Ortho Oracle - orthopaedic operative atlas

Rheumatoid Nodules

– Discussion:     – RA may cause symptoms because of pressure and location;     – nodules may be cosmetically unacceptable;     – nodulosis occurs in 20-25% of patients with RA     – associated with strong seropositivity;     – implies aggressive disease with poor prognosis;     – may occur in benign … Read more

Rheumatoid Trigger Finger

– See: Rheumatoid Hand – Sites of Triggering in the Rheumatoid Patient:     – A1 pulley (as w/ convential trigger finger)     – FDS decussation (may require excising slip of sublimis or an intratendinous nodule);     – nodule in FDP near A2 can cause finger to lock into extension; – Non Operative … Read more

Rhomboids

  – Rhomboid Major:     origin: spinous process of 2nd to 5th thoracic vertebrae;     insertion: medial border of scapula from spine to inferior angle;     action: adducts scapula and elevation of medial border; the inferior fibers aid in rotating the glenoid cavity inferior;     nerve supply: dorsal scapular (C4, C5); … Read more

Rheumatoid Forefoot

– See:        – Hyperpronation of Rheumatoid Foot;        – Rheumatoid Arthrtis        – Rheumatoid Foot – Discussion:     – most commonly affected portion of the rheumatoid foot;     – typical forefoot deformities are hallux valgus, hyperextension of MP joints, and flexion ofthe IP joints of the … Read more

Rheumatoid Gamekeeper’s Thumb

– See: Traumatic Gamekeeper’s Thumb – Discussion: – characterized by abduction deformity of MCP joint; – results from attenuation of ulnar collateral ligament; – there is also an adduction contracture of the metacarpal; – Exam: – stability of the MCP joint should be tested by applying an ulnarly      directed force to joint, both … Read more

Rheumatoid Hand

– See: Rheumatoid Arthritis – Pathoanatomy: – RA Disease in the Wrist – Extensor Tendon Rupture – Tenosynovitis – diff dx: w/ RF negative tenosynovitis consider myobacterium marium infection; – Flexor Tendon Rupture – Ulnar drift – MP joint – PIP Joint – Boutonniere – Swan Neck Deformity – Thumb Deformities – Intrinsic Contracture – … Read more