Clinical Application (bronze)

anterior compartment syndrome

characterized by increased pressure in the lower leg secondary to swelling, which can occlude blood flow and cause ischemia and necrosis of the surrounding nerves and musculature

chronic cases may occur secondary to athletic exertion, acute cases are often caused by a traumatic injury and are considered a medical emergency

symptoms include tightness and tenderness over the muscle belly of the anterior tib, pain with passive stretching or active use of the muscle, and paresthesias and/or numbness in the distribution of the deep fibular nerve

colles’ fracture

frequently occurs when an individual reaches forward with their hands while attempting to break a fall, characterized by a transverse fracture of the distal radius

trauma related to this maneuver is commonly termed a FOOSH

x-ray of the wrist is the preferred method of confirming a fx and identifying displaced fragments or damange to adjacent bony structures

dequervain’s tenosynovitis

results from an inflammatory process involving the tendons and synovium of the abductor pollicis longus and extensor pollicis brevis at the base of the thumb

onset is typically due to repetitive activives involving thumb abduction and extension suchas racquet sports and repeated heavy lifting

symptom onset may be gradual or sudden depending on the mechanism of injury with report of localized pain and tenderness in the area of the anatomical snuffbox which may radiate

myositis ossificans

chraacterized by the calcification of muscle that is usually caused by neglecting to properly treat a muscle strain or contusion

development of this condition occurs within a few weeks after the initial injury and may include a noticeable hard lump in the muscle belly, an increase in pain, and a decrease in ROM

x-ray is the primary imaging study to confirm the dx

osteochondritis dissecans

condition in which loss of blood flow to subchondral bone causes a piece of bone and its associated cartilage to crack and separate away from the end of the bone

symptoms may include pain wiht functional activities, joint popping or locking, weakness, swelling and decreased range of motion

x-ray can be used to confirm the dx

osteomyelitis

an infection that occurs within the bone, most commonly secondary to the staphyloccocus aureus microbe

damage to the bone from a surgical procedure, compound fracture or puncture wound that penetrates the bone may directly expose the bone to infectious microbes

a bone biopsy is the most conclusive procedure for diagnosing osteomyelitis and determining the specific infectous microbe present

tarsal tunnel syndrome

occurs as a result of compression of the tibial nerve as it passes through the tarsal tunnel, causing neuropathy in the distribution of the nerve

signs and symptoms include pain, numbness and paresthesias in the foot, muscle atrophy and weakness, diminished light touch and temperature sensation and an antalgic gait pattern

tinel’s sign can be used to confirm the presence of the condition

ulnar collateral ligament sprain - thumb

occurs secondary to traumatic event in which an excessive valgus force is applied to the metacarpophalangeal joint or the thumb

the therapist should perform ligament stability testing of the thumb by applying a valgus force to the joint, with a movement of greater than 30-35 degrees indicating a complete tear of the UCL

x-rays should be ordered to rule out the existence of a fracture or dislocation