Lower Extremity Injuries: Diagnosis and Treatment Overview

Avascular necrosis

Bone tissue death due to interrupted blood supply.

Greater trochanteric bursitis

Inflammation of the bursa near the hip.

IT Band syndrome

Pain caused by friction of the IT band.

Hip fractures

Breaks in the hip bone, identified via imaging.

Quadriceps tendonitis

Inflammation of the quadriceps tendon.

Quadriceps tendon tear

Rupture of the quadriceps tendon.

Patellar tendonitis

Inflammation of the patellar tendon.

Patellar tendon tear

Rupture of the patellar tendon.

Patellar dislocation

Displacement of the kneecap from its position.

Osgood-Schlatter disease

Knee pain in adolescents due to growth.

ACL injury mechanism

Injury from sudden stops or changes in direction.

PCL injury mechanism

Injury from direct impact to the knee.

LCL injury mechanism

Injury from a force applied to the inner knee.

MCL injury mechanism

Injury from a force applied to the outer knee.

Meniscal injury mechanism

Injury from twisting motions during weight-bearing.

Ottawa ankle rules

Guidelines to determine need for ankle X-rays.

Achilles tendonitis

Inflammation of the Achilles tendon.

Achilles tendon rupture

Complete tear of the Achilles tendon.

Plantar fasciitis

Heel pain caused by inflammation of the plantar fascia.

5th metatarsal fractures

Fractures of the fifth toe bone, some need specialist.

Osteonecrosis

Another term for avascular necrosis.

Common Sites

Femoral head, talus, scaphoid affected.

Bisphosphonate Use

Associated with osteonecrosis of the jaw.

Leg-Calve-Perthes Disease

Avascular necrosis occurring in children.

Etiology of AVN

Caused by corticosteroids, alcoholism, trauma.

Clinical Presentation of AVN

Dull ache, pain with movement, decreased ROM.

Antalgic Gait

Gait pattern to avoid pain in lower extremity.

Crescent Sign

X-ray finding pathognomonic for hip AVN.

MRI in AVN

Detects changes earlier than X-ray.

Non-Operative Treatment

Includes NSAIDs, activity modification, physical therapy.

Core Decompression

Surgical treatment for early-stage AVN.

Total Joint Replacement

Surgical option for advanced AVN.

Trochanteric Bursitis

Inflammation of bursa over greater trochanter.

Hip Bursitis

Common cause of lateral hip pain.

Clinical Presentation of Bursitis

Localized pain, tenderness, worsens with activity.

Iliotibial Band Syndrome

Overuse injury causing lateral knee pain.

Ober Test

Diagnostic test for IT Band Syndrome.

Pathologic Fractures

Fractures due to underlying conditions like malignancy.

Classification of Hip Fractures

Based on anatomic location: head, neck, intertrochanteric.

Inability to bear weight

Inability to support body weight on leg.

Shortened leg

Leg appears shorter than the opposite leg.

Externally rotated leg

Leg rotated outward from the hip joint.

Ecchymosis

Bruising due to bleeding under the skin.

Swelling

Increase in size due to fluid accumulation.

X-Ray

Imaging technique for visualizing bone structure.

MRI

Imaging for soft tissue and bone abnormalities.

Occult femoral neck fracture

Fracture not visible on initial X-ray.

Subcapital femoral fracture

Fracture at the femur just below the head.

Transcervical femoral fracture

Fracture through the neck of the femur.

Basicervical femoral fracture

Fracture at the base of the femoral neck.

Intertrochanteric fracture

Fracture between the greater and lesser trochanters.

Subtrochanteric femur fracture

Fracture below the trochanters of the femur.

Pathologic fracture

Fracture caused by underlying disease or condition.

Surgical fixation

Procedure to stabilize fractured bones surgically.

Fascia iliaca block

Nerve block for pain control in hip injuries.

Hemiarthroplasty

Partial hip replacement surgery.

Total arthroplasty

Complete hip joint replacement surgery.

Traumatic dislocations

Dislocations caused by high-energy impacts.

Developmental dysplasia of hip

Improper formation of hip joint in infants.

Barlow test

Test for hip dislocation by posterior movement.

Ortolani test

Test for hip reduction by anterior movement.

Slipped capital femoral epiphysis (SCFE)

Displacement of femoral head in adolescents.

Legg-Calve-Perthes disease

AVN of the hip in children.

Developmental Hip Dysplasia

Abnormal hip joint formation in infants.

Legg-Calve Perthes

Avascular necrosis of the femoral head.

Slipped Capital Femoral Epiphysis

Displacement of the femoral head in adolescents.

Osgood Schlatter Disease

Knee pain due to tibial tuberosity inflammation.

Quadriceps Tendinitis

Inflammation of the quadriceps tendon from overuse.

Quadriceps Tendon Rupture

Complete tear of the quadriceps tendon.

Patellar Tendinitis

Inflammation of the patellar tendon from repetitive strain.

Patellar Tendon Rupture

Complete tear of the patellar tendon.

Patella Baja

Lowered position of the patella in chronic rupture.

Patella Alta

Elevated position of the patella in injuries.

Clinical Diagnosis

Diagnosis based on physical examination findings.

X-Ray Evaluation

Imaging to assess patellar position and alignment.

US/MRI

Imaging techniques for tendon tear confirmation.

Extensor Lag

Inability to fully extend the knee actively.

Pain with Straight Leg Raise

Indicates quadriceps tendon injury severity.

Activity Modification

Adjusting activities to prevent further injury.

NSAIDs

Non-steroidal anti-inflammatory drugs for pain relief.

Knee Immobilizer

Device to restrict knee movement post-injury.

Surgical Repair

Operation to fix torn tendons or ligaments.

Risk Factors for Rupture

Includes diabetes, obesity, and steroid use.

Palpable Defect

Visible gap in tendon indicating rupture.

Pain with Weight Bearing

Indicates severity of patellar tendon injury.

Partial Tear

Injury requiring knee immobilization for 6 weeks.

RICE Protocol

Rest, Ice, Compression, Elevation for injury treatment.

Cortisone Injection

Avoided treatment for knee injuries.

Patella Dislocation

Displacement of patella from femoral sulcus.

Mechanism of Injury (MOI)

Caused by quadriceps contraction and leg rotation.

Re-dislocation Rate

20-45% chance of patella re-dislocating.

Clinical Presentation

Symptoms include knee pain and effusion.

Diagnostic Evaluation

Immediate reduction of patella is critical.

X-Rays

Imaging technique for knee assessment.

Tibial Tubercle

Bony prominence where patellar tendon attaches.

Self-Limiting Condition

Condition that resolves without treatment.

Anterior Knee Pain

Pain located at the front of the knee.

Patellofemoral Pain Syndrome

Common knee pain due to patellar malalignment.

Runners Knee

Another term for patellofemoral pain syndrome.

Quad Weakness

Reduced strength in quadriceps muscle.