– Use of Medications in Pregnancy: – calcium supplementation – intra-articular steroids – note that intra-articular steroids may interfere w/ lactation in nursing mothers; – ref: The use of antirheumatic medication during pregnancy and in the puerperium. – Surgical Considerations: – positioning: – avoid supine positioning because of hypotensive effects from aortocaval compression by the … Read more
– Discussion: – multidirectional instability implies three-way subluxations or dislocations either anteriorly, posteriorly, or inferiorly; – these patients usually have no true Bankart lesion and incontrast patients have a capacious axillary pouch; – ref: The Effect of Variation in Definition on the Diagnosis of Multidirectional Instability of the Shoulder. – … Read more
– Mosaicplasty: – refers to the technique of harvesting small circular (4-8 mm) autogenous grafts from the knee from non wt bearing regions of the knee, and transplanting the grafts in a mosaic pattern until the osteochondral defect is filled; – typically the grafts are harvested from the periphery of the supero-lateral trochlea, but often, the … Read more
– See: MP joint in RA – Planning: – indications: – irretrievable articular cartilage damage; – volar subluxation; – dislocation are indications for surgery; – cautions: – cervical spine … Read more
– Discussion: – index finger is most commonly involved, often found in older pts w/degenerative arthritis; – Etiology: – muscular contracture or trauma; – collateral ligament or volar plate tethering on prominent MP head or osteophyte (on either side or volar aspect of metacarpal head); – torn palmar … Read more
– Discussion: – it is not a neuroma but a perineural fibrosis and it was not first accurately described by Morton but by Durlacher, a chiropodist in 1845; both Thomas G. Morton (1876) and Thomas K. Morton (1892) mistook it for a painful affection of the fourth MTP articulation – it is a type of nerve compression … Read more
– Discussion: – adult: – 0.1-0.3 mg/kg/dose IM/IV/SC – 8-20mg PO q4hr, 30mg (MS Contin) PO q8-12 hr / 5-15 mg SQ/IM q4hr – IM/SC: Max. analgesic effect at 45-60 min; duration 3-4 hrs; t/2: 2-3 hr; … Read more
– Discussion: – for evaluation of both the patella and trochlea surfaces of femur; – disadvantages: – this view does not necessarily predict which patients will show functional improvements w/ surgical realignment; – as pointed out by O’Neil (1997) some patients … Read more
– Discussion: – semilunar cartilages are extensions of tibial articulation of knee; – w/o menisci, tibial articulation is incongruous with the femur; – microscopic features – vascular anatomy – anatomy: – medial meniscus – bucket handle meniscus tear – posterior horn tears of medial meniscus – lateral meniscus – discoid meniscus – ref: A Quantitative … Read more
– Discussion: – most common form of plica; – located over the medial femoral condyle; – vulnerable to direct trauma when the knee is flexed; – repeated trauma or irritation may lead to inflammation and fibrosis of the plica; – fibrotic plica has decreased elasticity which causes … Read more