blood supply, bone cells die, a process called avascular necrosis.

Although the term “disease” is still used, Perthes is actually a multifaceted process of stages that can last numerous years. As the condition progresses, the weakened bone in the head of the femur (the “ball” of the “ball” joint in the hip) gradually begins to collapse. Over time, the blood supply to the head of the femur returns, and the bone begins to grow again.

Treatment for Perthes emphasizes helping the bone grow back into a more rounded shape that still fits into the hole of the hip joint. This will help the hip joint to move normally and prevent hip problems in adulthood. The long-term prognosis for offspring with Perthes is good in most cases. After 18 to 24 months of treatment, most children return to their daily activities without major limitations.

Alternate name

Perthes disease, also known as Legg-Calve-Perthes

What causes perthes disease?

Technically, the ball of the femur dies because the blood supply is temporarily cut off. The reasons for this are not well understood. There is some evidence that genetics may play a role, but more studies are needed. The lack of a constant supply of blood to the ball of the femur causes a sequence of events. First, the bone cells in the head of the femur die.

Then weakness in this area causes the head of the femur to eventually collapse (usually over a two-year period) and lose its roundness; This is called “fragmentation”. The body then absorbs the damaged bone tissue. When the blood supply returns, new bone tissue begins to grow and takes the shape of a new head of the femur. This stage can last a few years. Finally, the bone recovers its final shape, although this final shape is not always a perfect round head.

How the head of the femur recovers and becomes rounded depends on the extent of the bone collapse and the age of your child at the time the disease process began. Bone tends to remodel better in younger children and improves as the child grows.

Risk factors for perthes disease

Risk factors for Legg-Calve-Perthes disease include:

  • Although Legg-Calve-Perthes disease can affect children of almost any age, it usually begins between the ages of 4 and 10.
  • The gender of your child. Legg-Calve-Perthes is about four times more common in boys than girls.
  • White children are more likely to develop the disorder than black children.
  • Genetic mutations. For a small number of people, Legg-Calve-Perthes disease appears to be connected to mutations in certain genes, but more studies are needed.

Perthes disease symptoms

The usual presenting symptom is limpness. This can be accompanied by pain, not just in the hip, but also in the knee, groin, or thigh. There may be stiffness in the affected hip (less movement than the other hip).

Perthes disease diagnosis

Hip X-rays can suggest and/or verify the diagnosis. Radiographs usually show a flattened and then fragmented femoral head. A bone scan or MRI can be helpful in making the diagnosis in cases where the x-rays are inconclusive. Simple radiographic changes are usually delayed 6 weeks or more from the clinical onset, so a bone scan and MRI are performed for early diagnosis.

The MRI results are more accurate, that is, 97-99% versus 88-93% on plain radiography. If an MRI or bone scans are necessary, a positive diagnosis is based on irregular areas of vascularization at the epiphysis of the femoral head (the developing femoral head)

Perthes disease treatment options

Nonoperative Treatment

It is very important to keep the joint moving. This is because the cartilage in the femoral head relies on the fluid in the joint, called synovial fluid, for its nutrition. Moving the hip helps supply the cartilage with this fluid.

It is also important to keep the head in the hip socket so that when the bone re-forms, it is as round and as well shaped as possible. Sometimes your child’s hip becomes stiff and may need help keeping the ball in the cup. Your doctor may recommend a period of casting, braces, and/or physical therapy to help achieve this.

Surgical Treatment

Surgery may be warranted to treat Legg-Calve-Perthes disease, but it is often not recommended for children younger than 6 years old. The goal of surgery is containment. The imprint is to keep the femoral head within the acetabulum. To do this, the pediatric orthopaedic surgeon can alter the angle of the femoral and/or acetabulum bones and fix them in a more anatomically correct position. This procedure, called an osteotomy, allows the femoral head to grow into its normal spherical shape.

Prevention of perthes disease

  • Limit activity: Evading high-impact activities, such as running and jumping, will help release pain and protect the femoral head. Sometimes your doctor may also recommend crutches or a walker to prevent your child from putting too much weight on the joint.
  • Physiotherapy exercises: Hip stiffness is common in children with Perthes disease, and physical therapy exercises are recommended to help restore range of motion to the hip joint. These exercises usually focus on hip abduction and internal rotation. Parents or other caregivers are often needed to help the child complete the exercises.

Complications of perthes disease

Complications of this condition include:

  • The head of the femur may lose its normal spherical shape and collapse
  • Degenerative joint disease can occur
  • The affected leg may lose some of its movement and become shorter than the other leg.
  • Children with Perthes disease are at higher risk of developing hip arthritis later in life.
  • Irregular contouring, flattening, or fungal growth on the head
  • Shortening and widening of the neck
  • Flattening of the vertical wall of the acetabulum

Chondrosarcoma | Preventive Measures | Orthopaedics

What is chondrosarcoma?

Chondrosarcoma is a bone sarcoma, main cancer composed of cells derived from transformed cells that produce cartilage. Chondrosarcoma is a member of a category of bone and soft tissue tumors known as sarcomas. About 30% of bone sarcomas are chondrosarcomas.

It is resistant to chemotherapy and radiation therapy. Different from other primary bone sarcomas that mainly affect children and adolescents, chondrosarcoma can current at any age. It affects the axial skeleton more frequently than the appendicular skeleton.

What causes chondrosarcoma?

As with many cancers, the cause of chondrosarcoma is not perfect. However, people with certain medical conditions are at higher risk of developing this disease. These conditions include:

  • Ollier disease
  • Maffucci syndrome
  • Multiple hereditary exostoses (MHE, also known as osteochondromatosis)
  • Wilms tumor
  • Paget’s disease
  • Illnesses in children that required previous treatment with chemotherapy or radiotherapy

Risk factors

While it can occur at any age, the most prevalent variety generally affects middle-aged to older adults.

Ollier’s disease and Maffucci syndrome are circumstances marked by an increased number of benign cartilage lesions (enchondromas) in the body. These lesions sometimes develop into chondrosarcoma.

Chondrosarcoma symptoms

The symptoms of this disease can vary contingent on the location of the tumor. The subsequent are the most shared symptoms of this disease. However, each individual may experience symptoms differently. Symptoms can include:

  • The large mass in the affected bone
  • The sensation of pressure around the dough.
  • Pain that gradually increases over time. It is usually worse at night and can be relieved by taking anti-inflammatory medications, such as ibuprofen. It is usually not relieved by rest.
  • Pain that is often worse at night and can be relieved with anti-inflammatory drugs, such as ibuprofen
  • Local swelling

Chondrosarcoma diagnosis

Plain X-ray:

Plain radiography is used for the initial evaluation. Plain radiographs can identify the cartilaginous nature and aggressiveness of the lesion. Plain X-rays can reveal the following findings:

  • Lytic lesions in 50% of cases
  • Intralesional calcifications: in approximately 70% of cases (popcorn calcification or ring and arch calcification)
  • Endosteal scallop
  • Penetrating or moth-eaten appearance in high-grade chondrosarcomas
  • Cortical remodelling, thickening, and periosteal reaction

CT scan:

Computed tomography can reveal the following findings:

  • Calcification of the matrix in 94% of the cases
  • Endosteal scallop
  • A cortical tear in about 90% of long bone chondrosarcoma
  • Heterogeneous contrast enhancement

Magnetic resonance imaging:

In typical forms, MRI shows a lobulated lesion with high signal intensity on T2 and a low or intermediate signal on T1-weighted images.

Tissue biopsy:

Tissue biopsy is essential to diagnose this disease and distinguish it from other malignant or benign bone tumors. A biopsy should be taken from the most aggressive portion of cancer as determined by imaging.

Chondrosarcoma treatment options

Chondrosarcomas are rare, so they are treated by a side of physicians and other healthcare professionals at a specialist hospital. This means you may have to travel to have treatment.

The treatment you have depends on:

  • The position and size of the cancer
  • If it has a feast to other parts of the body
  • The grade of the cancer
  • Your general health.

Surgery is the main treatment for this disease. Other treatments sometimes used are chemotherapy and radiotherapy. You may be offered some treatments as part of a clinical trial.


There is no known way to prevent this disease. People with rare bone-related conditions may be more likely to develop this disease. Also, some scientists have observed a connection between chondrosarcoma and injury to the affected area.


Tumor recurrence

Distant metastasis: The main site of metastasis is the lung. The rate of metastasis differs contingent on the degree of this disease.

  • Low grade: less than 10%
  • Intermediate grade: 10% -50%
  • High grade: 50% -70%.

Symptoms and Causes of Avascular Necrosis | Orthopaedics


What is avascular necrosis?

Avascular necrosis (AVN) is the death of bone tissue due to loss of blood supply. You may also hear it called osteonecrosis, aseptic necrosis, or ischemic bone necrosis. If left untreated, AVN can cause the bone to collapse. Avascular necrosis most often affects your hip. Other common sites are the shoulders, knees, and ankles.

Symptoms of avascular necrosis

The hip bone is the joint most commonly affected with avascular necrosis. AVN also commonly affects the knee. Less commonly, AVN affects the bones in these areas:

  • Shoulder
  • Ankle
  • Hands
  • Feet

In its early phases, AVN may not cause symptoms. As blood cells die and the disease progresses, symptoms may appear roughly in this order:

  • Mild or severe pain in or about the affected joint
  • Pain in the groin that extends to the knee
  • Pain that occurs when weight is placed on the hip or knee
  • Joint pain severe enough to limit movement

The pain can dramatically increase in intensity due to small breaks in the bone, called microfractures. These can cause the bone to collapse. Ultimately, the joint can break and develop arthritis. The time between the first symptoms and the inability to move a joint varies.

In general, it varies from a few months to more than a year. Symptoms can appear bilaterally, that is, on both sides of the body. If avascular necrosis grows in the jaw, symptoms comprise exposed bone in the jaw bone with pain or pus, or both.

Causes of avascular necrosis

Although the precise mechanism for the development of avascular necrosis is unknown, it is suspected that interruption of the blood supply to the affected bone plays a role. This can occur when a traumatic impact injures the blood vessels of the bone or when diseases produce areas of abnormal circulation.

There are many causes of avascular necrosis, but the vast majority of avascular necrosis is caused by traumatic injury to the affected bone (such as fracture and dislocation), the use of steroid medications (glucocorticoid medications such as prednisone and prednisolone, particularly when administered in high doses). dose), or excessive alcohol consumption.

Other risk factors for developing avascular necrosis include cigarette smoking, pregnancy, radiation and chemotherapy treatments, diseases of the bone marrow and blood (including sickle cell disease, leukemia, Gaucher disease, thalassemia), and diver’s disease. underwater (from the bone effects of Caisson’s disease, too). known as dysbarism or “the curves”). Avascular necrosis occurs more frequently in patients with certain underlying diseases, such as systemic lupus erythematosus, diabetes mellitus, vasculitis, and inflammatory bowel disease.

Currently, some researchers suspect that intravenous bisphosphonate medications, including zoledronate (Zometa) and pamidronate (Aredia), are used to reduce elevated calcium levels in cancer patients and to treat osteoporosis, which may grow the risk of avascular necrosis of the chin and bone. Ironically, some use bisphosphonates to treat bone pain and decrease disability in patients with avascular necrosis.

Risk factors of avascular necrosis

Risk factors include:

  • Injury
  • Use of steroids
  • Gaucher disease
  • Caisson disease
  • Alcohol consumption
  • Blood disorders, such as sickle cell anemia
  • Radiation treatments
  • Chemotherapy
  • Pancreatitis
  • Decompression sickness
  • Hypercoagulable state
  • Hyperlipidemia
  • Autoimmune disease
  • HIV

Diagnosis of avascular necrosis

  • An X-ray is usually the first test done when AVN is suspected. It can help distinguish AVN from other causes of bone pain, such as a fracture. Once the diagnosis is made, and in the latter stages of AVN, X-rays are helpful in monitoring the course of the condition.
  • MRI is sometimes used to diagnose AVN because it can detect AVN in the early stages when symptoms are not yet present.
  • Bone scans can also be used to diagnose AVN. They are helpful because a scan can show all areas of the body affected by AVN. However, bone scans do not detect AVN in the early stages.
  • A CT scan provides a three-dimensional image of the bone and can be helpful in determining the extent of bone damage.
  • Surgical procedures, such as a bone biopsy, can conclusively diagnose VAP but are not often performed.

Treatment for avascular necrosis

Treatment will be contingent on your symptoms, age, and overall health. It will also be contingent on the severity of the condition. The goal of treatment is to improve your ability to use the joint and stop further damage to the bone or joint. Treatments are needed to prevent the joints from breaking. They may include:

  • Medicines: They are used to control pain.
  • Assistive devices: They are used to reduce weight on the bone or joint.
  • Core decompression: For this surgery, the inner layer of bone is removed to reduce pressure, increase blood flow, and slow or stop the destruction of bones and joints.
  • Osteotomy: This procedure reshapes the bone and reduces stress on the affected area.
  • Bone injury: In this procedure, healthy bone is transplanted from another part of the body to the affected area.
  • Joint replacement: This surgery removes and substitutes an arthritic or injured joint with an artificial joint. This can be considered only after other treatments have failed to alleviate pain or disability.

Other treatments may comprise electrical inspiration and combination therapies to promote bone growth.

Complications of avascular necrosis

Untreated avascular necrosis worsens over time. Eventually, the bone can collapse. Avascular necrosis also causes the bone to lose its smooth shape, which could lead to severe arthritis.

Prevention of avascular necrosis

To reduce your risk of avascular necrosis and improve your overall health:

  • Restrict alcohol consumption: Excessive alcohol consumption is one of the main risk factors for developing avascular necrosis.
  • Keep cholesterol levels low: Small pieces of fat are the most common substance that blocks the blood supply to the bones.
  • Monitor steroid use: Be sure to tell your doctor about your past or present use of high-dose steroids. Steroid-related bone damage seems to worsen with repeated cycles of high-dose steroids.
  • Do not smoke: Smoking increases your risk.