epidemiology

Osteoporosis

Epidemiology

 

1/3 caucasian women > 64

 

Risk Factors

 

Insufficient bone mass at time of skeletal maturity

- peak bone mass is achieved at age 25

 

Rapid loss of bone after menopause

 

Low body weight / weight loss / history of smoking / steroids

 

Primary

 

Type 1

- postmenopausal

- high turnover / osteoclast mediated

- F x 6

Deltoid Ligament

 

Epidemiology

 

Incidence isolated deltoid ligament injury 2.5%

 

Anatomy

 

Strong fan-shaped structure 

- composed of a deep and superficial layer

 

Superficial layer 

- inserts as one continuous structure 

- navicular anteriorly, spring ligament (calcaneonavicular), sustentaculum, and calcaneum 

- measures 10 mm wide at its origin and 2 to 3 mm thick

Heterotopic ossification

Definition

 

Pathological bone formation in soft tissues

 

Epidemiology

 

In elbow

- 3% of trauma

- 89% if head injury + trauma

 

Types

 

Completely different

 

1.  Myosisitis Ossificans Circumscripta

- post traumatic

- more common

- recognised as a consequence of neurological injury

 

Background

Bilateral Hip AVN Xray

 

Definition

 

Non-traumatic or traumatic condition of femoral head with bone death

 

Epidemiology

 

20 - 50 yo (average 38)

- M: F 4:1

 

NHx  

 

70-80% with AVN will progress within 1 year

 

Talar Neck Fracture

Epidemiology

 

Second most common  hindfoot after calcaneal fractures

 

Aetiology

 

Aviators Astragalus

 

Fall from height

- hyper-dorsiflexion injury

- neck of talus strikes the anterior tibia

 

Anatomy

 

More than half surface covered by articular cartilage

- medial articular wall straight

- lateral articular wall curves posteriorly

Os Trigonum FHL Impingement

Posterior Ankle Impingement

 

Epidemiology

 

Repetitive plantar flexion

- soccer players, ballet dancers

 

Cause

 

Os trigonum

FHL stenosing tenosynovitis

Soft tissue mass

 

Os Trigonum

 

Secondary centre of ossification of talus

- lateral to groove for FHL

- 2-7% of normal feet

- impinges against plafond with forced PF

Plantar Fibromatosis

Definition

 

Fibrous proliferative lesion in plantar fascia

 

Epidemiology

 

Male, white, middle age

 

May arise in isolation

 

Association Dupuytren's Diathesis

- aka Lederhosen disease

 

Pathology

 

Proliferative Fibroblastic lesion

- May resemble fibrosarcoma histologically