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ChronicInjuryofLocomotorSystem

HUANG,ShilongDepartmentofOrthopedics,TongjiHospitalChronicInjuryofLocomotorSystem

ClassificationChronicInjuryofSoftTissueCartilagechronicinjuryEntrapmentSyndromeofPeripheralNervechronicmusculoskeletalinjuriesClassificationsignsandsymptomssignsandsymptomsSpecificsite:pressurepoint,massesPainoveruseRelatedwithvocation,sittingposition,workhabits,etc.

Localinflammationisnotobviousprincipleoftreatment1Rest2Physicaltherapy,massage3Corticosteroidinjection435NASIDsSurgeryChronicInjuryofSoftTissuesmechanicalbackpainmuscle-orligament-relatedinjuries.CausesStrainedmusclesSprainedligamentsSignsandsymptoms2obviouspressurepoint1pain3musculussacrospinaliscontracturesign4radiatingpainTreatmentPainrelief,NonSteroidAntiInflammatoryDrugs(NSAIDs)andMusclerelaxants.(eperisonehydrochloride)Bursitistheinflammationofoneormorebursae(smallsacs)ofsynovialfluidinthebodyExampleofElbowBursitisSignsandsymptomsBursitissymptomsvaryfromlocaljointpainandstiffness,tostingingpainthatsurroundsthejointaroundtheinflamedbursa.Inthiscondition,thepainusuallyisworseduringandafteractivity,andthenthebursaandthesurroundingjointbecomestiffthenextmorning.Treatmentrest,ice,elevation,physiotherapyanti-inflammatorydrugsandpainmedicationbursectomyStenosingtenosynovitis

Stenosingtenosynovitis(oftencalledtriggerfinger,triggerthumb,stenosingtenovaginitis)isapainfulconditioncausedbytheinflammation(tenosynovitis)andprogressiverestrictionofthesuperficialanddeepflexorsfibroustendonsheathadjacenttoA1pulleyatametacarpalhead.CausesoverusefromchronicrepetitiveactivitiesusingthehandortheinvolvedfingerSignsandsymptomsPainCatchingLockingSwellingtriggerfingerTreatmentModificationofhandactivitiesCorticosteroidinjectionsSurgicalreleaseSurgicalreleaseGanglionisaswellingthatoftenappearsonoraroundjointsandtendonsinthehandorfoot.AspirationSurgicaltreatmentsTreatmentLateralepicondylitisknownastenniselbow,isaconditionwheretheouterpartoftheelbowbecomessoreandtender.CausesdirectblowstotheepicondyleasuddenforcefulpullforcefulextensionSignsandsymptoms1.Painontheouterpartofelbow.2.Grippingandmovementsofthewristhurt.3.Activitiesthatusethemusclesthatextendthewrist.Treatment2Corticosteroidinjection1preventre-irritationofthetendon3NSAIDs4SurgeryFrozenshoulderisadisorderinwhichtheshouldercapsule,theconnectivetissuesurroundingtheglenohumeraljointoftheshoulder,becomesinflamedandstiff,greatlyrestrictingmotionandcausingchronicpain.Signsanddiagnosis2Thejointbecomessotightandstiffthatitisnearlyimpossibletocarryoutsimplemovements.1Female＞MaleLeft＞RightCommonlyinquinquagenarian3Theactiverangeofmotionarethesameoralmostthesameasthelimitstothepassiverangeofmotion4AnarthrogramoranMRIscanmayconfirmthediagnosisTreatmentrestoringjointmovementandreducingshoulderpain,involvingmedications,physicaltherapy,and/orsurgicalintervention.

AvascularNecrosisofFemoralHeadavascularnecrosisofthefemoralhead

isadiseasewherethereiscellulardeath(necrosis)ofbonecomponentsduetointerruptionofthebloodsupply.CausesCausesvascularcompressionposttraumacaissondiseaseexcessivesteroiduseothersalcoholismFemurheadshowingaflapofcartilage(osteochondritisdissecans)duetoavascularnecrosis.Specimenfromtotalhipreplacementsurgery.SignsandsymptomsPatientsmayhavetendernessaroundtheaffectedboneBothactiveandpassivejointmovementsmayberestrictedandpainful.CausejointdeformityandmusclewastingDiagnosisX-rayimagesofavascularnecrosisintheearlystagesusuallyappearnormalCTMRITreatment2coredecompression1conservativetreatment3thefreevascularfibulargraft4transplantingMSCs5totalhipreplacement

ChronicTraumaofBoneandCartilagechondromalaciapatellaeChondromalaciaisduetoanirritationoftheundersurfaceofthekneecap.

Signsandsymptoms1.Painatthefront/innersideofthekneeiscommoninyoungadults

2.Thepainofchondromalaciapatellaeistypicallyfeltafterprolongedsitting,likeforamovie,andsoitisalsocalled"moviesign"or"theatersign."TreatmentphysiotherapyRICE(rest,ice,compression,elevation)anti-inflammatorymedications

surgery(goodoutcomeswithoutsurgery)Intra-articularinjectioncortisone(Careful)Legg-PerthediseaseLegg–Calvé–Perthessyndromeisaformofosteochondritisofthehipjoint,wheregrowth/lossofbonemassleadstosomedegreeofcollapseofthehipjointandtodeformityoftheballofthefemurandsometimesthesurfaceofthehipsocket.Thediseaseistypicallyfoundinyoungchildren

EntrapmentSyndromeofPeripheralNerveentrapmentsyndromeofperipheralnerve

Itisamedicalconditioncausedbydirectpressureonasinglenerve.Itssymptomsincludepain,tingling,numbness,andmuscleweakness.Thesymptomsaffectjustoneparticularpartofthebody,dependingwhichnerveisaffected.carpaltunnels

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