Minimal trauma fracture
- secondary to osteoporosis
- wedge fractures
F > M
More common in elderly patients
Uncommon in men < 75
- look for alternative diagnosis
Renal failure
Malignancy - metastasis
Infection
Can present with pain
Groin pain in athletes
- secondary to tear in external oblique fascia
Sports with aggressive adduction
- hockey / soccer
Tears in external oblique fascia
- tend to be central
- around spermatic cord and ilioinguinal nerve
- pain may be from nerve entrapment
Adductor Longus Tear
Throwing injury
- seen in the throwing athlete
- repetitive microtrauma / valgus stress
- develop laxity
Initially
- lose velocity / accuracy
Develop medial pain
40% ulna nerve symptoms
Usually occurs in patients over 60
- due to decreased vascularity & collagen weakness
Younger patient on steroids / growth hormone
Occasionally occurs in young athlete with excessive contracture
Often preceded by quadriceps tendinosis
Adolescent apophyseal avulsion
- treat non operatively
- unless displaced > 2 cm
Adult
- soft tissue avulsion
Usually associated with sporting activities
- skiing
- water skiing
Violent contraction
- knee extended
- hip flexing
Multi-ligament knee injury (MLKI)
- 2 or more ligaments disrupted
Knee dislocation
- ACL + PCL + one of collaterals
High energy (MVA)
Low energy (sport)
- low energy has 5% arterial injury
Primary malignancy arising from remnants of the notochord
Rare malignant tumour
Middle-aged adults (50-70)
M>F
In midline in axial skeleton
Base of skull 35%
Vertebrae 15%
- especially cervical
Sacrum 50%
Pigmented Villo-Nodular Synovitis
- benign inflammatory process that arises in synovial tissues
- contains significant amounts of hemosiderin
Age: 20 - 50
Sex: M > F
A. Diffuse
- throughout joint synovium
- more difficult to treat / excise fully
