Question

Complete the following table with brief description of what these conditions or terminologies mean.

Condition/Terminology Description

.1)     Bursitis

2.2)     Carpel Tunnel Syndrome

2.3)     Muscular Dystrophy

2.4)     Myalgia

2.5)     Osteoarthritis

2.6)     Osteomyelitis

2.7)     Osteoporosis

2.8)     Scoliosis

2.9)     Sprain

2.10)     Total Knee Replacement

Answer 1

ANSWER:-

1. Bursitis :

Bursitis is defined as inflammation of a bursa. Humans have approximately 160 bursae. These are saclike structures between skin and bone or between tendons, ligaments, and bone. The bursae are lined by synovial tissue, which produces fluid that lubricates and reduces friction between these structures.

Bursitis occurs when the synovial lining becomes thickened and produces excessive fluid, leading to localized swelling and pain.The following bursae are most commonly affected:

• Subacromial

• Olecranon

• Trochanteric

• Prepatellar

• Infrapatellar

2. Carpel Tunnel Syndrome : Carpal tunnel syndrome (CTS) is a collection of characteristic symptoms and signs that occurs following compression of the median nerve within the carpal tunnel. Usual symptoms include numbness, paresthesias, and pain in the median nerve distribution. These symptoms may or may not be accompanied by objective changes in sensation and strength of median-innervated structures in the hand.

3. Muscular Dystrophy : Muscular dystrophy (MD) is a collective group of inherited noninflammatory but progressive muscle disorders without a central or peripheral nerve abnormality. The disease affects the muscles with definite fiber degeneration but without evidence of morphologic aberrations.

4. Myalgia : Myalgia, or muscle pain, is a symptom of many diseases and disorders. The most common causes are the overuse or over-stretching of a muscle or group of muscles. Myalgia without a traumatic history is often due to viral infections. Longer-term myalgias may be indicative of a metabolic myopathy, some nutritional deficiencies or chronic fatigue syndrome.

5. Osteoarthritis : It can be thought of as a degenerative disorder arising from the biochemical breakdown of articular (hyaline) cartilage in the synovial joints. However, the current view holds that osteoarthritis involves not only the articular cartilage but the entire joint organ, including the subchondral bone and synovium.

Symptoms of osteoarthritis include the following:

• Deep, achy joint pain exacerbated by extensive use - The disease’s primary symptom

• Reduced range of motion and crepitus - Frequently present

• Stiffness during rest (gelling) - May develop, with morning joint stiffness usually lasting for less than 30 minutes

6.Osteomyelitis : Osteomyelitis is inflammation of the bone caused by an infecting organism. Although bone is normally resistant to bacterial colonization, events such as trauma, surgery, the presence of foreign bodies, or the placement of prostheses may disrupt bony integrity and lead to the onset of bone infection. Osteomyelitis can also result from hematogenous spread after bacteremia. When prosthetic joints are associated with infection, microorganisms typically grow in biofilm, which protects bacteria from antimicrobial treatment and the host immune response.

Early and specific treatment is important in osteomyelitis, and identification of the causative microorganisms is essential for antibiotic therapy. ^[1] The major cause of bone infections is Staphylococcus aureus. Infections with an open fracture or associated with joint prostheses and trauma often must be treated with a combination of antimicrobial agents and surgery. When biofilm microorganisms are involved, as in joint prostheses, a combination of rifampin with other antibiotics might be necessary for treatment.

7. Osteoporosis :

Osteoporosis generally does not become clinically apparent until a fracture occurs. Two thirds of vertebral fractures are painless. Typical findings in patients with painful vertebral fractures may include the following:

• The episode of acute pain may follow a fall or minor trauma

• Pain is localized to a specific, identifiable, vertebral level in the midthoracic to lower thoracic or upper lumbar spine

• The pain is described variably as sharp, nagging, or dull; movement may exacerbate pain; in some cases, pain radiates to the abdomen

• Pain is often accompanied by paravertebral muscle spasms exacerbated by activity and decreased by lying supine

• Patients often remain motionless in bed because of fear of causing an exacerbation of pain

• Acute pain usually resolves after 4-6 weeks; in the setting of multiple fractures with severe kyphosis, the pain may become chronic

8. Scoliosis : scoliosis is the most common type of spinal deformity confronting orthopedic surgeons.Its onset can be rather insidious, its progression relentless, and its end results deadly. Proper recognition and treatment of idiopathic scoliosis help to optimize patient outcomes. Once the disease is recognized, effective ways exist to treat it.

Scoliosis represents a disturbance of an otherwise well-organized 25-member intercalated series of spinal segments. It is, at times, grossly oversimplified as mere lateral deviation of the spine, when in reality, it is a complex three-dimensional (3D) deformity. In fact, some have used the term rotoscoliosis to help emphasize this very point. Two-dimensional (2D) imaging systems (plain radiographs) remain somewhat limiting, and scoliosis is commonly defined as greater than 10° of lateral deviation of the spine from its central axis.

9.

An ankle sprain is usually that of an inversion-type twist of the foot, followed by pain and swelling. The most commonly injured site is the lateral ankle complex, which is composed of the anterior talofibular, calcaneofibular, and posterior talofibular ligaments. ^{[1, 2, 3, 4]}

Signs and symptoms

Signs and symptoms of an ankle sprain include the following:

• Pain/tenderness

• Swelling and/or bruising

• Cold foot or paresthesia (possible neurovascular compromise) ^[1]

• Muscle spasm

10. Total Knee Replacement :

The primary indication for total knee arthroplasty (TKA; also referred to as total knee replacement [TKR]) is relief of significant, disabling pain caused by severe arthritis.

TKA is performed as follows:

• The knee joint is usually approached anteriorly through a medial parapatellar approach, though some surgeons use a lateral or subvastus approach

• Bone cuts in the distal femur are made perpendicular to the mechanical axis, typically using an intramedullary alignment system (which is then checked against the center of the hip)

• The proximal tibia is cut perpendicular to the mechanical axis of the tibia using either intramedullary or extramedullary alignment rods

• Restoration of mechanical alignment is important to allow optimum load sharing and prevent eccentric loading through the prosthesis

• Sufficient bone is removed so that the prosthesis recreates the level of the joint line

• Ligaments around the knee that are contracted because of preoperative deformity are carefully released in a stepwise fashion

• Patellofemoral tracking is assessed with trial components in situ and balanced if necessary with a lateral release or medial reefing procedure

• If the patellofemoral joint is significantly diseased, it can be resurfaced with a polyethylene button

• Once the definitive prosthetic components have been selected, they are cemented into place with polymethyl methacrylate cement

• If an uncemented system is being used, press-fit and bony ingrowth provide fixation of the component

• Foot pulses are checked at the end of the procedure