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Musculoskeletal system
Published in A Stewart Whitley, Jan Dodgeon, Angela Meadows, Jane Cullingworth, Ken Holmes, Marcus Jackson, Graham Hoadley, Randeep Kumar Kulshrestha, Clark’s Procedures in Diagnostic Imaging: A System-Based Approach, 2020
A Stewart Whitley, Jan Dodgeon, Angela Meadows, Jane Cullingworth, Ken Holmes, Marcus Jackson, Graham Hoadley, Randeep Kumar Kulshrestha
Elbow ultrasound is used in the investigation of: Lateral pain that increases with active extension of the wrist.Posterior pain, particularly in the presence of olecranon bursitis (or student’s elbow) and triceps tendinosis or tear.Medial pain, in the suspicion of medial epicondylitis, worsened by resisted forearm pronation and wrist flexion, or in the assessment of entrapment or subluxation of the ulnar nerve.Anterior pain related to biceps tendinosis or tear.
Joint and soft tissue corticosteroid injection: what is the evidence?
Published in David Silver, Silver's Joint and Soft Tissue Injection, 2018
Medial epicondylitis or ‘golfer’s elbow’ is less common than lateral epicondylitis but is often observed in labourers and those involved in repetitive wrist flexion and throwing athletes. Stahl et al7 showed symptom improvement following corticosteroid administration at 6 weeks compared with controls, but no difference at 3 or 12 months.
History taking and clinical examination in musculoskeletal disease
Published in Professor Sir Norman Williams, Professor P. Ronan O’Connell, Professor Andrew W. McCaskie, Bailey & Love's Short Practice of Surgery, 2018
Professor Sir Norman Williams, Professor P. Ronan O’Connell, Professor Andrew W. McCaskie
Medial epicondylitis (synonym = golfer's elbow). The medial epicondyle is the common origin of the forearm flexors and the pronator muscle. Palpate the medial epicondyle for tenderness. The diagnostic test is resisted wrist flexion, which reproduces the pain over the medial epicondyle.
Erognomic education on housework for women with upper limb repetitive strain injury (RSI): a conceptual representation of therapists’ clinical reasoning
Published in Disability and Rehabilitation, 2018
Therma W. C. Cheung, Lindy Clemson, Kate O’ Loughlin, Russell Shuttleworth
Repetitive strain injury (RSI) refers to a soft tissue disorder either caused by the overloading of certain muscle groups from repetitive use or by maintaining constrained posture during activities [1]. Upper limb RSI simply refers to the condition’s location in the body. There are many alternative terms that describe the condition. These include: upper extremity musculoskeletal disorders (UEMSDs) [2], or work-related neck and upper limb musculoskeletal disorders (WRULDs) [3], or upper extremity disorders (UEDs) [4]. All refer to a similar cluster of conditions in the upper limbs. Twelve diagnostic groups are classified as upper limb work-related musculoskeletal disorders [5] under the Swedish National Institute for Working Life classification system, referred to as upper limb RSI within the context of this article. They include: radiating neck pain, rotator cuff syndrome, medial epicondylitis, lateral epicondylitis, ulna nerve entrapment in the cubital tunnel, radial tunnel syndrome, flexor and extensor tendinitis at the hand and fingers, De Quervain tenosynovitis, carpal tunnel syndrome, ulnar nerve entrapment in Guyon’s tunnel, Raynaaud’s phenomenon or peripheral neuropathy related to vibrations of the hand and arm, and osteoarthritis of the elbow, wrist, and fingers.
Clinical potential of implantable wireless sensors for orthopedic treatments
Published in Expert Review of Medical Devices, 2018
Salil Sidharthan Karipott, Bradley D. Nelson, Robert E. Guldberg, Keat Ghee Ong
Orthopedic injuries [1] can be traumatic injuries like bone fractures and ligament tears [7], or cumulative injuries (also called repetitive strain injuries (RSIs) or overuse syndromes) like cubital tunnel syndrome and lateral/medial epicondylitis [8]. Traumatic injuries are caused by the exposure to a sudden external force on the body, or from underlying pathological conditions like osteopenia and mechanical weakness due to implants [9]. The number of bone fractures, just one type of traumatic injury, varied between 12 million to 15 million from 1998 to 2010, with the majority of them upper limb injuries. A total of $59.5 million was spent on hospital care for bone fractures alone in 2011, which accounts for 72% of all traumatic orthopedic injuries [6]. On the other hand, RSIs are commonly caused by repetitive motion, recurrent micro-trauma, or sustained awkward positioning [1]. RSIs take a heavy toll on the economy due to the high costs associated with absence from work by the patients. On average, a worker’s compensation claim due to RSIs ranges from $5000 to $8000, with the total cost reaches $6.5 billion per year in the US alone [8].
Is average club head speed a risk factor for lower back injuries in professional golfers? A retrospective case control study
Published in The Physician and Sportsmedicine, 2021
Hayden P. Baker, William Mosenthal, Charles Qin, Elan Volchenko, Aravind Athiviraham
We identified 36 golfers who withdrew from PGA events during the study period. Of those 36 golfers 14 suffered lower back injuries and were included in this study. Other injuries identified in the cohort included the following: 5 ankle sprains, 4 shoulder labrum tears, 3 medial epicondylitis, 2 foot stress fractures, 1 meniscal tear, 1 triceps strain, 2 wrist sprains, and 2 oblique strain, We did not exclude any PGA golfers who were identified as having suffered a back injury. Of the 14 golfers we identified, 3 of them had spine surgery (1 microdisectomy, 2 posterior interbody fusions) for management of their back injuries. There were 28 age matched controls included in the control group. All age matched controls were active PGA tour golfers in 2019 who were not included in the injured group. The average number of events participated in yearly by PGA golfers (injured cohort excluded) over the 3 seasons included in this study was 24.4 (SD: 4.4), with a maximum and minimum of 8 and 35 respectively. The average number of events participated in by the injured group during the year the injury occurred was 14.1 (SD 8.1), approximately 10 events less than the tour average. The average weeks missed due to injury was 10. The rate of injury (all injuries) requiring a PGA golfer to withdraw from an event due to injury over 3 years was 0.03 per 1000 AE. While the rate of lower back injuries requiring a PGA golfer to withdraw from an event was 0.012 per 1000 AE. We found average club head speed of PGA golfers to be normally distributed using the Shapiro Wilk test for normal distribution. The injured group had a higher mean club head speed when compared with the control group, 116.5 (110.3–120.4) mph versus 112.2 mph (105.2–120.1) respectively P = <0.01 (Table 1). There was a significant difference in number of PGA events played during the season of injury (Average 14.2 events; SD 8.3) when compared with age matched control (Average 20.6; SD 6.9) P = 0.01. Of the 14 golfers included in the injured group 5 of them have not returned to play from their lower back injury; 3 of them are playing competitively 1 year after their injury, and 1 of those 3 injured had a 2 mph drop in their average club head speed 1 year out from injury, the other two showed no significant difference in their club head speed following the injury; the other 6 were injured in 2019 and not enough data is currently available to claim that the injury has significantly impacted their average club head speed. Descriptive statistics are listed in (Table 2).