management

Definition

Pseudogout 

- Calcium Pyrophosphate Dihydrate (CPPD) crystals

- inflammatory arthritis of older individuals 

Types

1.  Dorsal lip fracture / Tuberosity fracture

- avulsion fractures

- most common

- beware avulsion T post

2.  Body fracture

3.  Stress Fractures

Body Fractures

Types

A.  Transverse fracture in coronal plane

B.  Transverse from dorsolateral to plantarmedial

C.  Central or lateral comminution

Definition

Partial or complete rupture of one or parts of lateral ligaments of ankle

- common ankle sprain

Epidemiology

Lateral ligaments sprains are the most common ligamentous injuries of the human body

- account for approximately 15% of all athletic injuries

- it is estimated that there is one ankle inversion injury per day per 10,000 people

Most common young males

- average age 27

Anatomy

Bony

- 90% load through plafond to talus

- 10% load through lateral talofibular articulation

Ligaments

A.  Lateral Ligament Complex

ATFL (Anterior Talo-Fibular Ligament) 

- tight in plantar flexion

Epidemiology

More common in girls

High incidence of positive family history (75%)

Can be associated with mild CP

Pathology

Congruent joint

- 50% compared with 9% in adult HV

Metatarsus primus varus

Definition

Neuropathic Arthropathy

Progressive destructive arthropathy 2° to neurological condition

- usually minimal to no trauma

Aetiology

Epidemiology

80% cancer patients have spinal metastasis at autopsy 

Spine is number one site for bony metastasis (50%)

Cause

Hexagon: PBBLTK

                 Prostate    Breast

Definition 

Structural kyphosis of thoracic or thoracolumbar spine

- characterised by vertebral wedging & subsequent growth disturbance of vertebral end plate

X-ray Diagnostic Criteria Sorensen 1964

1.  Kyphosis > 45°

2. > 5° wedging 3 or more adjacent apical vertebrae

Other features

- Schmorl nodes

Definition

Pain in region of coccyx

Epidemiology

Women

- often obese

- mean age 40 years

Aetiology

Fracture

Difficult vaginal delivery

Subluxation / hypermobile coccyx

Anatomy

3 or 4 fused coccygeal vertebrae

Triangular structure

Definition

Presentation of scoliosis deformity after skeletal maturity

- must be > 21 years at first presentation

- any of usual causes

Typically

- thoracolumbar / lumbar

Epidemiology

Idiopathic 

- most common cause of adult scoliosis

- incidence is  ~ 5% in population