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Apophyseal Injury

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81. Malunited anterior inferior iliac spine fracture as a cause of hip impingement: A case report and review of literature Full Text available with Trip Pro

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

2016 Chinese Journal of Traumatology

82. 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

83. Anterior inferior iliac spine avulsion fracture: a series of 5 cases. Full Text available with Trip Pro

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

2015 Medicine

84. 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

85. 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

86. 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

87.

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

88. The Approach to the Painful Joint (Diagnosis)

spine, ask the patient to touch the chin to the chest (flexion) and then look up at the ceiling (extension). For lateral flexion, ask the patient to touch an ear to the shoulder. For lateral rotation, ask the patient to touch the chin to a shoulder. During lateral rotation and flexion, pain that occurs on the ipsilateral side of the neck is bony in origin (eg, from apophyseal joint disease), whereas pain on the contralateral side is muscular or ligamentous in origin. With the thoracic spine (...) polyarthritis include the following: Traumatic osteoarthritis (see ) Hypertrophic pulmonary osteoarthropathy Amyloidosis (see ) Differential diagnoses for regional musculoskeletal pain Shoulder Referred pain may derive from cervical disorders, Pancoast tumor of the lung, subphrenic pathology, or entrapment neuropathies and brachial neuritis (see ). Rotator cuff tendinitis (see ) [ ] is inflammation of the rotator cuff tendons, arising acutely as a result of a recognizable injury (throwing) or insidiously

2014 eMedicine.com

89. Hip Tendonitis and Bursitis (Diagnosis)

pain, such as a hamstring tendinopathy from repetitive activities such as running. Training errors, biomechanical issues, and sudden increases in activity levels are also risk factors. In the adolescent age group, traction injuries such as avulsion fracture and apophysitis can occur and cause difficulties with training and performance. [ , ] The investigation into the cause and treatment of hip overuse injuries can often be frustrating for clinicians and patients alike. Many musculoskeletal (...) . Sports Med . 1998 Apr. 25(4):271-83. . Garrick JG, Webb DR. Sports Injuries: Diagnosis and Management . 2nd ed. Philadelphia, Pa: WB Saunders; 1999. Shbeeb MI, Matteson EL. Trochanteric bursitis (greater trochanter pain syndrome). Mayo Clin Proc . 1996 Jun. 71(6):565-9. . Kujala UM, Orava S, Karpakka J, Leppävuori J, Mattila K. Ischial tuberosity apophysitis and avulsion among athletes. Int J Sports Med . Feb 1997. 18(2):149-55. . Kivlan BR, Martin RL. Functional performance testing of the hip

2014 eMedicine.com

90. Lumbosacral Spondylolysis (Diagnosis)

):487-99, ix. . Dubousset J. Treatment of spondylolysis and spondylolisthesis in children and adolescents. Clin Orthop Relat Res . 1997 Apr. 337:77-85. . Albanese M, Pizzutillo PD. Family study of spondylolysis and spondylolisthesis. J Pediatr Orthop . 1982. 2(5):496-9. . Stinson JT. Spondylolysis and spondylolisthesis in the athlete. Clin Sports Med . 1993 Jul. 12(3):517-28. . Patel DR, Nelson TL. Sports injuries in adolescents. Med Clin North Am . 2000 Jul. 84(4):983-1007, viii. . Sakai T, Goda Y (...) , Saifuddin A, Wolman RL. The radiological investigation of lumbar spondylolysis. Clin Radiol . 1998 Oct. 53(10):723-8. . Lowe J, Schachner E, Hirschberg E, Shapiro Y, Libson E. Significance of bone scintigraphy in symptomatic spondylolysis. Spine . 1984 Sep. 9(6):653-5. . Bellah RD, Summerville DA, Treves ST, Micheli LJ. Low-back pain in adolescent athletes: detection of stress injury to the pars interarticularis with SPECT. Radiology . 1991 Aug. 180(2):509-12. . . Collier BD, Johnson RP, Carrera GF, et

2014 eMedicine.com

91. Lumbosacral Radiculopathy (Diagnosis)

, and from the opposite side. The sinuvertebral nerve supplies the posterior longitudinal ligament, superficial annulus fibrosus, epidural blood vessels, anterior dura mater, dural sleeve, and posterior vertebral periosteum. The 2 structures capable of transmitting neuronal impulses that result in the experience of pain are the sinuvertebral nerve and the nerve root. The posterior rami of the spinal nerves supply the apophyseal joints above and below the nerve as well as the paraspinous muscles (...) at multiple levels. Herniation of the intervertebral disc can cause impingement of the above neuronal structures, thus causing pain. The presence of disc material in the epidural space is thought to initially result in direct toxic injury to the nerve root by chemical mediation and then exacerbation of the ensuing intraneural and extraneural swelling, which results in venous congestion and conduction block. Notably, the size of the disc herniation has not been found to be related to the severity

2014 eMedicine.com

92. Lumbosacral Facet Syndrome (Diagnosis)

zygos , meaning yoke or bridge, and physis , meaning outgrowth. This “bridging of outgrowths” is most easily seen from a lateral view, where the Z-joint bridges adjoin the vertebrae. The term facet joint is a misnomer because the joint occurs between adjoining zygapophyseal processes, rather than facets, which are the articular cartilage lining small joints in the body (eg, phalanges, costotransverse and costovertebral joints). This joint is also sometimes referred to as the apophyseal joint (...) surgeons or neurosurgeons is not surprising. As the primary cause of work-related injuries, LBP is the most costly of all medical diagnoses when time off from work, long-term disability, and medical and legal expenses are taken into account. [ ] The lumbosacral Z-joint is reported to be the source of pain in 15-40% of patients with chronic LBP. Ray believed that Z-joint–mediated pain is the etiology for most cases of , [ ] whereas other authors have argued that it may contribute to nearly 80% of cases

2014 eMedicine.com

93. Little League Elbow Syndrome (Diagnosis)

year. This increase in participation has been paralleled by an increase in sports-related injuries in the pediatric population. [ , , , , , , , , , , , ] Increased single-sport participation with year-round training, higher intensities at young ages, and longer competitive seasons are contributing factors to the increased injury rates seen in pediatric athletes. [ ] Conditioning and training errors also contribute significantly to the risk and frequency of injury. Although briefly discussed below (...) , injuries to the lateral, posterior, and anterior elbow are separate entities and should not be confused with the medial injuries referred to as little league elbow syndrome. During the throwing motion, valgus stress is placed on the elbow. This valgus stress results in tension on the medial structures (ie, medial epicondyle, medial epicondylar apophysis, medial collateral ligament complex) and compression of the lateral structures (ie, radial head, capitellum). Repeated stress results in overuse injury

2014 eMedicine.com

94. Medial Epicondylitis (Diagnosis)

has also been reported in bowlers, archers, and weight lifters. [ , , , ] Little leaguer's elbow is sometimes considered a variant of medial epicondylitis, but this condition is technically a traction apophysitis of the medial epicondyle, which requires a different treatment course. For patient education resources, see the , as well as . Next: Epidemiology Frequency United States Medial epicondylitis accounts for only 10-20% of all epicondylitis diagnoses [ ] ; the annual incidence is between 3-4 (...) NS, Schickendantz MS. Medial epicondylitis: evaluation and management. J Am Acad Orthop Surg . 2015 Jun. 23 (6):348-55. . Kiel J, Kaiser K. Golfers Elbow. StatPearls [Internet] . 2018 Jan. . . Kohn HS. Prevention and treatment of elbow injuries in golf. Clin Sports Med . 1996 Jan. 15(1):65-83. . Nirschl RP. Prevention and treatment of elbow and shoulder injuries in the tennis player. Clin Sports Med . 1988 Apr. 7(2):289-308. . Nirshal RP. Muscle and tendon trauma: tennis elbow. The Elbow and Its

2014 eMedicine.com

95. Osteoarthritis (Diagnosis)

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

96. Osgood-Schlatter Disease (Diagnosis)

traction (traction apophysitis) on the anterior portion of the developing ossification center leads to multiple subacute microavulsion fractures and/or tendinous inflammation, resulting in a benign, self-limited disturbance manifested as pain, swelling, and tenderness. The most common long-term ramifications of OSD are pain on kneeling as an adult and the cosmesis of a bony prominence on the anterior knee. Less common complications are the persistence of a painful ossicle requiring surgical excision (...) persist for 2-3 years until the tibial growth plate closes. Previous Next: Patient Education Inform patients about activities that aggravate Osgood-Schlatter disease and about the self-limiting nature of the condition. For patient education information, see the , the , and the , as well as . Previous References Pommering TL, Kluchurosky L. Overuse injuries in adolescents. Adolesc Med State Art Rev . 2007 May. 18(1):95-120, ix. . Smith JM, Varacallo M. Osgood Schlatter Disease. StatPearls [Internet

2014 eMedicine.com

97. Medial Epicondylitis (Overview)

has also been reported in bowlers, archers, and weight lifters. [ , , , ] Little leaguer's elbow is sometimes considered a variant of medial epicondylitis, but this condition is technically a traction apophysitis of the medial epicondyle, which requires a different treatment course. For patient education resources, see the , as well as . Next: Epidemiology Frequency United States Medial epicondylitis accounts for only 10-20% of all epicondylitis diagnoses [ ] ; the annual incidence is between 3-4 (...) NS, Schickendantz MS. Medial epicondylitis: evaluation and management. J Am Acad Orthop Surg . 2015 Jun. 23 (6):348-55. . Kiel J, Kaiser K. Golfers Elbow. StatPearls [Internet] . 2018 Jan. . . Kohn HS. Prevention and treatment of elbow injuries in golf. Clin Sports Med . 1996 Jan. 15(1):65-83. . Nirschl RP. Prevention and treatment of elbow and shoulder injuries in the tennis player. Clin Sports Med . 1988 Apr. 7(2):289-308. . Nirshal RP. Muscle and tendon trauma: tennis elbow. The Elbow and Its

2014 eMedicine.com

98. Cervical Facet Syndrome (Overview)

, , and , and . Next: Epidemiology Frequency United States Aprill and Bogduk estimated the prevalence of cervical facet joint pain by reviewing the records of patients who had presented with neck pain for at least 6 months secondary to some type of injury. [ ] These patients underwent discography, facet joint nerve blocks, or both at the request of the referring physicians. A total of 318 patients were investigated, and 26% of the patients had at least one symptomatic facet joint. However, only 126 patients (...) , but there was often a painful disc at the same level. This finding is not surprising when one considers how the facet joints and discs are intimately involved in motion of the cervical spine. Cervical facet joint pain is a common sequela of whiplash injury. Barnsley and Lord et al studied the prevalence of chronic cervical facet joint pain after whiplash injury using double-blind, controlled, diagnostic blocks of the facet joints. [ ] The joints were blocked randomly with either a short-acting or long-acting

2014 eMedicine.com

99. Cervical Disc Disease (Overview)

Updated: Mar 21, 2018 Author: Michael B Furman, MD, MS; Chief Editor: Dean H Hommer, MD Share Email Print Feedback Close Sections Sections Cervical Disc Disease Overview Practice Essentials Cervical disc disorders encountered in physiatric practice include (HNP), (DDD), and internal disc disruption (IDD). HNP (seen in the image below) is defined as localized displacement of nucleus, cartilage, fragmented apophyseal bone, or fragmented anular tissue beyond the intervertebral disc space. [ ] Most (...) of the herniation is made up of the annulus fibrosus. DDD involves degenerative annular tears, loss of disc height, and nuclear degradation. IDD describes annular fissuring of the disc without external disc deformation. can result from nerve root injury in the presence of disc herniation or stenosis, most commonly foraminal stenosis, leading to sensory, motor, or reflex abnormalities in the affected nerve root distribution. [ , ] Sagittal magnetic resonance imaging (MRI) scan demonstrating cervical

2014 eMedicine.com

100. Sickle Cell Anemia (Overview)

by a spinal artery branch) results in the characteristic H vertebrae of sickle cell disease. The outer portions of the plates are spared because of the numerous apophyseal arteries. Osteonecrosis of the epiphysis of the femoral head is often bilateral and eventually progresses to collapse of the femoral heads. This same phenomenon is also seen in the humeral head, distal femur, and tibial condyles. Infarction of bone and bone marrow in patients with sickle cell disease can lead to the following changes (...) and an inability to deal with infective encapsulated microorganisms, particularly Streptococcus pneumoniae, ensue, leading to an increased risk of sepsis in the future. Chronic hemolytic anemia SCD is a form of hemolytic anemia, with red cell survival of around 10-20 days. Approximately one third of the hemolysis occurs intravascularly, releasing free hemoglobin (plasma free hemoglobin [PFH]) and arginase into plasma. PFH has been associated with endothelial injury including scavenging nitric oxide

2014 eMedicine.com

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