olecranon bursitis , repetitive strain injury ,Epicondylitis, De Quervain’s tenosynovitis i
medial epicondylitis
golfer's elbow. Medial epicondylitis causes pain and tenderness at the medial epicondyle (inner elbow). The pain often radiates down the forearm. It can lead to weakness in grip strength.
what to exclude in olecranon bursitis
if infecition if septic arthritis -- swelling in joint rather than bursa and normally painful and ROM of joint
epicondylitis
inflammation at the point where the tendons of the forearm insert into the epicondyles at the elbow. It is a specific type of repetitive strain injury.
golfers elbow test
involves stretching the flexor muscles of the forearm while palpating the medial epicondyle. The elbow is extended, the forearm supinated, and the wrist and fingers are extended. The examiner holds the patient's elbow with pressure on the medial epicondyle. If this causes pain, the test is positive, indicating medial epicondylitis.
tests for lateral epicondylitis
mills test cozens test
De Quervain's tenosynovitis symptoms
pain on radial side of wrist near base of thumb Pain, often radiating to the forearm Aching Burning Weakness Numbness Tenderness sometimes called mummy thumb-- parents repeativiely lifting up baby in a way that stresses the tendons of the thumb
RICE
rest, ice, compression, elevation
mills test
stretching the extensor muscles of the forearm while palpating the lateral epicondyle The elbow is extended, the forearm pronated, and the wrist is flexed. The examiner holds the patient's elbow with pressure on the lateral epicondyle. If this causes pain, the test is positive, indicating lateral epicondylitis.
lateral epicondylitis
tennis elbow causes pain and tenderness at the lateral epicondyle (outer elbow). The pain often radiates down the forearm. It can lead to weakness in grip strength.
Repetitive strain injury
umbrella term that refers to soft tissue irritation, microtrauma and strain resulting from repetitive activities. It can affect the muscles, tendons and nerves. Lateral epicondylitis (tennis elbow) is a specific example of a repetitive strain injury.
olecranon bursitis presentation
young middle aged man often elbow Is - Swollen Warm Tender Fluctuant (fluid-filled)
lateral epicondyle use
extend wrist
medial epicondyle use
flex wrist
tendons affected in de quaervains tenosynovitis
Abductor pollicis longus (APL) tendon Extensor pollicis brevis (EPB) tendon both abduct thumbs and wrist
causes of repetitive strain injury
Almost any repetitive movement can result in repetitive strain injury if done long enough. It often results from occupational activities, where the same movement is performed for many hours at a time, day after day increased risk if - small repetitive acitivities - vibration -aqrard position
if infection suspected in olecranon bursitis management
Aspiration of the fluid for microscopy and culture Antibiotics- eg flucloxacillin
test for de quervains tenosynovitis
Finkelstein's test involves the patient making a fist with their thumb inside their fingers. Then, the wrist is adducted (ulnar deviation), causing strain on the APL and EPB tendons. If this movement causes pain at the radial aspect of the wrist, the test is positive, indicating De Quervain's tenosynovitis.
cause of bursitis
Friction from repetitive movements or leaning on the elbow Trauma Inflammatory conditions (e.g., rheumatoid arthritis or gout) Infection - referred to as septic bursitis
repetitive strain injury presentation
Pain, exacerbated by using the associated joints, muscles and tendons Aching Weakness Cramping Numbness , the area may be tender to palpation may be mild swelling
management of repetitive straing
RICE rest and adapting activates f the repetitive movement continues, the condition will get worse. Analgesia (e.g., NSAIDs) Physiotherapy Steroid injections (in specific scenarios) OH - amendments in the workplace
management of epicondylitis
Rest Adapting activities Analgesia (e.g., NSAIDs) Physiotherapy Orthotics, such as elbow braces or straps Steroid injections Platelet-rich plasma (PRP) injections Extracorporeal shockwave therapy ca.n take years to resolve Rarely, surgery may be required to debride, release or repair damaged tendons.
olecranon bursitis management
Rest Ice Compression Analgesia (e.g., paracetamol or NSAIDs) Protecting the elbow from pressure or trauma Aspiration of fluid may be used to relieve pressure Steroid injections may be used in problematic cases where infection has been excluded
management of de quervains
Rest and adapting activities Using splints to restrict movements Analgesia (e.g., NSAIDs) Physiotherapy Steroid injections Rarely, surgery may be required to release (cut) the extensor retinaculum, releasing the pressure and creating more space for the tendons.
Cozen's test
elbow extended, forearm pronated, wrist deviated in the direction of the radius and hand in a fist. The examiner holds the patient's elbow with pressure on the lateral epicondyle. The examiner applies resistance to the back of the hand while the patient extends the wrist. If this causes pain, the test is positive, indicating lateral epicondylitis.
De Quervain's tenosynovitis i
a condition where there is swelling and inflammation of the tendon sheaths in the wrist. It primarily affects two tendons: Abductor pollicis longus (APL) tendon Extensor pollicis brevis (EPB) tendon type of repetitive strain injury
students elbow
another name for olecranon bursitis because may leann on elbow for long time
investigation for olecranon bursittis
aspirate joint if infection suspected - Pus indicates infection Straw-coloured fluid indicates infection is less likely Blood-stained fluid may indicate trauma, infection or inflammatory causes Milky fluid indicates gout or pseudogout send for microscopy and culutre do before starting antibiotics
investigations for reparative straing
clinical may do XR, US or bloods to exclude other causes
olecranon bursitis
cnflammation and swelling of the bursa over the elbow. The olecranon is the bony lump at the elbow, which is part of the ulna bone.
