What diseases can be associated with synovitis?
Gout and rheumatoid arthritis.
In which joints can synovitis occur?
In any synovial joint, e.g., elbow joint.
p.9
Adhesive Capsulitis of Shoulder Joint (Frozen Shoulder)
How much apparent abduction can a patient achieve in the shoulder?
Up to 45° by upward rotation of the scapula.
p.5
Elbow Joint Dislocation
What associated injury can occur with elbow joint dislocation?
Avulsion of medial epicondyle.
How does synovitis typically affect the joints?
It usually affects joints on both sides.
What additional symptom may be present in synovitis?
Presence of hard lumps (nodules).
What sensation might be felt in the GH joint during movement with a glenoid labrum tear?
A sense of popping or snapping.
p.6
Subluxation of Radial Head (Nursemaid’s Elbow)
What happens to the radial head during a sudden pull?
It moves distally out of the 'socket' formed by the annular ligament, resulting in radial subluxation.
p.9
Adhesive Capsulitis of Shoulder Joint (Frozen Shoulder)
What is a common symptom of shoulder pain and stiffness?
Loss of ability to move the shoulder, especially abduction.
What is a common presentation of a glenoid labrum tear?
Pain while throwing objects, especially during the acceleration phase.
p.1
Acromioclavicular Joint Dislocation
Which muscles contribute to the elevation of the clavicle in AC joint dislocation?
Sternocleidomastoid and trapezius.
p.4
Glenohumeral Joint Dislocation
What happens to the head of the humerus after dislocation?
It is initially inferior to the glenoid cavity but can be pulled anterosuperiorly into a subcoracoid position due to muscle spasms.
p.7
Dislocation of Radial Head
Where does the supinator muscle insert?
Into the proximal 1/3 of the radius.
p.3
Glenohumeral Joint Dislocation
What causes anterior dislocation of the Glenohumeral joint?
A hard blow to the humerus when the joint is fully abducted or excessive extension and lateral rotation of the humerus.
p.5
Elbow Joint Dislocation
What is a typical presentation of an elbow joint dislocation?
Upper extremity flexed and appears shortened with exaggerated prominence of olecranon.
p.3
Glenohumeral Joint Dislocation
How does a blow to the humerus when fully abducted lead to dislocation?
The head of the humerus tilts inferiorly onto the weak part of the joint capsule, tearing the capsule and dislocating the shoulder.
What are the risk factors for rheumatoid arthritis?
Genetic factors and environmental factors (e.g., smoking).
p.4
Glenohumeral Joint Dislocation
How is the arm typically positioned in anterior/inferior dislocations?
Held in an abducted and laterally rotated position.
p.7
Dislocation of Radial Head
What is a common cause of radial head dislocation in children?
Secondary to radial subluxation.
p.3
Glenohumeral Joint Dislocation
What causes posterior dislocation of the Glenohumeral joint?
Direct anterior trauma to the shoulder.
p.3
Glenohumeral Joint Dislocation
What happens to the humeral head during excessive extension and lateral rotation?
The head of the humerus is driven anteroinferiorly, potentially stripping the fibrous capsule and glenoid labrum from the anterior aspect of the glenoid cavity.
p.5
Elbow Joint Dislocation
What can cause severe hyperextension of the elbow leading to dislocation?
A blow that drives the ulna posteriorly.
p.7
Dislocation of Radial Head
What position does the patient hold their limb in when experiencing radial head dislocation?
Elbow flexed and forearm pronated.
p.2
Acromioclavicular Joint Dislocation
What happens to the shoulder bump when a patient rotates their head to the opposite side of the injury?
The shoulder bump may become more prominent due to the action of the sternocleidomastoid pulling the clavicle upwards.
p.1
Acromioclavicular Joint Dislocation
What is a common cause of acromioclavicular joint dislocation?
Direct blow to the AC joint or a hard fall on the shoulder.
What causes osteoarthritis?
Constant wear and tear, and repeated microtrauma to a joint.
p.1
Acromioclavicular Joint Dislocation
What happens to the clavicle in a complete acromioclavicular joint dislocation?
The lateral end of the clavicle elevates due to muscle pulling.
p.6
Subluxation of Radial Head (Nursemaid’s Elbow)
What is a key presentation of a child with Nursemaid's elbow?
The patient refuses to move the limb, especially at the elbow.
Where are common sites of occurrence for rheumatoid arthritis?
Elbow joint, wrist joint, and metacarpophalangeal joints.
p.4
Glenohumeral Joint Dislocation
What is a rare cause of posterior dislocation of the humerus?
Blunt trauma pushing the head of the humerus through the posterior part of the joint capsule.
p.7
Dislocation of Radial Head
What should be done if the annular ligament is torn?
The limb is placed in a sling for 2 weeks.
What is the pathophysiology of synovitis?
Swollen and inflamed synovial membrane due to various underlying illnesses.
What is the pathophysiology of osteoarthritis?
It is a degenerative disease involving gross cartilage loss and morphological damage to other joint tissues.
What are common symptoms of osteoarthritis?
Joint pain, stiffness, decreased range of motion, and joint swelling.
What is the pathophysiology of rheumatoid arthritis?
An autoimmune attack on the synovial membrane of joints, leading to inflammation.
p.7
Dislocation of Radial Head
How is the radius typically dislocated in radial head dislocation?
Usually dislocated anteriorly.
p.5
Elbow Joint Dislocation
What is a common cause of elbow joint dislocation?
Fall on hands with a flexed elbow.
p.3
Glenohumeral Joint Dislocation
What is a potential cause of inferior dislocation of the Glenohumeral joint?
An avulsion fracture to the greater tubercle of the humerus.
p.1
Acromioclavicular Joint Dislocation
What type of trauma usually leads to acromioclavicular separation?
Milder (usually indirect) trauma.
p.6
Subluxation of Radial Head (Nursemaid’s Elbow)
What is a common cause of Nursemaid's elbow?
A child being abruptly lifted by the upper limb while the arm is pronated.
What complication can arise from a glenoid labrum tear?
Recurrent dislocation of the GH joint.
What are the common symptoms of synovitis?
Joint swelling, pain, and stiffness.
p.2
Acromioclavicular Joint Dislocation
What causes the shoulder to drop when the clavicle separates from the scapula?
The weight of the upper limb causes the shoulder to drop.
Where are common sites of occurrence for osteoarthritis?
Shoulder joint and 1st carpometacarpal joint.
p.8
Adhesive Capsulitis of Shoulder Joint (Frozen Shoulder)
What can lead to adhesive capsulitis of the shoulder joint?
Shoulder trauma, rotator cuff tears, fractures, or prolonged immobilization.
p.6
Subluxation of Radial Head (Nursemaid’s Elbow)
Why does flexing the elbow cause severe pain in a child with a subluxated radial head?
Because the radial head pinches on the injured annular ligament due to the pulling action of the biceps brachii.
p.7
Dislocation of Radial Head
Why does attempting to supinate the arm cause pain in radial head dislocation?
It pulls on the subluxated radius and presses on the annular ligament.
What are common causes of a glenoid labrum tear?
Acute trauma, repetitive shoulder movements, and usually associated with GH joint dislocation.
p.2
Acromioclavicular Joint Dislocation
What is the role of the clavicle in the pectoral girdle?
The clavicle is the sole structure connecting the pectoral girdle to the trunk.
p.1
Acromioclavicular Joint Dislocation
What ligaments are torn in a complete acromioclavicular joint dislocation?
Coracoclavicular ligaments.
p.6
Subluxation of Radial Head (Nursemaid’s Elbow)
Why is the radial head prone to subluxation in children?
The head of the radius is often not well developed, and the annular ligament is relatively loose and thin.
p.7
Dislocation of Radial Head
What clinical presentation is associated with radial head dislocation?
Prominent lump on the anterior/lateral aspect of the elbow.
p.2
Acromioclavicular Joint Dislocation
In AC joint dislocation with intact coracoclavicular ligaments, what is the likely observation?
There would likely be no shoulder bump since the ligaments prevent the upwards subluxation of the clavicle.
p.5
Elbow Joint Dislocation
What ligament is often torn in elbow joint dislocation?
Ulnar collateral ligament.
p.6
Subluxation of Radial Head (Nursemaid’s Elbow)
What may occur to the annular ligament during radial head subluxation?
The annular ligament may be torn.
p.7
Dislocation of Radial Head
What happens when the patient is asked to supinate their arm?
They are unable or unwilling to do so due to pain.
p.8
Adhesive Capsulitis of Shoulder Joint (Frozen Shoulder)
What underlying conditions are associated with adhesive capsulitis of the shoulder joint?
Diabetes mellitus, thyroid disease, and hypertriglyceridemia.
p.8
Adhesive Capsulitis of Shoulder Joint (Frozen Shoulder)
What is the pathophysiology of adhesive capsulitis?
Adhesive fibrosis and scarring between the inflamed capsule of the GH joint, rotator cuff, subacromial bursa, and deltoid.
p.7
Dislocation of Radial Head
What type of injury can cause radial head dislocation in adults?
High force injury, such as a motor vehicle accident or fall on an outstretched arm.
p.4
Glenohumeral Joint Dislocation
What causes inferior dislocation of the humerus?
An avulsion fracture of the greater tubercle prevents muscles from pulling the humerus superiorly and medially.
p.7
Dislocation of Radial Head
What is the initial treatment for a child with radial head dislocation?
Supination of the child’s forearm while the elbow is flexed.
