Orthopaedic Condition-1

A common condition characterised by tender points in joints, muscles, tendons, & other soft tissues due to sleep disturbances, muscu


  • Long standing, body wide pain & defined tender points.
  • Deep aching, shooting, radiating & burning pain
  • Early morning aches & stiffness

Reduce exercise tolerance loskeletal conditions, chronic fatigue

  • Arthritis” refers to the inflammation involving articular cartilage disruption, synovial membrane, & the peri-articular structures.
  • Is a degenerative joint disease d/t the wear & tear of the articular cartilage.
  • It affects the weight bearing joints of the body- hip, knee & spinal joints.
  • Slow preogression over many years in response to the mechanical stress.
  • Onset- after 40 yrs
  • Knee pain can originate in any of the bony structures compromising the knee joint (femur,tibia, fibula) , the kneecap (patella), or the ligaments & cartilage (meniscus) of the knee


  • Morning stiffness usually < 30 mins.
  • Pain with strenuous activity / weight bearing/ @ night
  • Joint discomfort before/during a change in weather
  • Loss of joint flexibility
  • Pain subsides with rest usually

This is also called a popliteal cyst and typically involves the gastrocnemius- semimembranosus bursa and is located between the medial femoral condyle, semimembranosus tendon and the medial head of the gastrocnemius.It may or may not communicate with the knee joint. It may rupture and extend inferiorly along the gastrocnemius muscle into the calf or extend superiorly into thigh along the semimembranosus.On MRI they appear as well-defined hyperintense lesions on T2W images at the characteristic location. Axial images are the best to demonstrate the communication with the knee joint and also the characteristic location between the semimembranosus tendon and medial head of gastrocnemius.


Primary restraint posterior translation of tibia due to fall on flexed knee with foot plantar flexed which apply posterior force to proximal tibia.

Clinical Features

  • diffuse pain with haemarthrosis & vague tenderness.
  • medial & patellofemoral osteoarthritis.

  • Commonly caused due to hyperextension injury as twisting force on a semi-flexed knee
  • Stopping and changing direction suddenly
  • Complain of knee forced beyond normal range with popping/ tear/ snapping sound.


The reconstruction of the joint by replacing partially/fully with an artificial joint, torestore pain free rom in the joint.

The auto-immune inflammatory disease involving small joints.

Ligament injury due to falling, twisting, or trauma


  • localised swelling
  • tenderness
  • ecchymosis over ligament
  • hemarthrosis
  • unable to move
  • popping sound during injury


Torn muscle/ tendon due to overstretching at rest, twisting, pulling force.

If the injury is followed by severe pain & restricted movements- noticeable tenderness over an isolated part, it signifies signs of fracture or complete muscle tear.

The inflammation of the medial epicondyle at the origin of flexor tendons resulting in pain and tenderness over the elbow. pain is felt due to stress on tendon due to large amount of grip exerted by digits & torsion of the wrist.

This injury is actually caused by the inflammation of the tendons and muscles in the forearm, and as such is a form of tendonitis. These particular muscles are used to bend the wrist back, causing the palm to be face up. The reason the injury is referred to as tennis elbow is that sports such as tennis can cause these muscles to become overused, bringing on the inflammation and pain.

The syndrome caused due to the compression of median nerve due to excessive working on computers or as the complication of colle’s fracture.

• Clinically, motor loss- intrinsic muscle wasting—weak gripping
• Ape thumb deformity
• Loss of opposition of thumb
• Paralysis of first & second lumbricals- unable to make fist
• Sensory loss lateral 3 half digits
• Dry skin & warm due to arteriolar dilatation

Plantar fasciitis, also known as plantar fasciosis or jogger’s heel, is a disorder that results in pain in the heel and bottom of the foot. The pain is usually most severe with the first steps of the day or following a period of rest. Pain is also frequently brought on by bending the foot and toes up towards the shin and may be worsened by a tight Achilles tendon. The condition typically comes on slowly. In about a third of people both sides are affected. Typically there are no fevers or night sweats. The causes of plantar fasciitis are not entirely clear. Risk factors include overuse such as from long periods of standing, an increase in exercise, and obesity. It is also associated with inward rolling of the foot and a lifestyle that involves little exercise. While heel spurs are frequently found it is unclear if they have a role in causing the disease. Plantar fasciitis is a disorder of the insertion site of the ligament on the bone characterized by micro tears, breakdown of collagen, and scarring.

The loss of curvature (medial longitudinal arch) of foot.

Amputation is the removal of a limb by trauma, medical illness, or surgery. As a surgical measure, it is used to control pain or a disease process in the affected limb, such as malignancy or gangrene. In some cases, it is carried out on individuals as a preventative surgery for such problems.

A disease in which defective metabolism of uric acid causes arthritis, especially in the smaller bones of the feet, deposition of chalk-stones, and episodes of acute pain. IT IS caused by too much uric acid in the blood. The most common sign of gout is a nighttime attack of swelling, tenderness, redness, and sharp pain in your big toe.

• Slumped, hunched/ rounded shoulders, protruding abdomen, caved-in chest.
• Pot belly
• Knees flexed while walking/standing.
• Neck & back pain

Loss of lumbar lordosis with actual kyphosis

• Difficulty standing upright
• Thigh and groin pain


  • IVD’s are soft, rubbery pads found b/w the hard bones (vertebrae) making up the spinal column.
  • IVD’s acts as shock absorbers/ lubricating/ cushioning agent providing painfree flexion & extension movts. adding length to the vertebral column.
  • Pivd means the protrusion/ extrusion of nucleus pulposus through a weakness in the outer part of the disc that is, annulus fibrosus


  • Low back ache with or without radiation to the back of leg. (mostly associated with sciatica) or front of thigh (femoral nerve).
  • Paraesthesia & tingling in one leg that can begin in buttock or behind the knee & extend to thigh, ankle, or foot.
  • Muscle weakness u/l or b/l.
  • Pain worse at night or with coughing/sneezing/ laughing, after standing/ sitting, flexion
  • Later, muscle atrophy


It is a chronic generalised inflammatory disease of spine with the involvement of peripheral joints & non-articular surfaces, more common in males.
strong association with hla-b27


• Backache worse in the morning/ during inactivity/ at night
• Intercostal tenderness
• Flattening of lower back
• Diffuse tenderness of spine
• Increase thoracic kyphosis
• Generalised osteoporosis
• Sacroilitis


Characterised by one/ combination of the following—
• Constant pain only one side of buttock/ leg
• Dull ache / pain worse with sitting/ standing up/ coughing
• Leg pain associated with burning/tingling
• Weakness, difficulty in walking

  • The syndrome characterised by pain and instability over the ischial tuberosity.
  • location of pain- hip, coccyx, buttock, groin, distal part of the leg.


  • Pain & weakness on resisted abduction & ext. rotation of the thigh.
  • Tenderness over ischial tuberosity.
  • Intolerance to sitting.
  • Nature of pain- radiating (may be ) which worsens with walking/ squattin


• Dull ache, sharp/ stabbing
• Pain- buttocks/ back of thigh/ low back
• Unilateral or bilateral
• Worst– prolonged sitting / twisting movt
• Morning stiffness
• Pain over posterior superior iliac spine
• Radiation above the knee
• Resolves with exercise generally


  • Forward bending- normal/blocked movt
    • Psis on injured site moves sooner than normal
    • Slr- pain inc. after 45*
    • Side bending- pain inc. on i/l side
    • Upslip- psis & asis higher
    • Anterior rotatory fall- asis lower & psis high with tight hip flexors & weak gluteals
    • Posterior rotatory fall- asis higher, psis lower with tight piriformis/gluteals/hip flexors


It is a most common overuse injury to the knee, mostly due to running, cycling, hiking, weight lifting or sqautting.


  • Lateral knee pain with swelling over the knee.
  • Pain when foot strikes the ground and after activity.
  • Pain increases with time.

It is the tuberculosis of the spine where the intervertebral joints are affected. tissue necrosis and breakdown of inflammatory cells results in paraspinal ABSCESS.


  • High fever with chills
  • Abscess formation
  • Persistent back pain
  • Deformilties- scoliosis/kyphosis