Tendinitis
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Definition Inflammation of the tendon
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Tenosynovitis Definition Inflammation of the enclosed tendon shealth
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Etiology Overuse injuries and systemic disease (arthritides)
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Clinical Features Pain with movement, swelling, impaired function. Commonly in rotator cuff, patella, hip, flexor carpi radialis and ulnaris, flexor digitorum. May resolve w/in a few weeks, but also recurrent.
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Treatment Ice, rest, stretching, NSAIDs. Corticosteroid + lidocaine injections. Excision of scar tissue last resort. (Scar tissue from repetitive tissue microtrauma)
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Bursitis
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Definition An inflammatory disorder of the bursa (thin-walled sac lined with synovial tissue) caused by trauma or overuse
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Clinical features Pain, swelling, tenderness x weeks. Commonly in subacromial, subdeltoid, trochanteric, ischial, prepatellar, suprapatellar ("housemaid's knee")
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Treatment Prevent precipitating factors, rest, NSAIDs, steroid inj.
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Osteomyelitis
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Definition Inflammation of the bone caused by a pyogenic organism. Described by duration (acute/chronic), cause (surgical, etc.), site, extent, and patient type
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Most common pyogenic organism Stap. aureus
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Most commonly affects long bones of children Acute hematogenous osteomyelitis
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Patients with sickle cell anemia at risk for salmonella osteomyelitis
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When viable bacterial colonies harbor in necrotic and ischemic tissue even after original infection treated, and this can lead to recurrent of infection Chronic hematogenous osteomyelitis
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Results from open fracture or surgery Exogenous osteomyelitis
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Clinical features - Acute Hematogenous Osteomyelitis Pain, loss of motion, soft-tissue swelling, drainage is rare
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Clinical features - Chronic Hematogenous Osteomyelitis Recurrent flare-ups of tender, warm, sometimes swollena reas. Malaise, anorexia, fever, weigh loss, night sweats, pani and drainage from sinus tract
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Lab Studies Culture or bone bx to ID organism, WBC/CRP/ESR might be elevated, can see changes on x-ray after 7-10 days, MRI earlier
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Treatment Acute-->3 wk course of abx (1wk IV, 2wks oral). Chronic-->at least 4wks to 24mo of IV and PO abx. Surgical drainage and treatment possibly necessary.
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