Here is a patient with an acute prepatellar bursitis and distal quadriceps contusion. Watch how I…
▶determine if he has a patellar fracture or not.
▶do a brief evaluation of the patient’s knee
▶talk about the prepatellar bursitis
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Dr. Ebraheim’s educational animated video describes conditions associated with ankle pain.
.
What are the common causes of ankle pain?
We are going to group all of the causes of ankle pain into 4 groups:
Anterior ankle pain (in front of the ankle)
Anterior lateral impingement: This is painful limitation of full range of motion of the ankle due to soft tissue thickening or tibial bony spur impinging on the talus, limiting dorsiflexion of the ankle.
Arthritis of the ankle: Arthritis of the ankle can occur due to injury or due to inflammation. It can be diagnosed by examination or by an x-ray.
Osteochondritis dissecans of the talus: A little chip fracture inside the ankle that causes pain, swelling, and stiffness.
Medial ankle pain (inside of the ankle)
Tarsal tunnel syndrome: Compression on the posterior tibial nerve produces symptoms of pain and numbness on the medial (inside) side of the ankle. When conservative treatment fails, surgical treatment of the tarsal tunnel release may be needed.
Posterior tibial tendon tendonitis or rupture: Posterior tibial tendon problems can occur from overuse activities, from degeneration, or trauma. The posterior tibial tendon is one of the major supporting structures of the foot. The tendon helps to keep the arch of the foot in its normal position. When there is insufficiency or rupture of this tendon, the arch begins to sag, and a flatfoot deformity can occur associated with a tight Achilles tendon. The posterior tibial tendon rupture occurs in the hypovascular area, which is distal to the medial malleolus. The patient will have painful swelling on the posteriomedial aspect of the ankle. The patient will be unable to perform a single heel toe raise, too many toes sign, or flatfoot or fixed deformity of the hindfoot. Rupture of this tendon could be missed!
Flexor hallucis longus tendonitis: Pain, swelling, and weakness posterior to the medial malleolus. Dorsiflexion of the big toe may be reduced when the ankle is placed in dorsiflexion. Triggering and pain along the tendon sheath may also occur with toe flexion.
Posterior ankle pain (behind the ankle)
Posterior ankle impingement (os trigonum): Os trigonum is a nonunited piece of accessory bone seen posterior to the talus. Tenderness in the posterior lateral aspect of the ankle posterior to the peroneal tendons, especially with passive plantarflexion of the ankle, may be seen in association with Flexor hallucis longus (FHL) tenosynovitis.
Achilles tendonitis: Irritation and inflammation occurs due to overuse. Pain, swelling, and tears within the tendon. It is usually treated with therapy and eccentric exercises. It is rarely treated with surgery.
Achilles tendon rupture: The Achilles tendon can become prone to rupture with age, lack of use, or by aggressive exercises. Rupture of the Achilles tendon is diagnosed by the Thompson test or by an MRI. Treatment may be conservative without surgery by doing early functional rehab. Or it can be treated with surgery by approximation of the torn ends of the tendon. The risk of surgery is infection and skin/wound complications. The risk of conservative treatment is a high rate of rerupture of the tendon.
Lateral ankle pain (outside of the ankle)
The cause of ankle pain on the outer side of the ankle may be a sprained ankle, but diagnosis of a sprained ankle may be the wrong diagnosis. There are other structures in this area that can mimic an ankle sprain, but it is not an ankle sprain.
Ankle sprain: When the pain is anterior and around the fibula, it can be attributed to ligament sprain. Ankle sprain can be high ankle sprain (rare) or a low ankle sprain (common). Both types of ankle sprains are seen in this diaphragm.
High ankle sprain: High ankle sprain is a syndesmotic injury and requires surgery. The high ankle sprain is a serious injury because it injures the ligament that connects the tibia to the fibula at the ankle joint. The diagnosis is usually done by the use of external rotation stress views or by CT scan.
Low ankle sprain: A low ankle sprain is not a serious injury and it does not require surgery. Low ankle sprain is collateral ligament injury. With an ankle sprain, although the condition is painful, the patient will be able to walk. When there is a fracture of the ankle, the patient will be unable to walk due to severe pain. The treatment of ankle sprains will include immobilization, ice therapy, physical therapy, and rarely surgery.
Diagnosis of a sprained ankle may be the wrong diagnosis. So, let us see what else can cause pain on the outside of
the ankle.
Peroneal tendon subluxation: Occurs due to rupture of the superior peroneal retinaculum.
Rupture of the peroneus longus tendon: The os peroneum displaces proximally.
Peroneal tendinitis
Anterior process of the calcaneus fracture
Lateral process of the talus fracture Video Rating: / 5
Cape Town, 27 Novemeber 2015 – Former Springbok captain Joost van der Westhuizen is using his profile and daily struggling to help fellow MND patients live a better life. Video Rating: / 5
Breaking news:
“It’s a terrifying disease that brings a death sentence with it.”
“…the link between blue-green algae and the motor neurone disease …”
“the best advice I gave give people is, don’t swim in the lake, don’t drink the water, don’t eat the seafood out of the lake if you can avoid it…just stay away.”
“They have already been warned and they are doing nothing”
If untreated, vitamin b12 deficiency can have severe consequences – including neurological problems like nerve damage, blood diseases like anemia, and physical impairments. Even though the average adult only needs about 2.4 micrograms of vitamin b12 a day, many people don’t get enough from their diet or supplements.
The lack of vitamin b12 is even more prevalent in those who follow a vegan or a vegetarian diet or live with a condition that interferes with nutrient absorption.
Furthermore, vitamin b12 deficiency symptoms are varied and common among other conditions as well; thus, most people easily overlook the signs of a vitamin deficiency until it’s too late. Don’t be one of them!
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Pale white skin was the signature look for the upper class in the Elizabethan era and Queen Elizabeth I’s makeup was perhaps one of the most iconic examples. But what was IN all that caked on makeup? Turns out, there was quite a cost for that noble, porcelain skin as the makeup contained lead. The price for beauty? Slowly poisoning yourself. Yikes. Video Rating: / 5
Vitamins are a popularly advocated requirement for the human body and the water soluble ones are crucial players. Watch this video to understand the “What and Why” of vitamin B complex and its testing by Thyrocare Technologies Limited.
We all know it is our DNA which makes us….which gives the how’s and why’s of our being! Cytogenetics is a diagnostic tool, which can help us understand problems at the molecular level. Watch this video to understand what is cytogenetics/karyotyping and why should anyone get tested?
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Hepatitis B infection globally is one of the most important medical infection that human beings face. Nearly 350 million people live with chronic hepatitis B i.e. in their blood or liver there is infection and this virus is multiplying in their body. Sometimes they know that it is there and many times they are unaware of being infected with hepatitis B. Vaccination against hepatitis B is one of the most effective way to prevent getting hepatitis B breaking the cycle of transmission. Typically the hepatitis B vaccine is given in three doses. If a teenager receives two doses and these are appropriately timed and a part of routine vaccination series I do not expect any untoward incident. As with any medicine or vaccine a very small proportion of patients receiving the vaccine may have a reaction. Most of these tend to be very mild. In some cases it will be a little more serious. If you are experiencing any symptoms after receiving the vaccine seek the help of a family medicine doctor. Majority of people won’t get any untoward incident. It is a very safe vaccine. Video Rating: / 5
CBS News Investigative Correspondent Sharyl Attkisson spoke with Dr. Andrew Wakefield about a recent study comparing the developmental differences between vaccinated and unvaccinated animals.
https://www.tendonitisexpert.com/nothing-stops-my-strep-throat-levaquin-hurt-my-joints.html Nothing Stops my Strep Throat, Levaquin Hurt My Joints
A Levaquin victim asks about chronic strep throat and side effects of Levaquin
Sorry, still haven’t got the sound sorted out.
