Heterotopic ossification
DDx
Parosteal OS
- bone is not continuous with cortex in MO
Aetiology
3% incidence in elbow joint trauma to some degree
differential diagnosis
Lateral epicondylitis
Incidence
Lateral : Medial 9:1
Epidemiology
4th & 5th decades
- M = F
- 75% dominant arm
50% of regular tennis players
- especially > 2 hrs / week
Aetiology
Insertion pathology / Enthesopathy
Over-extension of the elbow with supination / pronation
Anatomy
Lateral epicondyle
- anconeus from posterior face
- ECRB and EDC from anterior face (CEO)
DDx Anterior Knee Pain
Plica
Jumper's knee / Tendonitis
Bursitis
- prepatellar most common
- Pes anserinus
Excessive Lateral Pressure Syndrome / Patella Tilt
Hoffa's Disease / Fat Pad Syndrome
ITB Syndrome
RSD
Others
- RA
Common Peroneal Nerve Palsy
Incidence
Most common lower limb neuropathy
Aetiology
Valgus TKR - 3%
HTO - 10%
Direct Trauma / Compression
Knee Dislocation
Tibial fracture
Cast / Dressing
Lateral Meniscus Repair
AVN
SONK vs Atraumatic AVN
>55 Often mid 30's
Painful THA
Aetiology
Intrinsic
Infection
Loosening
Thigh pain in uncemented
- micro motion at distal end of stem
- modulus mismatch
Stress fracture / insufficiency fracture
- pubic rami, sacral
Intra-operative fracture
Prosthesis failure
Subtle instability
Extrinsic
Child Abuse / Non Accidental Injury
Definition
Any act or failure to act that
- results in or potentially results in harm / death / physical / emotional / sexual abuse
- by a parent or caretaker who is responsible for the child
4 types
Neglect
Physical (punch / kick / bite / burn / shake)
Sexual
Emotional
Risk factors
Toe Walking
Epidemiology
70% male
70% positive FHx
20% learning difficulties
DDx toe walking
Early / late onset
Unilateral / bilateral
1. Habitual
Toddlers - child can heel walk
2. Structural
Fixed equinus - CTEV / arthrogryposis
Short / tight T Achilles
Space occupying lesion in calf
Calcaneovalgus
Definition
Condition present at birth
- ankle dorsiflexed & in valgus
- foot abducted
Epidemiology
1 in 1000 births
Aetiology
Probably result of intrauterine positioning
- packaging defect
Associations
Oligohydramnios
DDH
Blount's disease
Definition
Progressive varus deformity of knees
- secondary to abnormality of medial upper tibial physis
- localised varus & internal rotation deformity
Infantile form
- onset 1-3 years / bilateral
Adolescent form