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Greater trochanteric pain syndrome

Definition

Chronic lateral trochanteric pain

- abductor tendon tendonitis

- trochanteric bursitis

Epidemiology

Women 40 - 60 years old

Mechanism

? repetitive friction of iliotibial tract over GT

Symptoms

Pain over upper lateral thigh with activity

- often related to hip flexion

Definition

Present with pain but not instability

Types

Traumatic

Degenerative

Different treatment algorithms for each

History

Ulna side wrist pain

- may be worse with rotation

- opening doors and jars

History of trauma

Examination

Local tenderness DRUJ

Definition

Pigmented Villo-Nodular Synovitis

- benign inflammatory process that arises in synovial tissues

- contains significant amounts of hemosiderin

Epidemiology

Age: 20 - 50

Sex: M > F

Types

A.  Diffuse

- throughout joint synovium

- more difficult to treat / excise fully

Bristow

Concept

Non-anatomical bony block 

- transfer of coracoid process through subscapularis

- dynamic anteroinferior musculotendinous sling

- provides subscapularis tenodesis

- preventing lower portion from displacing proximally as arm abducted

- when shoulder in vulnerable position abduction and ER

Biomechanics

Able to achieve relatively high level of function after STJ fusion

- previously believed that isolated STJ fusion should not be performed

- believed that triple arthrodesis was operation of choice for hindfoot

- STJ fusion has superior result with less stress on AJ

Average loss of DF 30% / PF 10%

Position of hindfoot determines flexibility of transverse tarsal (CCJ & TNJ) joints

- imperative that fusion be positioned in ~ 5^o valgus 

Surgical Options

1.  Open antero-lateral approach 

Large / Massive Cuff Tear

2.  Deltopectoral approach

Large Subscapularis tear

3.  Arthroscopic Assisted Mini-open

Indication

- Small / Moderate Cuff Tear < 3cm

- no retraction

Technique

- arthroscopic SAD

Epidemiology

Most common tumour of hand

F > M

2nd - 4th decade

Aetiology 

Unknown 

Trauma

Mucoid degeneration of collagen tissue

Synovial herniation

Location

Definition

Stenosing tenosynovitis of the first dorsal compartment of wrist

Epidemiology

Most are middle aged women

Aetiology

Repetitive thumb movements

- abduction & extension

- combined with RD & UD movements

Any mechanical irritation

- foreign body

- prominent bony surface

- restricted fascial compartment