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Quadriceps Contusion

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21. Traumatic knee problems

will disappear or reduce in most cases over the course of three months. ? If there is much pain advise rest for the first few days and possibly using elbow crutches. ? Advise to bend, extend and put weight on the knee as soon as the pain allows this, and to put increasingly more weight on it as soon as the pain and the swelling decrease. ? Give quadriceps exercises to avoid muscle atrophy (see also the NHG Patient Letter on exercising the front upper leg muscles). ? In the event of distortion, contusion (...) collateral ligament injury: in case of pain and laxity in the valgus test. ? Contusion or distortion: • no or slight degree of ballottement or (self-reported) swelling; • no or slightly limited passive movement; • full weight-bearing capability of the leg. ? Patellar dislocation: patella is (or was) displaced in a lateral direction ballottement. ? Give information on the type and course of the condition. ? With a (possible) injury of the cruciate ligament, meniscal or collateral ligament, the symptoms

2010 Dutch College of General Practitioners (NHG)

22. 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

23. 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

24. 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

25. 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

26. 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

27. 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

28. 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

29. 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

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 (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

35. 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

36. Treatment of post-traumatic myositis ossificans of the anterior thigh with extracorporeal shock wave therapy (PubMed)

Treatment of post-traumatic myositis ossificans of the anterior thigh with extracorporeal shock wave therapy This case study demonstrates the effectiveness of a novel approach to the treatment of post-traumatic myositis ossificans with extracorporeal shockwave therapy in an elite athlete.A 20 year-old male semi-professional rugby player presented with progressive pain and loss of range of motion after sustaining a severe, right quadriceps contusion nine weeks earlier. The differential diagnosis

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2011 The Journal of the Canadian Chiropractic Association

37. 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)

38. 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)

39. 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)

40. Renal Trauma

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 (...) according to severity into 5 grades (see Figure: ). Grades of renal injury. Renal injuries are classified by severity as follows: Grade 1: Renal contusion and/or nonexpanding subcapsular hematoma Grade 2: Laceration < 1 cm in depth sparing the renal medulla and collecting system and/or nonexpanding retroperitoneal hematoma Grade 3: Laceration > 1 cm sparing the collecting system Grade 4: Laceration > 1 cm involving the collecting system and/or renal vessel injury with contained hemorrhage Grade 5

2013 Merck Manual (19th Edition)

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