pediagenosis: Musculoskeletal >
News Update
Loading...
Showing posts with label Musculoskeletal. Show all posts
Showing posts with label Musculoskeletal. Show all posts

Tuesday, February 9, 2021

SLIPPED CAPITAL FEMORAL EPIPHYSIS

SLIPPED CAPITAL FEMORAL EPIPHYSIS

SLIPPED CAPITAL FEMORAL EPIPHYSIS

Slipped capital femoral epiphysis refers to the displacement of the epiphysis of the femoral head. It occurs most commonly in boys 10 to 17 years of age (average age at onset is 12 years). The initial examination reveals bilateral involvement in about one third of patients, but patients with unilateral involvement have little risk of a subsequent slip on the contralateral side.

DEVELOPMENTAL DISLOCATION OF THE HIP

DEVELOPMENTAL DISLOCATION OF THE HIP

DEVELOPMENTAL DISLOCATION OF THE HIP

Methods for the early detection of developmental dislocation of the hip (DDH) have been reported for nearly 100 years. The first screening program in the United States was described and initiated in the 1930s. After World War II, extensive screening programs in the United States, Sweden, and England resulted in the early identification and, ultimately, the simple, effective, and safe treatment protocols.

PROXIMAL FEMORAL FOCAL DEFICIENCY

PROXIMAL FEMORAL FOCAL DEFICIENCY

PROXIMAL FEMORAL FOCAL DEFICIENCY

Proximal femoral focal deficiency is a randomly occurring congenital abnormality of the proximal femur and hip joint. It is usually unilateral and in 68% of patients is accompanied by fibular hemimelia on the ipsilateral side. About 50% of the patients have skeletal abnormalities of other limbs as well. Based on results of a large radiographic survey, proximal femoral focal deficiency has been classified into four types, according to the type and severity of the femoral and acetabular defects (see Plate 2-22).

PHYSICAL EXAMINATION

PHYSICAL EXAMINATION

PHYSICAL EXAMINATION

Physical examination of the hip is initiated with observation of the patient. Specific note is made of body habitus. Gait is evaluated directly, looking for a Trendelenburg or antalgic gait that favors the affected side. Both gait patterns are associated with intra-articular and extra-articular hip pathologic processes.

Monday, January 11, 2021

BLOOD SUPPLY OF THIGH

BLOOD SUPPLY OF THIGH

BLOOD SUPPLY OF THIGH

ARTERIES

The femoral, obturator, superior gluteal, and inferior gluteal arteries supply the thigh. The former two distribute principally anteriorly; the latter two distribute in the hip region. The femoral artery is the continuation of the external iliac artery. It distributes largely in the femoral triangle and descends through the midregions of the thigh in the adductor canal.

FASCIAE AND MUSCLES OF HIP AND THIGH

FASCIAE AND MUSCLES OF HIP AND THIGH

FASCIAE AND MUSCLES OF HIP AND THIGH

The region of the hip and thigh extends from the iliac crest to the knee. The upper portion is the hip, which is limited generally by the level of the greater trochanter of the femur. The subcutaneous connective tissue contains a considerable amount of fat, especially in the gluteal region. The subcutaneous tissue here is continuous with the similar layer of the lower abdomen, and the membranous layer of the latter region continues beyond the inguinal ligament to become attached to the fascia lata a short distance beyond the ligament. The layer attaches medially to the pubic tubercle and laterally to the iliac crest. It also attaches to the margins of the saphenous opening and fills the opening itself with the cribriform fascia, a subcutaneous connective tissue perforated for the passage of the greater saphenous vein and other blood and lymphatic vessels.

NERVES OF THIGH

NERVES OF THIGH

NERVES OF THIGH

FEMORAL NERVE

The femoral nerve (L2, 3, 4) is the largest branch of the lumbar plexus (see Plate 2-5). It originates from the posterior divisions of the ventral rami of the second, third, and fourth lumbar nerves, passes inferolaterally through the psoas major muscle, and then runs in a groove between this muscle and the iliacus, which it supplies. It enters the thigh behind the inguinal ligament to lie lateral to the femoral vascular sheath in the femoral triangle. Twigs are given off to the hip and knee joints and adjacent vessels, and cutaneous branches are given off to anteromedial aspects of the lower limb.

Thursday, November 5, 2020

LUMBOSACRAL PLEXUS

LUMBOSACRAL PLEXUS

LUMBOSACRAL PLEXUS

NERVE SUPPLY

In describing the lower limb, the lumbosacral plexus may be said to be formed from the ventral rami of the first lumbar to third sacral nerves (L1 to S3), with a common small contribution from the 12th thoracic nerve (T12) (see Plates 2-2 to 2-4). The lumbar portion of the plexus arises from the four upper lumbar nerves and gives rise to the iliohypogastric, ilioinguinal, genitofemoral, lateral femoral cutaneous, obturator, accessory obturator, and femoral nerves.

SUPERFICIAL VEINS AND CUTANEOUS NERVES

SUPERFICIAL VEINS AND CUTANEOUS NERVES

SUPERFICIAL VEINS AND CUTANEOUS NERVES

SUPERFICIAL VEINS

Certain prominent veins, unaccompanied by arteries, are found in the subcutaneous tissue of the lower limb (see Plate 2-1). The principal ones are the greater and lesser saphenous veins, which arise in the venous radicles in the feet and toes. Dorsal digital veins lie along the dorsal margins of each digit, uniting at the webs of the toes into short dorsal metatarsal veins that empty into the dorsal venous arch. There are also plantar digital veins, which drain into the dorsal metatarsal veins.

LUMBOSACRAL AGENESIS

LUMBOSACRAL AGENESIS

LUMBOSACRAL AGENESIS

Lumbosacral agenesis is a condition in which the sacrum and some of the lumbar vertebrae, or both, fail to develop. Although the etiology is not certain, it has been noted that 14% to 18% of patients have mothers with diabetes or a strong family history of diabetes.

MYELODYSPLASIA

MYELODYSPLASIA

MYELODYSPLASIA

The number of infants with myelodysplasia who survive infancy has increased dramatically in the past 30 years, and as clinical experience with these patients has increased, new principles and techniques of treatment have emerged.

SPONDYLOLYSIS AND SPONDYLOLISTHESIS

SPONDYLOLYSIS AND SPONDYLOLISTHESIS

SPONDYLOLYSIS AND SPONDYLOLISTHESIS

Spondylolysis may represent a stress fracture of the pars interarticularis of the fifth lumbar vertebra. When the fracture allows L5 to slip forward on S1, it is called isthmic spondylolisthesis. Dysplastic, or congenital, spondylolisthesis, in contrast, is due to anomalous development of the posterior structures of the lumbosacral junction.

CONGENITAL KYPHOSIS

CONGENITAL KYPHOSIS

CONGENITAL KYPHOSIS

Congenital kyphosis is due to the same embryologic failure of segmentation or formation of the vertebrae as congenital scoliosis. The direction of the curve (lateral or posterior) depends on the location of the spinal defect. Anterior defects cause kyphosis, and lateral defects cause scoliosis. A combined deformity, kyphoscoliosis, is common. In about 15% of patients, congenital deformities are associated with an anomaly of the neural elements (e.g., diastematomyelia, neurenteric cyst).

SCHEUERMANN DISEASE

SCHEUERMANN DISEASE

SCHEUERMANN DISEASE

Although an exaggerated thoracic kyphosis has been documented for centuries, it was only with the advent of medical radiography that Scheuermann identified the disease. This progressive disorder occurs in patients near puberty, manifested by an increase in the normal kyphosis in the thoracic spine with an abnormal degree of wedging of the vertebrae at the apex of the kyphotic curve. The diagnosis of Scheuermann disease is limited to patients with a kyphotic curve greater than 60 degrees. (Measurements are done in a manner similar to the coronal plane Cobb method; see Plate 1-40.) Typically the curve is measured from T4 to T12 on the lateral view. Normal kyphosis is 20 to 45 degrees in which at least three adjacent vertebrae are wedged 5 degrees or more and where disc space narrowing and end plate irregularity are noted. Although Schmorl’s nodules are common radiographic findings, they are not part of the diagnostic criteria of Scheuermann disease.

SCOLIOSIS

SCOLIOSIS

SCOLIOSIS

Scoliosis is a rotational deformity of the spine and ribs. While in most cases the cause of scoliosis is unknown (idiopathic scoliosis), in excess of 50 genetic markers have been identified as having a major role in adolescent idiopathic curves. Scoliosis may also result from a variety of congenital, neuromuscular, mesenchymal, and traumatic conditions, and it is commonly associated with neurofibromatosis.

ANATOMY PHYSIOLOGY

[AnatomyPhysiology][recentbylabel2]
Notification
This is just an example, you can fill it later with your own note.
Done