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Anterior Tibial Tendinopathy

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1. Anterior Tibial Tendinopathy

Anterior Tibial Tendinopathy Anterior Tibial Tendinopathy Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Anterior Tibial Tendinopathy (...) Anterior Tibial Tendinopathy Aka: Anterior Tibial Tendinopathy , Anterior Tibial Tendonitis , Tibialis Anterior Tendinitis From Related Chapters II. Physiology Anterior tibial tendon function dorsiflexion (major function) adduction inversion III. Causes Forced dorsflexion against resistance of a plantar flexed foot (eccentric stress on tibialis anterior tendon) Distance Soccer or football Chronic overuse in age over 45 years IV. Signs Pain localized to the anterior ankle Palpable mass in low anterior

2018 FP Notebook

2. Anterior Tibial Tendinopathy

Anterior Tibial Tendinopathy Anterior Tibial Tendinopathy Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Anterior Tibial Tendinopathy (...) Anterior Tibial Tendinopathy Aka: Anterior Tibial Tendinopathy , Anterior Tibial Tendonitis , Tibialis Anterior Tendinitis From Related Chapters II. Physiology Anterior tibial tendon function dorsiflexion (major function) adduction inversion III. Causes Forced dorsflexion against resistance of a plantar flexed foot (eccentric stress on tibialis anterior tendon) Distance Soccer or football Chronic overuse in age over 45 years IV. Signs Pain localized to the anterior ankle Palpable mass in low anterior

2015 FP Notebook

3. Achilles Pain, Stiffness, and Muscle Power Deficits; Midportion Achilles Tendinopathy Revision

foot function as a risk factor for lower-limb overuse injuries included only 1 study related to Achilles tendinopathy. This prospective study found altered posterior/anterior force displacement and an increase in later- ally directed force distribution underneath the forefoot as risk factors for developing Achilles tendinopathy in runners who were noted to be “heel-strikers.” 200 A prospective cohort study not included in this review found that runners who displayed more medial pressure during (...) - mum, 479). 140 in gluteus medius function in those with Achilles tendinopa- thy. A study not included in this review found weakness in the hip abductors, external rotators, and extensors bilaterally in recreational male athletes with chronic midportion Achil- les tendinopathy. 86 Other studies have specifically identified neuromuscular deficits in the gluteus maximus, 70 rectus femoris, 214 tibialis anterior, 214 lateral gastrocnemius, 214 and triceps surae muscle complex 204 ; altered hip, knee

2018 The Orthopaedic Section of the American Physical Therapy Association (APTA), Inc.

4. Exercise Therapy for Patellar Tendinopathy Evaluated With Advanced UTE-MRI

for eligibility information Ages Eligible for Study: 18 Years to 35 Years (Adult) Sexes Eligible for Study: All Accepts Healthy Volunteers: No Criteria Inclusion Criteria: Age 18-35 years old (the chosen age range will minimize chances of other conditions causing anterior knee pain such as osteoarthritis and osteochondrotic diseases like Sinding-Larsen-Johansson syndrome and Osgood-Schlatter disease) History of knee pain in patellar tendon or its patellar or tibial insertion in association with training (...) Exercise Therapy for Patellar Tendinopathy Evaluated With Advanced UTE-MRI Exercise Therapy for Patellar Tendinopathy Evaluated With Advanced UTE-MRI - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before adding more. Exercise

2016 Clinical Trials

5. Clinical Trial to Evaluate the Adjuvant Effect of Shock Wave Therapy in the Insertional Achilles Tendinopathy

therapies; Any physical or social limitation that makes the protocol continuation unviable; Impossibility or incapacity to sign the Free Informed Consent Form; History or documented evidence concerning the blood coagulation disorders (treatment with anti-coagulant, excluding aspirin); Use of heart pacemaker; Presence of infectious process (superficial on skin and cellular tissue, or deep in the bone) in the region to be treated; Non-palpable anterior or posterior tibial pulse; or abnormal capillary (...) Clinical Trial to Evaluate the Adjuvant Effect of Shock Wave Therapy in the Insertional Achilles Tendinopathy Clinical Trial to Evaluate the Adjuvant Effect of Shock Wave Therapy in the Insertional Achilles Tendinopathy - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies

2016 Clinical Trials

6. Overview of sport-related injuries

be particularly vulnerable to developing this condition due to repetitive movements of the hand and wrists involved. A general term that describes tendon degeneration characterised by a combination of pain, swelling, and impaired performance. Approximately 10% of runners develop Achilles tendinopathy, presenting with insidious onset of heel pain, often after a sudden increase in training intensity. Patellar tendinopathy (jumper's knee) is common in jumping sports or activities that involve repetitive knee (...) extension (e.g., volleyball, basketball, and football). Patients present with an insidious onset of well-localised anterior knee pain located at the inferior pole of the patella. Lower back pain (LBP) is a symptom, but not a diagnosis. The majority of patients (85% or more) who present to primary care have low back pain that cannot reliably be attributed to any specific cause (nonspecific low back pain). Chou R, Qaseem A, Snow V, et al.; Clinical Efficacy Assessment Subcommittee of the American College

2018 BMJ Best Practice

7. AIM Clinical Appropriateness Guidelines for Joint Surgery

Test ? Tenderness over the AC joint ? Imaging findings (x-ray or MRI) consistent with AC joint arthritis o Moderate to severe degenerative joint disease of the AC joint, distal clavicle edema, or osteolysis of the distal clavicle on MRI o Moderate to severe AC joint arthritis on x-ray ? Failure of at least twelve (12) weeks of conservative management Tendinopathy of the Long Head of the Biceps All of the following are required: ? Anterior shoulder pain, weakness ? Tenderness over the biceps groove (...) infections) or open wound within the planned surgical site of the shoulder ? Rapidly progressive neurological disease ? Deltoid or rotator cuff paralysis Labral Tear (including Superior Labral Anterior-Posterior [SLAP] Tears) All of the following are required: ? Shoulder pain = 4 on the VAS scale which interferes with age-appropriate activities of daily living ? Symptoms aggravated by heavy lifting, pushing, and overhead motion ? Physical exam demonstrating a positive response to at least one

2019 AIM Specialty Health

8. Exam Series: Guide to the Knee Exam

hinge joint and one of the most common sites of MSK injuries. Fortunately a diagnosis is usually possible with a good history and physical exam! Four ligaments – the anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), medial collateral ligament (MCL), and lateral collateral ligament (LCL) connect the femur to the tibial plateau, ensuring proper alignment and providing stability. Two menisci cushion the articulating surfaces while several bursa further reduce friction around the knee (...) joint. The suprapatellar and posterior bursa communicate directly with the joint cavity and will be enlarged with a joint effusion, posteriorly this is known as a Bakers cyst. The popliteal artery, vein, peroneal and tibial nerve run through the popliteal fossa. Anatomy of the Knee 1 Approach to the History A thorough history can provide several diagnostic clues and help to risk stratify patients. In some cases the physical examination may be limited by pain or a large effusion, so the history helps

2018 CandiEM

9. Chronic Knee Pain

total knee arthroplasty [27]. Even when a subchondral insufficiency fracture is diagnosed on a conventional radiograph, MRI may be indicated if an additional injury is suspected clinically. MRI can also detect tibial stress fractures as discussed in the ACR Appropriateness Criteria ® topic on “Stress (Fatigue/Insufficiency) Fracture, Including Sacrum, Excluding Other Vertebrae” [28]. Some patients with normal knee radiographs and anterior knee pain have abnormal cartilage on 3 T MRI using (...) 3 Chronic Knee Pain Variant 5: Adult or child greater than or equal to 5 years of age. Chronic knee pain. Initial knee radiograph demonstrates signs of prior osseous injury (ie, Segond fracture, tibial spine avulsion, etc). Next imaging procedure. Procedure Appropriateness Category Relative Radiation Level MRI knee without IV contrast Usually Appropriate O CT arthrography knee May Be Appropriate ? CT knee without IV contrast May Be Appropriate ? Aspiration knee Usually Not Appropriate Varies CT

2018 American College of Radiology

10. Knee Pain and Mobility Impairments: Meniscal and Articular Cartilage Lesions Full Text available with Trip Pro

. List of Abbreviations ACI autologous chondrocyte implantation ACL anterior cruciate ligament AE athlete exposure AGREE Appraisal of Guidelines for Research and Evaluation AMIC autologous matrix-induced chondrogenesis APM arthroscopic partial meniscectomy APTA American Physical Therapy Association CI confidence interval CPG clinical practice guideline EQ-5D European Quality of Life-5 Dimensions HCQ Hughston Clinic Questionnaire ICC intraclass correlation coefficient ICD International Classification (...) in the United States, associated with knee pain and mobility disorders are 836.0 Tear of medial cartilage or meniscus of knee, current; 836.1 Tear of lateral cartilage or meniscus of knee, current; 717.0 Old bucket handle tear of medial meniscus; 717.1 Derangement of anterior horn of medial meniscus; 717.2 Derangement of posterior horn of medial meniscus; 717.3 Other and unspecified derangement of medial meniscus; 717.40 Derangement of lateral meniscus unspecified; 717.41 Bucket handle tear of lateral

2018 American Physical Therapy Association

12. Ankle and Foot Surgical Guideline

tibial tendinopathy/ tenosynovitis AND/OR Spring ligament tear At least 12 weeks of any of the following: Activity modification Non- opioid analgesics Bracing Immobilization Orthotics Continued next page 10 Washington State Department of Labor and Industries Surgical Guideline for Work-related Ankle and Foot Injuries – October 2017 A request may be appropriate for If the patient has AND the diagnosis is supported by these clinical findings: AND this has been done Surgical Procedure Condition (...) Ligament Repair/ Reconstruction e.g. Br?strom procedure, Watson- Jones procedure Severe ankle sprain or recurrent sprains leading to instability A discrete documented work-related ankle injury AND Ankle “gives way” OR Swelling OR Difficulty walking on uneven ground Positive instability testing: e.g. Anterior drawer testing OR Asymmetric inversion laxity (when compared to contralateral side) Bilateral stress X-rays w/ asymmetrical stress tests: Talar tilt > 10 degrees OR Anterior displacement index

2017 Washington State Department of Labor and Industries

13. Chronic Ankle Pain

in the diagnosis of ligamentous and chondral pathology in the ankle. Foot Ankle Surg. 2010;16(2):78-80. 15. Oae K, Takao M, Uchio Y, Ochi M. Evaluation of anterior talofibular ligament injury with stress radiography, ultrasonography and MR imaging. Skeletal Radiol. 2010;39(1):41-47. 16. Rosenberg ZS, Cheung Y, Jahss MH, Noto AM, Norman A, Leeds NE. Rupture of posterior tibial tendon: CT and MR imaging with surgical correlation. Radiology. 1988;169(1):229-235. 17. Cha SD, Kim HS, Chung ST, et al. Intra (...) ]. Discussion of Procedures by Variant Variant 1: Chronic ankle pain. Initial imaging. Radiography Radiography should be considered as the initial imaging study. Radiographs may reveal osteoarthritis, calcified or ossified intra-articular bodies, osteochondral abnormalities, stress fractures, or evidence of prior trauma. Ankle effusions may also be identified in the anterior ankle joint recess by radiography with 53% to 74% accuracy [19]. They are often associated with ligamentous injury or fracture [19

2017 American College of Radiology

14. Imaging After Total Knee Arthroplasty

not appropriate; 4,5,6 May be appropriate; 7,8,9 Usually appropriate *Relative Radiation Level ACR Appropriateness Criteria ® 7 Imaging After Total Knee Arthroplasty Variant 12: Pain after total knee arthroplasty. Suspect periprosthetic soft-tissue abnormality unrelated to infection, including quadriceps or patellar tendinopathy (quadriceps or patellar tendon tears, postoperative arthrofibrosis, patellar clunk syndrome, or impingement of nerves or other soft tissues). Radiologic Procedure Rating Comments RRL (...) views and a tangential axial view of the patellofemoral joint. Some practitioners also use standing long-leg (hip-to-ankle) views to provide for optimal assessment of alignment [4]. Skytta et al [14] compared hip-to-ankle radiographs and AP knee radiographs, both obtained standing, for assessment of alignment and measurement of the tibiofemoral angle and of tibial and femoral component alignment. They found that the standard AP knee radiograph was a valid alternative to the hip-to-ankle radiograph

2017 American College of Radiology

15. AIM Clinical Appropriateness Guidelines for Joint Surgery

(12) weeks of conservative management Tendinopathy of the Long Head of the Biceps All of the following are required: ? Anterior shoulder pain, weakness ? Tenderness over the biceps groove ? Pain in the anterior shoulder during resisted supination of the forearm ? Positive Speed or Yeagerson Test ? MRI confirmation of biceps pathology Copyright © 2017. AIM Specialty Health. All Rights Reserved. Joint Surgery 16 Selected References 1. American Academy of Orthopaedic Surgeons, Optimizing (...) of asymptomatic, full thickness rotator cuff tear ? Active infection of the joint ? Active systemic bacteremia ? Active skin infection (exception recurrent cutaneous staph infections) or open wound within the planned surgical site of the shoulder ? Rapidly progressive neurological disease ? Deltoid or rotator cuff paralysis Labral Tear (including Superior Labral Anterior-Posterior [SLAP] Tears) All of the following are required: ? Shoulder pain = 4 on the VAS scale which interferes with age-appropriate

2017 AIM Specialty Health

16. Knee Stability and Movement Coordination Impairments: Knee Ligament Sprain Full Text available with Trip Pro

associated with knee stability and movement coordination impairments are S83.4 Sprain and strain involving (fibular)(tibial) collateral ligament of knee, S83.5 Sprain and strain involving (anterior)(posterior) cruciate ligament of knee , and S83.7 Injury to multiple structures of knee, Injury to (lateral)(medial) meniscus in combination with (collateral)(cruciate) ligaments . The primary ICF body function codes associated with the above-noted ICD-10 conditions are b7150 Stability of a single joint (...) of a quadriceps force when combined with knee internal rotation, a valgus load combined with knee internal rotation, or excessive valgus knee loads applied during weight-bearing decelerating activities. The most common injury mechanism for a PCL injury was a “dashboard/anterior tibial blow injury” (38.5%), followed by a fall on the flexed knee with the foot in plantar flexion (24.6%), and, last, a sudden violent hyperextension of the knee joint (11.9%). The vast majority of MCL injuries involve a sudden

2017 American Physical Therapy Association

17. Patellofemoral Pain

) in a flexed position, such as stair climbing or descent, as diagnostic tests for PFP . B Clinicians should make the diagnosis of PFP using the fol- lowing criteria: (1) the presence of retropatellar or peri- patellar pain, (2) reproduction of retropatellar or peripatellar pain with squatting, stair climbing, prolonged sitting, or other func- tional activities loading the PF J in a flexed position, and (3) exclu - sion of all other conditions that may cause anterior knee pain, including tibiofemoral (...) , soleus, lateral reti- naculum, or iliotibial band. EXAMINATION – OUTCOME MEASURES: ACTIVITY LIMITATIONS/SELF-REPORT MEASURES A Clinicians should use the Anterior Knee Pain Scale (AKPS), the patellofemoral pain and osteoarthritis sub- scale of the Knee injury and Osteoarthritis Outcome Score (KOOS-PF), or the visual analog scale (VAS) for activity or Eng and Pierrynowski Questionnaire (EPQ) to measure pain and func- tion in patients with PFP . In addition, clinicians should use the VAS for worst pain

2019 The Orthopaedic Section of the American Physical Therapy Association (APTA), Inc.

18. AHA/ASA Guidelines for Adult Stroke Rehabilitation and Recovery

tendon and supraspinatus. Hemiplegic shoulder pain is multifactorial. Pain is associated with shoulder tissue injury, abnormal joint mechanics, and central nociceptive hypersensitivity. About one third of patients with acute stroke have abnormal ultrasound findings in the hemiplegic shoulder when studied at the time of admission to acute inpatient rehabilitation, including effusion in biceps tendon or subacromial bursa; tendinopathy of biceps, supraspinatus, or subscapularis; and rotator cuff tear

2016 American Heart Association

19. CRACKCast E049 – General Principles to Orthopedic Injuries

anesthesia e) Acetabular fracture i) Sciatic nerve Motor: plantar flexion, knee flexion, lower leg muscles. Spares the hamstrings Sensory: peroneal, tibial, sural f) Hip fracture i) Femoral nerve Motor: quads weakness Sensation: anterior or medial thigh g) Femoral shaft fracture i) Sciatic Motor: leg weakness of the lower leg Same as sciatic. h) Knee dislocation i) Tibial or peroneal Peroneal Weak dorsiflexion and eversion dorsum of foot, first webspace, lateral foot. Tibial: Motor: foot muscle atrophy (...) puncture wound even in close proximity should be assessed and considered Exact anatomic location: Bone name, left/right, and reference points: g. Right posterior tibial tubercle Long bones are divided into thirds Describe the direction of the fracture line Transverse Oblique Spiral Comminuted (>2 fragments) Position and alignment of the fracture fragments: The amount of displacement of the distal fragment is always described first Valgus = angling AWAY from the midline Varus = angling of the part

2016 CandiEM

20. Knee Pain and Mobility Impairments: Meniscal and Articular Cartilage Lesions

reserved.Knee Pain and Mobility Impairments: Clinical Practice Guidelines Revision 2018 journal of orthopaedic & sports physical therapy | volume 48 | number 2 | february 2018 | a3 List of Abbreviations ACI: autologous chondrocyte implantation ACL: anterior cruciate ligament AE: athlete exposure AGREE: Appraisal of Guidelines for Research and Evaluation AMIC: autologous matrix-induced chondrogenesis APM: arthroscopic partial meniscectomy APTA: American Physical Therapy Association CI: con?dence interval CPG (...) of lateral cartilage or meniscus of knee, current; 717.0 Old bucket handle tear of medial meniscus; 717.1 Derangement of anterior horn of medial meniscus; 717.2 Derangement of posterior horn of medial meniscus; 717.3 Other and unspeci?ed derangement of medial meniscus; 717.40 Derangement of lateral meniscus unspeci?ed; 717.41 Bucket handle tear of lateral meniscus; 717.42 De- rangement of anterior horn of lateral meniscus; 717.43 Derangement of posterior horn of lateral meniscus; 717.49 Other derangement

2018 The Orthopaedic Section of the American Physical Therapy Association (APTA), Inc.

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