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Quadriceps Contusion

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21. Trochanteric Bursitis (Overview)

anesthetic patches. [ , ] Extracorporeal shock wave therapy (ESWT) is a good alternative to traditional nonoperative therapy. A physical therapist can instruct the patient in a home exercise program, emphasizing stretching of the iliotibial band (ITB), the tensor fascia lata (TFL), the external hip rotators, the quadriceps, and the hip flexors. The use of phonophoresis and soft-tissue massage also may be helpful. [ ] Transcutaneous electrical nerve stimulation (TENS) can be considered in cases that prove (...) resistant to the rehabilitation program, and surgical interventions can be useful in refractory cases. [ ] When surgery is warranted, longitudinal release of the ITB combined with subgluteal bursectomy appears to be safe and effective for most patients. [ ] Next: Pathophysiology Acute or repetitive (cumulative) trauma may give rise to inflammation of the affected bursa. Acute trauma includes contusions from falls, contact sports, and other sources of impact. Other factors that may predispose

2014 eMedicine.com

22. Trochanteric Bursitis (Overview)

anesthetic patches. [ , ] Extracorporeal shock wave therapy (ESWT) is a good alternative to traditional nonoperative therapy. A physical therapist can instruct the patient in a home exercise program, emphasizing stretching of the iliotibial band (ITB), the tensor fascia lata (TFL), the external hip rotators, the quadriceps, and the hip flexors. The use of phonophoresis and soft-tissue massage also may be helpful. [ ] Transcutaneous electrical nerve stimulation (TENS) can be considered in cases that prove (...) resistant to the rehabilitation program, and surgical interventions can be useful in refractory cases. [ ] When surgery is warranted, longitudinal release of the ITB combined with subgluteal bursectomy appears to be safe and effective for most patients. [ ] Next: Pathophysiology Acute or repetitive (cumulative) trauma may give rise to inflammation of the affected bursa. Acute trauma includes contusions from falls, contact sports, and other sources of impact. Other factors that may predispose

2014 eMedicine.com

23. Groin Injury (Overview)

differences are obvious, several factors play important roles in determining injury patterns in female athletes. These factors include (1) differences in metabolism, circulation, and cardiorespiratory capacity; and (2) differences in body shape, size, and composition. An example of such is the higher rate of patellofemoral disorders in female athletes, possibly accounted for by an increased quadriceps angle, less developed vastus medialis, and greater degree of . [ ] For patient education resources, see (...) that produce high-speed collisions, usually result in contusions. However, such injuries may cause (iliac wing); they may exacerbate previously asymptomatic inguinal ; and, in rare cases, they may produce bladder, testicular, or even urethral (straddle) injuries. Any patient with lower abdominal or pelvic impact injury that causes severe groin pain, loss of function, or blood in the urine should be immediately evaluated by a physician. Findings from anteroposterior radiographs of the pelvis, hip images

2014 eMedicine.com

24. Trochanteric Bursitis (Diagnosis)

anesthetic patches. [ , ] Extracorporeal shock wave therapy (ESWT) is a good alternative to traditional nonoperative therapy. A physical therapist can instruct the patient in a home exercise program, emphasizing stretching of the iliotibial band (ITB), the tensor fascia lata (TFL), the external hip rotators, the quadriceps, and the hip flexors. The use of phonophoresis and soft-tissue massage also may be helpful. [ ] Transcutaneous electrical nerve stimulation (TENS) can be considered in cases that prove (...) resistant to the rehabilitation program, and surgical interventions can be useful in refractory cases. [ ] When surgery is warranted, longitudinal release of the ITB combined with subgluteal bursectomy appears to be safe and effective for most patients. [ ] Next: Pathophysiology Acute or repetitive (cumulative) trauma may give rise to inflammation of the affected bursa. Acute trauma includes contusions from falls, contact sports, and other sources of impact. Other factors that may predispose

2014 eMedicine.com

25. Trochanteric Bursitis (Diagnosis)

anesthetic patches. [ , ] Extracorporeal shock wave therapy (ESWT) is a good alternative to traditional nonoperative therapy. A physical therapist can instruct the patient in a home exercise program, emphasizing stretching of the iliotibial band (ITB), the tensor fascia lata (TFL), the external hip rotators, the quadriceps, and the hip flexors. The use of phonophoresis and soft-tissue massage also may be helpful. [ ] Transcutaneous electrical nerve stimulation (TENS) can be considered in cases that prove (...) resistant to the rehabilitation program, and surgical interventions can be useful in refractory cases. [ ] When surgery is warranted, longitudinal release of the ITB combined with subgluteal bursectomy appears to be safe and effective for most patients. [ ] Next: Pathophysiology Acute or repetitive (cumulative) trauma may give rise to inflammation of the affected bursa. Acute trauma includes contusions from falls, contact sports, and other sources of impact. Other factors that may predispose

2014 eMedicine.com

26. Groin Injury (Follow-up)

differences are obvious, several factors play important roles in determining injury patterns in female athletes. These factors include (1) differences in metabolism, circulation, and cardiorespiratory capacity; and (2) differences in body shape, size, and composition. An example of such is the higher rate of patellofemoral disorders in female athletes, possibly accounted for by an increased quadriceps angle, less developed vastus medialis, and greater degree of . [ ] For patient education resources, see (...) that produce high-speed collisions, usually result in contusions. However, such injuries may cause (iliac wing); they may exacerbate previously asymptomatic inguinal ; and, in rare cases, they may produce bladder, testicular, or even urethral (straddle) injuries. Any patient with lower abdominal or pelvic impact injury that causes severe groin pain, loss of function, or blood in the urine should be immediately evaluated by a physician. Findings from anteroposterior radiographs of the pelvis, hip images

2014 eMedicine.com

27. Groin Injury (Treatment)

differences are obvious, several factors play important roles in determining injury patterns in female athletes. These factors include (1) differences in metabolism, circulation, and cardiorespiratory capacity; and (2) differences in body shape, size, and composition. An example of such is the higher rate of patellofemoral disorders in female athletes, possibly accounted for by an increased quadriceps angle, less developed vastus medialis, and greater degree of . [ ] For patient education resources, see (...) that produce high-speed collisions, usually result in contusions. However, such injuries may cause (iliac wing); they may exacerbate previously asymptomatic inguinal ; and, in rare cases, they may produce bladder, testicular, or even urethral (straddle) injuries. Any patient with lower abdominal or pelvic impact injury that causes severe groin pain, loss of function, or blood in the urine should be immediately evaluated by a physician. Findings from anteroposterior radiographs of the pelvis, hip images

2014 eMedicine.com

28. Groin Injury (Diagnosis)

differences are obvious, several factors play important roles in determining injury patterns in female athletes. These factors include (1) differences in metabolism, circulation, and cardiorespiratory capacity; and (2) differences in body shape, size, and composition. An example of such is the higher rate of patellofemoral disorders in female athletes, possibly accounted for by an increased quadriceps angle, less developed vastus medialis, and greater degree of . [ ] For patient education resources, see (...) that produce high-speed collisions, usually result in contusions. However, such injuries may cause (iliac wing); they may exacerbate previously asymptomatic inguinal ; and, in rare cases, they may produce bladder, testicular, or even urethral (straddle) injuries. Any patient with lower abdominal or pelvic impact injury that causes severe groin pain, loss of function, or blood in the urine should be immediately evaluated by a physician. Findings from anteroposterior radiographs of the pelvis, hip images

2014 eMedicine.com

29. Nerve Entrapment Syndromes of the Lower Extremity (Overview)

and then divides into multiple branches within the femoral triangle. In the proximal thigh, the femoral nerve divides into sensory branches, which innervate the upper and anterior thigh, and muscular branches, which innervate the quadriceps. One of the major branches is the lateral femoral cutaneous nerve (see below). [ ] Probably the best-known cutaneous nerve arising from the femoral nerve is the saphenous nerve (see below). Another important branch of the femoral nerve is the medial femoral cutaneous nerve (...) causes can include wounds and contusions, direct fractures involving the lateral knee, and direct lacerations or postoperative entrapment in suture hardware. Common peroneal nerve injuries at the region of the fibular head include ankle sprains with associated proximal fibular fractures, knee dislocations, tibial osteotomies, total knee and hip arthroplasties, and arthroscopies. Compression from intraneural or extraneural tumors has been seen, including compression from neurilemomas, intraneural

2014 eMedicine Surgery

30. Knee, Posterior Cruciate Ligament Injuries (MRI)

in combined injuries involving the arcuate complex of the posterolateral corner of the knee. Most neurapraxia resolves with conservative therapy within 18 months. The incidence of vascular injury, such as thrombosis and transection of the popliteal artery, can be as high as 14% regardless of whether the dislocation was reduced spontaneously. Bone contusions along the inferior aspect of the femoral condyle and the anterior aspect of the tibial plateau can be seen in hyperextension injuries. Frequency (...) site of injury, followed by the proximal portion near the femoral insertion. The tibial insertion site is strong and difficult to tear. Avulsion fractures are more common at this site and are more frequent in children. [ ] Rotational injuries with associated varus or valgus stress most commonly produce a PCL tear at the femoral attachment site. Sequelae of PCL tears Chronic tears of the PCL result in increased stress on the patellar ligaments and quadriceps tendon, resulting in chronic tendinitis

2014 eMedicine Radiology

31. Knee, Extensor Mechanism Injuries (MRI)

of the quadriceps muscle group, quadriceps tendon, patella, patellar retinaculum, patellar ligament, and adjacent soft tissues. Injuries to the extensor mechanism are common and consist of chronic degenerative injuries, overuse injuries, and acute trauma. [ , , , ] Patient education For patient information resources, see the , as well as and . Normal anatomy of the knee extensor compartment An understanding of normal anatomy and biomechanics of the knee extensor mechanism is necessary to comprehend the imaging (...) of extensor mechanism injuries. The extensor mechanism of the knee begins above the hip with the origin of the rectus femoris muscle on the anterior inferior iliac spine. The remainder of the quadriceps muscle group, vastus lateralis, vastus intermedius, and vastus medialis originate on the femoral shaft. The quadriceps tendon represents the confluence of the 4 muscle tendon units and inserts on the superior pole of the patella. The quadriceps tendon has 3 laminae, including (1) the most superficial

2014 eMedicine Radiology

32. Knee, Anterior Cruciate Ligament Injuries (MRI)

loss of proprioception in ACL-injured patients that can be clinically significant. Previous Next: Mechanism of Injury Mechanisms of anterior cruciate ligament (ACL) injury are numerous. Alpine-skiing ACL injury studies have served to demonstrate the complexity of this subject: a welter of characteristic mechanisms of injury have been identified in skiers, including aggressive quadriceps contraction, boot-induced injuries, "phantom foot" injuries, hit-from-behind injuries, and various types (...) mechanism (see the images below) is most commonly implicated: the slightly flexed knee incurs a valgus load, with internal rotation of the tibia or external rotation of the femur. Some studies indicate that the initial loading of the ACL is actually due to anterior drawer translation of the lateral tibia (marked quadriceps loading implicated), with the pivot-shift rotation occurring microseconds later. [ ] These pivot-shift injuries often occur with rapid simultaneous deceleration and directional

2014 eMedicine Radiology

33. Patella, Fractures

is primarily performed for occult or osteochondral injuries. The patient is placed in the supine position with his or her feet externally rotated 15° and pressed against a perpendicular footrest. CT-scan sections are obtained with the knee at rest, with the knee extended and quadriceps contracted, and with the knee in 15° of flexion with a relaxed quadriceps. The position of the fracture fragments can be determined by identifying the fracture line. The reconstructed images in the sagittal, coronal (...) fragments. The anatomy of the patellofemoral joint can be assessed in several planes. For example, axial imaging is useful for evaluating patellofemoral joint alignment, retinacular attachments, and overlying patellar cartilage. Sagittal images are useful for evaluating the quadriceps muscles and tendons, and the patellar tendon can be imaged in all 3 planes. Traumatic dislocation of the patella (seen in the image below) may result in patellar fracture, medial retinaculum damage, lateral femoral condyle

2014 eMedicine Radiology

34. Nerve Entrapment Syndromes of the Lower Extremity (Diagnosis)

and then divides into multiple branches within the femoral triangle. In the proximal thigh, the femoral nerve divides into sensory branches, which innervate the upper and anterior thigh, and muscular branches, which innervate the quadriceps. One of the major branches is the lateral femoral cutaneous nerve (see below). [ ] Probably the best-known cutaneous nerve arising from the femoral nerve is the saphenous nerve (see below). Another important branch of the femoral nerve is the medial femoral cutaneous nerve (...) causes can include wounds and contusions, direct fractures involving the lateral knee, and direct lacerations or postoperative entrapment in suture hardware. Common peroneal nerve injuries at the region of the fibular head include ankle sprains with associated proximal fibular fractures, knee dislocations, tibial osteotomies, total knee and hip arthroplasties, and arthroscopies. Compression from intraneural or extraneural tumors has been seen, including compression from neurilemomas, intraneural

2014 eMedicine Surgery

35. Should I Have Meniscus Surgery?

are as follows: “No evidence of fracture or dislocation. No suspicious focal bony lesion. No obvious soft tissue abnormality. Trace joint effusion. Quadriceps tendon and patellar tendon are intact. Anterior cruciate ligament and posterior cruciate ligament are intact. Medial collateral ligament and lateral collateral ligament are intact. Mild anterior extrusion of the anterior horn of the medial meniscus. Complex tear involving the posterior horn of the medial meniscus which extends into the body (...) meniscus on my left knee. I’ve been to an orthopedic surgeon who said that based on the time (6-7 weeks) since the injury happened he’s happy with my progress and doesn’t want to operate on my knee, but since then it’s been about 3-4 weeks and I really cant honestly say i’ve improved , if anything my knee feels worse and more painful, but i’ve noticed i have more flexibility when pulling my ankle back as if to stretch my quadriceps? So i guess what i’m asking is do you have any idea how long i’d

2016 Howard J. Luks, MD blog

36. Flail Chest

which of the following substances is most likely to increase a patient’s heat input? Alcohol Cannabis Cocaine Phencyclidine NEWS & VIDEOS Mental Health Symptoms Common After Mild Brain Injury WEDNESDAY, March 6, 2019 (HealthDay News) -- Approximately one in five individuals may develop mental health symptoms up to six months after mild traumatic brain injury (mTBI), according to... 3D Model Musculoskeletal Connective Tissues Video Prone Quadriceps Stretch 1. Lie on stomach. 2. Bend involved knee (...) . The paradoxical motion does not occur if the patient is mechanically ventilated, but the flail segment may be identified by its more extreme outward movement during lung inflation. Palpation can often detect crepitus of the flail segment and confirm abnormal chest wall motion. Chest x-ray can help confirm bone fractures and usually shows underlying pulmonary contusion; x-ray does not show cartilaginous disruption. Treatment Supportive care Sometimes mechanical ventilation Sometimes rib fracture repair

2013 Merck Manual (19th Edition)

37. Blunt Cardiac Injury

Illness Withdrawal from which of the following substances is most likely to increase a patient’s heat input? Alcohol Cannabis Cocaine Phencyclidine NEWS & VIDEOS 2004 to 2017 Saw Increase in Fractures for Elderly Dog Walkers THURSDAY, March 7, 2019 (HealthDay News) -- From 2004 to 2017, there was a significant increase in the annual number of elderly Americans presenting to U.S. emergency departments with fractures... 3D Model Musculoskeletal Connective Tissues Video Prone Quadriceps Stretch 1. Lie (...) on stomach. 2. Bend involved knee and loop towel or band around the ankle. 3. Gently pull towel or band to stretch muscle on front of thigh pulling ankle toward buttocks... SOCIAL MEDIA Add to Any Platform Loading , MD, MPH, Stanford University School of Medicine Click here for Patient Education NOTE: This is the Professional Version. CONSUMERS: Blunt cardiac injury is blunt chest trauma that causes contusion of myocardial muscle, rupture of a cardiac chamber, or disruption of a heart valve. Sometimes

2013 Merck Manual (19th Edition)

38. Aortic Disruption (Traumatic)

Overview of Heat Illness Withdrawal from which of the following substances is most likely to increase a patient’s heat input? Alcohol Cannabis Cocaine Phencyclidine NEWS & VIDEOS Women Less Likely to Get Periop Care Before Hip Fracture Surgery MONDAY, Feb. 11, 2019 (HealthDay News) -- Although more women have hip fracture surgery, they are less likely to receive perioperative geriatric care and anesthesia consultations, according... 3D Model Musculoskeletal Connective Tissues Video Prone Quadriceps (...) . Suggestive chest x-ray findings include the following: Widened mediastinum (high sensitivity except among elderly patients) 1st or 2nd rib fracture Obliteration of the aortic knob Deviation of the trachea or esophagus (and thus also any nasogastric tube) to the right Depression of the left mainstem bronchus Pleural or apical cap Hemothorax, pneumothorax, or pulmonary contusion However, some of these suggestive chest x-ray findings may not be present immediately. Also, no finding or combination

2013 Merck Manual (19th Edition)

39. Genital Trauma

Withdrawal from which of the following substances is most likely to increase a patient’s heat input? Alcohol Cannabis Cocaine Phencyclidine NEWS & VIDEOS Some Lose Independence After Surgical Tx of Femoral Neck Fx WEDNESDAY, March 6, 2019 (HealthDay News) -- A considerable proportion of older patients with femoral neck fracture are institutionalized or require walking aids 12 months after surgical treatment... 3D Model Musculoskeletal Connective Tissues Video Prone Quadriceps Stretch 1. Lie on stomach. 2 (...) trauma and child abuse. Most testicular injuries result from blunt trauma (eg, assaults, motor vehicle crashes, sports injuries); penetrating testicular injuries are far less common. Testicular injuries are classified as contusions or, if the tunica albuginea is disrupted, as ruptures. Scrotal injury may be caused by penetrating trauma, burns, avulsions, and bites. Penile injuries have diverse mechanisms. Zipper injuries are common. Penile fractures, which are ruptures of the corpus cavernosum, occur

2013 Merck Manual (19th Edition)

40. Bladder Trauma

Withdrawal from which of the following substances is most likely to increase a patient’s heat input? Alcohol Cannabis Cocaine Phencyclidine NEWS & VIDEOS 2004 to 2017 Saw Increase in Fractures for Elderly Dog Walkers THURSDAY, March 7, 2019 (HealthDay News) -- From 2004 to 2017, there was a significant increase in the annual number of elderly Americans presenting to U.S. emergency departments with fractures... 3D Model Musculoskeletal Connective Tissues Video Prone Quadriceps Stretch 1. Lie on stomach. 2 (...) surgery, gynecologic procedures (most commonly abdominal hysterectomy, , pelvic mass excision), or colon resection. Predisposing factors include scarring from prior surgery or radiation therapy, inflammation, and extensive tumor burden. Bladder injuries are classified as contusions or ruptures based on the extent of injury seen radiographically. Ruptures can be extraperitoneal, intraperitoneal, or both. Complications of bladder injuries include uroascites (free urine in the peritoneal cavity) due

2013 Merck Manual (19th Edition)

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