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Apophyseal Injury

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61. Osteoarthritis

sclerosis (bone density increased) Subchondral cysts Marginal osteophytes IV. Risk Factors Age over 50 years old Female gender Prior joint injury Job duties with frequent squatting or bending Osteoarthritis Repetitive-impact sports (e.g. soccer, football) V. Etiologies Primary Weight bearing joints Hands Hips, s, and feet Stressors (single most important factor) Overuse injuries Secondary Acute or Chronic History of knee meniscectomy Congenital abnormalities Rheumatic Conditions Calcium pyrophosphate (...) ) First carpometacarpal joint (thumb) Cervical and Mechanisms Apophyseal joint and Osteophytes Disc degeneration Secondary affects Local muscle spasm Nerve root impingement with radiculopathy Cervical stenosis ( ) VIII. Labs: General (if indicated) Routine labs are not indicated in typical Osteoarthritis Obtain for unclear diagnosis Abnormal results suggest alternative diagnosis normal normal negative normal IX. Labs: Synovial Fluid (if indicated) appearance Clear fluid High viscosity and good mucin

2018 FP Notebook

62. Cervical Spine XRay

: Cervical Spine XRay , C-Spine XRay , Cervical Spine XRay in Acute Traumatic Injury II. Efficacy: Blunt Trauma Inadequate for most patients ( is preferred) Adequate visualization of the entire is achieved in <30% of plain film C-Spine XRays Misses up to 16% of c-spine s in seriously injured, obtunded blunt patients However, NEXUS found that adequate 3-view C-Spine XRays have >99% for significant III. Indications: Acute Trauma Decision rules for imaging in general See See See Cases in which plain C-Spine (...) XRay may be adequate in Non-severe mechanism of injury (see ) and Adequate 3-view plain film C-Spine XRays can be obtained and Other CT imaging is not planned IV. Imaging: Views -Primary film : 60-80% of cervical s Must be adequate prior to other views (including visualization of C7-T1) AP C-Spine view V. Imaging: Views- Other Flexion-Extension XRay (F/E Views) Contraindications to flexion extension views Suspected cervical Subluxation Not recommended in Most injuries if visible on plain xray

2018 FP Notebook

63. Malunited anterior inferior iliac spine fracture as a cause of hip impingement: A case report and review of literature (PubMed)

Malunited anterior inferior iliac spine fracture as a cause of hip impingement: A case report and review of literature Apophyseal injuries of the pelvis have increased recently with increased participation of teenagers in contact sports. Apophyseal fractures of the pelvis should be ruled out from apophysitis, os acetabuli and bony tumors. We report a case of fracture of anterior-inferior iliac spine following indirect injury to the hip in a young football player. The patient failed to get

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2016 Chinese Journal of Traumatology

64. Two cases of combined patellar tendon avulsion from the tibia and patella (PubMed)

Two cases of combined patellar tendon avulsion from the tibia and patella Avulsion fractures of the inferior pole of the patella and proximal tibial apophysis are independently rare injuries. They occur in children due to the relative weakness of the apophyseal cartilage compared to the ligaments and tendons. The combination of these two fractures, is exceedingly rare, with only a few previously described cases in the literature. Due to the infrequent presentation of this injury, careful (...) examination and consideration of advanced imaging is important for diagnosis and preoperative planning. Here we present two cases of combined sleeve fractures of the inferior pole of the patella and tibial apophysis, with discussion of the pathophysiology, classification, identification and management of the injury.© The Authors, published by EDP Sciences, 2018.

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2018 SICOT-J

65. Causes and prevention of low back pain in young athletes

and improper training. During growth spurts, muscles and ligaments cannot keep pace with bone growth, causing decreased flexibility and muscle imbalances . Structural differences in the paediatric spine include growth cartilage and secondary ossification centres, which are susceptible to compression, distraction and torsion injury . Cartilaginous end plates and ring apophyses overlying the epiphyseal growth plates at either end of the vertebral bodies may be damaged by repeated flexion of the spine (...) single copies of this document from our website. For permission to reprint or reproduce multiple copies, please see our . Principal author(s) L Purcell; Canadian Paediatric Society, Paediatr Child Health 2009;14(8):533-5 Low back pain in young athletes must be taken seriously to avoid delays in diagnosis and treatment . The etiology of low back pain in youths is usually significantly different from that in adults - . Low back pain in youths tend to result from structural injuries

2010 Canadian Paediatric Society

66. Acute childhood limp

disease, such as cerebral palsy or spina bifida (usually diagnosed before the child is walking), or . Primary anatomical abnormality, such as limb length discrepancy. Inflammatory muscle or joint disease, such as . Fracture or soft tissue injury Fracture or soft tissue injury Trauma is the most common cause of limping in children [ ; ] . Children have growth plates that are more susceptible to injury than ligaments. An apparent sprain in a child should raise suspicion of an injury to the growth plate (...) that persists for longer than 6 weeks and has no known cause. Systemic symptoms of lethargy and anorexia may be present. Often children with JIA are otherwise well and blood tests and X-rays may be normal. Be aware that there is a high risk of uveitis in children with JIA and this may be asymptomatic initially. If undiagnosed and untreated, uveitis can lead to loss of vision. [ ] Sever's disease Sever's disease Sever's disease or apophysitis of the calcaneus produces heel pain as a result of inflammation

2015 NICE Clinical Knowledge Summaries

67. Osgood-Schlatter disease

. They develop during the adolescent growth spurt before the tibial tuberosity has completed ossification. At this time, the development of quadriceps strength, particularly in adolescents participating in sports that involve running and jumping, may exceed the ability of the tibial tuberosity to resist these forces. Healing and growth of avulsed fragments produces minimal to marked firm enlargement of the tibial tubercle, depending on the severity and frequency of injury. Bony fragments, known as 'ossicles (...) years of age with persistent hip pain, limp, and possible referred pain to the knee. Trauma Traumatic knee injury — this is likely when knee pain starts suddenly after knee trauma and is associated with abnormal physical signs. Possible injuries include meniscal injuries, collateral and cruciate ligament injuries, stress fractures of the patella, tibial tuberosity fracture, and prepatellar and infrapatellar bursitis. Other causes Osteochondritis dissecans — this is caused by avascular necrosis

2015 NICE Clinical Knowledge Summaries

68. Knowledge, confidence, and fun: First time conference goers (and physiotherapy students) reflect on the ACPSEM “Physios in Sport Young Athlete Conference”

and respectful of them is vital. (iii) The process of returning our athletes back to training and competition following injury or an off season break can be helped by using technology like GPS to monitor the load placed on athletes during these times. It was also interesting to hear about hot topics such as concussion and head injury (Dr Jonathan Hanson ), screening young athletes for cardiac problems as early as possible (Dr Andrew D’Silva) and Apophysitis Syndromes (Jenny Strickland). A final message we (...) excellent communication skills, a level of understanding of each discipline and how the roles interlink. A number of speakers mentioned great insights: (i) the importance of gaining the coaches trust and confidence (ii) Good communication between players/children or adolescent, their families and coaches is essential (ii) Correct diagnosis and understanding how training volumes affect injury risk is important, and explaining this to young patients, parents and coaches in language that is meaningful

2015 British Journal of Sports Medicine Blog

69. Missed the ACPSEM Biennial Young Athlete conference? Not to worry- here are some highlights with links to key resources

training programme for the younger athlete. A balance between resistance and power sessions was suggested to be the best route. The need to make sessions fun for youngsters was keenly stressed, giving examples of Manchester City’s playground and Brighton and Hove Albion’s climbing wall. Andy Renshaw highlighted one of the key messages of the conference: You simply cannot rely on adult data to predict injuries in younger athletes. Using the Fuller et al. (2006) injury definition consensus statement (...) , Andy was able to expertly illustrate the differences between the populations. His data showed for example that anterior thigh strains were the most commonly occurring injury in the academy teams (18% n=23) compared with a majority of posterior thigh injuries in the adult game. Paul Read went on next to identify some of the main risk factors for injury in adolescent populations including: Previous injury Fatigue Movement skill/neuromuscular skill Growth and Maturation Seasonal Variation (Greatly

2015 British Journal of Sports Medicine Blog

70.

injuries; the environment needed to facilitate smooth RTP; objective criteria for safe return to play. A session on disability sport will cover sports science and coaching in sports medicine; performance physiotherapy for disability sport; the athlete/ paralympian perspective; complexity of sports psych in disability sport; Athlete classification and ethical issues in disability sport The Adolescent Athlete: will cover spinal pain in adolescent sports, strength and conditioning training; apophysitis (...) Fortius International Sports Injury Conference (FISIC) – A conference you can’t afford to miss… | BJSM blog - social media's leading SEM voice by Wimbledon is well underway, cricket season is in full flow, football season is commencing and 20 national rugby squads are preparing to compete in the 2015 Rugby World Cup – needless to say it is another exciting summer of sport. With the home Rugby World Cup tournament fewer than three months away, the 50-man England squad are in boot camp

2015 British Journal of Sports Medicine Blog

71. Supporting young athletes to stay (and excel) in sport: what’s the role of the medical team? And what does expanding our view of maturation have to do with it?

the medical team do about that?!” Adolescent growth Children grow at their fastest rate in the first two years of infancy. However, we’re unlikely to see them in sport at this age! It is not until the adolescent growth spurt that we start to see issues relating to co-ordination and performance ( , ). As well as increased incidence of apophyseal injuries like Osgood-Schlatters, we also see an increased risk of joint injuries, which I discuss in an upcoming BJSM podcast, related to control of long-levers (...) to be comfortable with this then perhaps we can start talking about players competing “across” age groups, rather than “up or down”. It is also important to understanding that player development is a continual process, requiring regular assessment & re-assessment. Conclusion The exciting part about working in sport is that our role extends beyond injury management & prevention. We are an important cog of large machine that helps develop & maintain sporting talent. In youth athletes in particular, we have a big

2015 British Journal of Sports Medicine Blog

72. AlterG ACL Return to Running Case Series

following surgery ] Pediatric International Knee Document Committee (Pedi-IKDC) is a self-reported questionnaire relating to a young patients function, symptoms, and sports activity. This is a valid study in patients ages 10-18 Change in KOOS [ Time Frame: Measure week 6 and week 12 following surgery ] Knee injury and Osteoarthritis Outcome Score (KOOS) is a patient reported outcome measure intended for use in knee injuries that may result in osteoarthritis such as anterior cruciate reconstruction (...) : No Sampling Method: Non-Probability Sample Study Population Study population will include post operative ACL patients who meet the eligibility criteria who are being treated at Nationwide Children's Westerville Physical Therapy location. Criteria Inclusion Criteria: Patients with a diagnosis of post operative anterior cruciate reconstruction surgery. Exclusion Criteria: Patient has concurrent diagnosis of meniscal repair with ACL surgery. Patient ACL surgery is apophyseal sparing. Patient is unable

2015 Clinical Trials

73. Anterior inferior iliac spine avulsion fracture: a series of 5 cases. (PubMed)

Anterior inferior iliac spine avulsion fracture: a series of 5 cases. Avulsion fractures of the pelvic apophyses rarely occur in adolescent athletes in the course of sudden strong contraction of muscle attached to growth cartilage. This injury may usually be misdiagnosed for tendon or muscle strain. Patient's history, physical examination, and radiologic studies are important for diagnosis. The literature includes only a few case reports but no case series as yet. The aim of this study

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2015 Medicine

74. Osteoarthritis (Overview)

in previously intact joints and having no apparent initiating factor. Some clinicians limit the term primary osteoarthritis to the joints of the hands (specifically, the DIP and PIP joints and the joints at the base of the thumb). Others include the knees, hips, and spine (apophyseal articulations) as well. As underlying causes of osteoarthritis are discovered, the term primary, or idiopathic, osteoarthritis may become obsolete. For instance, many investigators believe that most cases of primary (...) , obesity may be an inflammatory risk factor for osteoarthritis. Obesity is associated with increased levels (both systemic and intra-articular) of adipokines (cytokines derived from adipose tissue), which may promote chronic, low-grade inflammation in joints. [ ] Other causes Trauma or surgery (including surgical repair of traumatic injury) involving the articular cartilage, ligaments, or menisci can lead to abnormal biomechanics in the joints and accelerate osteoarthritis. In individuals who have

2014 eMedicine.com

75. Diaphyseal Femur Fractures (Follow-up)

polytrauma patients) with these fractures. Surgery for diaphyseal femur fracture should be reserved for those able to tolerate the appropriate procedure for their circumstance. Young children can often be treated successfully with noninvasive measures; thus, surgery can be avoided. Definite indications include polytrauma patients, especially those with head and chest injuries, and those with injuries to multiple limbs or those otherwise unable to care for themselves to maximize postoperative independence (...) . Most others are surgical candidates because of the lower incidence of complication and the higher union rates with surgery. Those who should not be treated surgically include patients too unstable to tolerate the procedure and children weighing less than 80 lb. No one can argue with the high success rate of reamed locked antegrade nailing. However, patients with femoral-shaft fractures often present with a multitude of injuries including head and chest trauma. Laboratory studies have shown

2014 eMedicine Surgery

76. Atlantoaxial Instability (Diagnosis)

rotatory subluxation are shown in the image below. Shown are 4 types of atlantoaxial rotatory subluxation. Because the cervical spine has multiple synovial-lined articulations, RA can manifest itself in the upper cervical spine. [ , ] In a person with AAI, the rheumatoid process affects the articular cartilage of the apophyseal joints, even the type II articular cartilage in the transverse ligament. [ ] In addition, the rheumatoid pannus and the associated inflammation can weaken the transverse (...) for the management of acute cervical spine and spinal cord injuries: 2013 update. Neurosurgery . 2013 Aug. 60 Suppl 1:82-91. . Haid RW Jr. C1-C2 transarticular screw fixation: technical aspects. Neurosurgery . 2001 Jul. 49(1):71-4. . Naseer R, Bailey SI. Atlantoaxial instability treated with transarticular screw fixation. Int Orthop . 2001. 25(4):268-71. . Henriques T, Cunningham BW, Olerud C, Shimamoto N, Lee GA, Larsson S, et al. Biomechanical comparison of five different atlantoaxial posterior fixation

2014 eMedicine Surgery

77. Ankylosing Spondylitis (Diagnosis)

) and transforming growth factor-β (TGF-β), are also important in the inflammatory process by leading to fibrosis and ossification at sites of enthesitis. [ , , ] The initial presentation of AS generally relates to the SI joints; involvement of the SI joints is required to establish the diagnosis. SI joint involvement is followed by involvement of the discovertebral, apophyseal, costovertebral, and costotransverse joints and the paravertebral ligaments. Early lesions include subchondral granulation tissue (...) spondylitis. J Rheumatol . 1999 Apr. 26(4):971-4. . Anwar F, Al-Khayer A, Joseph G, Fraser MH, Jigajinni MV, Allan DB. Delayed presentation and diagnosis of cervical spine injuries in long-standing ankylosing spondylitis. Eur Spine J . 2011 Mar. 20(3):403-7. . . Baraliakos X, Hermann KG, Landewé R, Listing J, Golder W, Brandt J, et al. Assessment of acute spinal inflammation in patients with ankylosing spondylitis by magnetic resonance imaging: a comparison between contrast enhanced T1 and short tau

2014 eMedicine Surgery

78. Ankylosing Spondylitis and Undifferentiated Spondyloarthropathy (Overview)

) and transforming growth factor-β (TGF-β), are also important in the inflammatory process by leading to fibrosis and ossification at sites of enthesitis. [ , , ] The initial presentation of AS generally relates to the SI joints; involvement of the SI joints is required to establish the diagnosis. SI joint involvement is followed by involvement of the discovertebral, apophyseal, costovertebral, and costotransverse joints and the paravertebral ligaments. Early lesions include subchondral granulation tissue (...) spondylitis. J Rheumatol . 1999 Apr. 26(4):971-4. . Anwar F, Al-Khayer A, Joseph G, Fraser MH, Jigajinni MV, Allan DB. Delayed presentation and diagnosis of cervical spine injuries in long-standing ankylosing spondylitis. Eur Spine J . 2011 Mar. 20(3):403-7. . . Baraliakos X, Hermann KG, Landewé R, Listing J, Golder W, Brandt J, et al. Assessment of acute spinal inflammation in patients with ankylosing spondylitis by magnetic resonance imaging: a comparison between contrast enhanced T1 and short tau

2014 eMedicine.com

79. Ankylosing Spondylitis (Overview)

) and transforming growth factor-β (TGF-β), are also important in the inflammatory process by leading to fibrosis and ossification at sites of enthesitis. [ , , ] The initial presentation of AS generally relates to the SI joints; involvement of the SI joints is required to establish the diagnosis. SI joint involvement is followed by involvement of the discovertebral, apophyseal, costovertebral, and costotransverse joints and the paravertebral ligaments. Early lesions include subchondral granulation tissue (...) spondylitis. J Rheumatol . 1999 Apr. 26(4):971-4. . Anwar F, Al-Khayer A, Joseph G, Fraser MH, Jigajinni MV, Allan DB. Delayed presentation and diagnosis of cervical spine injuries in long-standing ankylosing spondylitis. Eur Spine J . 2011 Mar. 20(3):403-7. . . Baraliakos X, Hermann KG, Landewé R, Listing J, Golder W, Brandt J, et al. Assessment of acute spinal inflammation in patients with ankylosing spondylitis by magnetic resonance imaging: a comparison between contrast enhanced T1 and short tau

2014 eMedicine.com

80. Sever Disease (Overview)

Sever Disease (Overview) Calcaneal Apophysitis (Sever Disease): Background, Pathophysiology, Etiology Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMTIzNzQ3Ny1vdmVydmlldw== processing > Calcaneal Apophysitis (...) (Sever Disease) Updated: Jan 28, 2019 Author: Mark A Noffsinger, MD; Chief Editor: Vinod K Panchbhavi, MD, FACS Share Email Print Feedback Close Sections Sections Calcaneal Apophysitis (Sever Disease) Overview Background Sever disease, first described in 1912, [ , ] is a painful inflammation of the apophysis (calcaneal apophysitis). [ ] It is classified with the child and adolescent nonarticular osteochondroses. [ , , , ] (The other disease in this group is Iselin disease, which is inflammation

2014 eMedicine Surgery

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