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Bone and Spine

Orthopedic health, conditions and treatment

Hand and Upper Limb

Serratus Anterior Paralysis [Long Thoracic Nerve Palsy]

By Dr Arun Pal Singh

Serratus anterior muscle paralysis causes winging of scapula

Serratus anterior paralysis is a condition that characterized by pain, loss of shoulder movement and winging of scapula owing to damage or injury of the long thoracic nerve. This nerve evolves from the roots of neck vertebrae (C5-C7) and supplies to serratus anterior muscle that retains the scapula bone to the chest wall. Long thoracic […]

Filed Under: Hand and Upper Limb

Scapular Winging – Causes, Types and Treatment

By Dr Arun Pal Singh

Medial Winging of Scapula due to Long Thoracic Nerve Palsy

Scapular winging or winged scapula refers to a dysfunction involving the stabilizing muscles of the scapula resulting in imbalance and abnormal motion of the scapula and causing protrusion or prominence of scapula bone. Winging of the scapula is a rare but potentially debilitating condition that can affect the ability to lift, pull, and push heavy […]

Filed Under: Hand and Upper Limb

Scapulothoracic Dissociation – Presentation and Management

By Dr Arun Pal Singh

scapulothoracic dissociation

Scapulothoracic dissociation refers to complete separation of the scapula and the upper extremity from the thoracic attachments. It was defined as a complete disruption of the scapulothoracic articulation with lateral scapular displacement and intact skin by Oereck in 1984 who is credited with its first report. It is also called traumatic forequarter amputation with intact […]

Filed Under: Hand and Upper Limb

Scapular Dyskinesis – Causes, Tests and Treatment

By Dr Arun Pal Singh

type 3 scapular dyskinesis

Scapular dyskinesis is a term that denotes loss of control of normal scapular motion, physiology or mechanics. It is also called sometimes as scapular dyskinesia but dyskinesis is said to be a better term as dyskinesia is applied to abnormal active movements mediated by neurological factors e.g. tardive dyskinesia. Dyskinesis is a finding in the examination […]

Filed Under: General Ortho, Hand and Upper Limb

Swimmer’s Shoulder Causes, Symptoms and Treatment

By Dr Arun Pal Singh

Swimmer's shoulder

Swimmer’s shoulder is an umbrella term covering a range of painful shoulder in the competitive swimmer lead to a spectrum of overuse injuries seen in the swimmer’s shoulder, the most common of which is rotator cuff tendinitis. Shoulder pain is the most common musculoskeletal complaint in swimming with swimmer’s shoulder. Reports of incidence of disabling shoulder pain […]

Filed Under: Hand and Upper Limb

Acro-osteolysis Causes and Features

By Dr Arun Pal Singh

Acroosteolysis clinical image and x-rays

Acro-osteolysis is an osteolysis of the distal phalanges of the hands and feet. It can affect the terminal tuft [transverse acro-osteolysis] or the shaft of the distal phalanx (band acro-osteolysis). Acro-osteolysis is often associated with distal digital ischemia, digital calcinosis, or severe sensory neuropathy. It has been associated with occupational activities, infections, rheumatic disorders (systemic […]

Filed Under: Hand and Upper Limb

Palindromic Rheumatism – Presentation, Diagnosis and Treatment

By Dr Arun Pal Singh

Comparative view of Palindromic Rheumatism as compared to normal

Palindromic rheumatism is recurrent arthritis characterized by episodes of painful swelling of one [usually] or more joints for hours to days often without any obvious triggers or warning symptoms. Any joint(s) may be affected, but finger joints, wrists, and knees are most commonly affected Between episodes, people with palindromic rheumatism have no symptoms and the time between […]

Filed Under: Hand and Upper Limb

Scaphoid Fractures – Classification, Presentation and Treatment

By Dr Arun Pal Singh

Classification of scaphoid fractures

The scaphoid is most frequently fractured carpal bone. Scaphoid fractures account for up to 15% of acute wrist injuries and 50% to 80% of carpal fractures. Scaphoid fractures have been reported in people aged 10-70 years but commonly occur in young, active individuals,  peak incidence being in the second and third decades of life. Scaphoid […]

Filed Under: Hand and Upper Limb

Scapholunate Instability [Scapholunate Ligament Injury]

By Dr Arun Pal Singh

Terry Thomas Sign In Wrsit

Scapholunate instability is a spectrum of wrist instabilities that have occult scapholunate interosseous ligaments sprains on one side and scapholunate advanced collapse on the other side. Often the term is used interchangeably with scapholunate dissociation but in a strict sense, the scapholunate dissociation is one of the types of scapholunate instability. To summarize, acute disruption […]

Filed Under: Hand and Upper Limb

Allen Test – Details and Uses

By Dr Arun Pal Singh

Modified Allen Test

Allen Test is done to check the patency of radial and ulnar arteries. This important test has many uses in clinical practice. One of the common use is before drawing the arterial blood gas to determine if both vessels are patent.

Filed Under: Hand and Upper Limb

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MRI Image of Meniscal Cyst

Meniscal Cysts Causes, Presentation and Treatment

Meniscal cysts are characterized by a local collection of synovial fluid within or adjacent to the meniscus. They could be within the meniscus [perimeniscal cysts] or extend beyond the margins of the meniscus when they are they are termed parameniscal cysts. Meniscal cysts were first described by Ebner in 1904. Though there are no studies […]

King classification of scoliosis curves

Classification of Scoliosis Curves

Scoiliotic curves can be classified by many approaches. We are describing two mainly used methods for classification of scoliosis curves. These classifications are named as Ponseti and Friedman, and Kings’s classification of scoliosis curves. Scoliosis, as we know, is of non-idiopathic and idiopathic types. Neuromuscular and degenerative scoliosis are types of non-idiopathic scoliosis. Ponseti and […]

Grade IV KL OA

Knee Osteoarthritis Symptoms and Treatment

This article focuses on Knee Osteoarthritis. For details on Osteoarthritis, read Osteoarthritis Symptoms, Diagnosis and Treatment Knee osteoarthritis is can result in severe pain and disability, and affect activities like walking even for short distances or climbing stairs. Like all other osteoarthritides, knee osteoarthritis takes a quite some time to develop and worsens gradually. Earlier […]

purine rich foods

Purines and Foods Rich in Purines

Purines are natural substances that form part of the chemical structure of our genes and the genes of plants and animals. Though these are present in many foods, a relatively small number of foods contain concentrated amounts of them. By and large, these foods are also high-protein foods. Examples are meats like kidney, fish like […]

xray of cervical spine in extension

Flexion Extension Xrays of Cervical Spine

Flexion-extension x-rays of cervical spine are Dynamic motion studies of the neck.  These x-rays of the cervical spine are helpful in eliciting less than the obvious instability of the cervical spine and assessing the healing results of the cervical spine following trauma and other pathologies. Flexion-extension x-rays of the cervical spine are taken in different […]

undifferentiated spondyloarthropathy image

Undifferentiated Spondyloarthropathy

Undifferentiated Spondyloarthropathy is a term used to describe the condition where presentation does not meet the criteria for a definitive diagnosis of ankylosing spondylitis or related disease. Undifferentiated spondyloarthropathy may represent an early phase or incomplete form of ankylosing spondylitis or another spondyloarthropathy. However, more recent data suggest that these patients may represent a distinct […]

Approaches to Fibula

Surgical Approaches to Fibula

Posterolateral Approach to Fibula Posterolateral approach to fibula can be used to access the whole of the fibula from head to the lateral malleolus. But in practice, it is most commonly used in upper three-fourths of the fibula It is used in open reduction and internal fixation of fibula fractures, resection of fibula or excision […]

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