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Bone and Spine

Orthopedic health, conditions and treatment

Lower Limb

Posterior Cruciate Ligament injury or PCL Injury

By Dr Arun Pal Singh

posterior cruciate ligament injury

Posterior cruciate ligament injury or PCL injury is less common than the anterior cruciate ligament injury.  A posterior cruciate ligament tear may result in disability ranging from no impairment to severe impairment. The primary function of the PCL is to prevent posterior translation of the tibia on the femur. The posterior cruciate ligament is also important […]

Filed Under: Knee

Calcaneus Fracture – Causes, Presentation and Treatment

By Dr Arun Pal Singh

Anatomy of Calcaneus

Calcaneus fracture or os calcis represent 2% of all fractures seen in adults. The os calcis is the most frequently fractured tarsal bone and accounts for more than 60% of tarsal fractures. Calcaneus is the bone that forms the heel. Calcaneus fractures are most commonly seen in young men. Extra-articular fractures account for 30% of […]

Filed Under: Foot Ankle, Trauma

Genu Recurvatum or Knee Hyperextension

By Dr Arun Pal Singh

Genu Recurvatum in a child

Genu recurvatum is a deformity in the knee  where the knee angulates backwards because of hyperextension occurs in the tibiofemoral joint [the knee goes further into extension beyond the neutral] Genu recurvatum is also called knee hyperextension and back knee. Depending upon hyperextension, the recurvatum could be mild, moderate or severe. The normal range of motion of the knee joint is from […]

Filed Under: Knee

Anterior Cruciate Ligament Injury or ACL Injury

By Dr Arun Pal Singh

anterior cruciate ligament injury

Anterior cruciate ligament injury is a very common injury of the knee. It may occur in isolation or along with other soft tissue or bony injury of the knee. Anterior cruciate ligament injury or ACL injury most commonly results from a low velocity, noncontact deceleration injuries or pivoting injuries and contact injuries with a rotational […]

Filed Under: Knee

Trochlear Dysplasia of Femur

By Dr Arun Pal Singh

trochlear bump measurement

Trochlear dysplasia refers to a pathologic alteration in the shape of the femoral trochlea. Trochlea is also called facies patellaris, intercondylar groove, or intercondylar sulcus. Normal trochlea is sufficiently concave to guide and retain the patella throughout the normal range of movement. However trochlear dysplasia may cause the groove to be shallower than normal or […]

Filed Under: Knee

Patellar Translation or TT TG Distance

By Dr Arun Pal Singh

Calculation of Tibial Tuberosity - Trochlear Groove Distance

Patellar translation is the distance between tibial tubercle and trochlear groove and is also called TT-TG distance. It is measured on CT or MRI by overlapping or superimposing axial images of the femoral condyles and tibial tuberosity. The measurements are used to quantify patellar instability. The position of the tibial tubercle is crucial for the inferolateral force […]

Filed Under: Knee

Patellar Instability – Causes, Presentation and Treatment

By Dr Arun Pal Singh

Patella ligament stabilizers

Patellar instability or Patellofemoral instability is a frequent cause of symptoms of anterior knee pain and episodes of mechanical instability. It is also called patellar subluxation syndrome. There is a difference between symptoms of instability and patellar dislocation, though the former may cause the latter to happen. The term can denote a sign on physical examination or […]

Filed Under: Knee

Patella Baja or Low Lying Patella

By Dr Arun Pal Singh

Different ratios for calculating patellar height

Patella Baja or patella infera is an abnormally low lying patella [compare with patella alta, the high riding patella]. It is associated with a restricted range of motion, crepitations, and retropatellar pain. Patella baja could be congenital, acquired, or a combination of the two is commonly encountered in total knee arthroplasty. Any cause that would lead to […]

Filed Under: Knee

Patella Alta Causes, Presentation and Treatment

By Dr Arun Pal Singh

Camelback Sign Patella Alta

Patella alta, or a high riding patella, is a situation where the position of the patella is considered high in relation to distal femur. It may be idiopathic or may result secondary to an injury or disease process. The patella is up and above the knee joint instead of a normal position in the groove. As […]

Filed Under: Knee

Patellar Height Measurement – Insall Salvati, Blackburne-Peel and Caton-Deschamps Indices

By Dr Arun Pal Singh

Different indices for patellar height measurement

Patellar height measurement becomes important in the diagnosis of patella alta and patella baja. Patella alta is a condition where the patella is high riding than its normal position. Patella baja refers to low lying position of the patella. Both conditions have been discussed separately. Measurement of patellar height can confirm or rule out the […]

Filed Under: Knee

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Coccydynia or tailbone pain

Coccydynia – Causes, Symptoms and Treatment

Coccydynia, also called coccygodynia refers to pain in the coccyx region. The term was given by Simpson in 1859. However, the condition has been reported in the literature before that period too. The coccyx is lowermost part of the spine and is also called tailbone. One can feel the lower end of the coccyx in the […]

Muscles of Hip and Thigh

Muscles of Hip

Muscles of the hip joint are those muscles that cause movement in the hip. The muscles of the hip consist of four main groups. Gluteal Group The gluteal muscles cover the lateral surface of the ilium and include Gluteus maximus Gluteus medius Gluteus minimus Tensor fasciae latae Adductor group This group includes Adductor brevis Adductor […]

Spinal Stenosis, Lumbar Canal - In public domain

Spinal Stenosis – Causes, Types, Symptoms and Treatment

Spinal stenosis indicates a pathological condition causing the compression of the contents of the canal, especially neural structures. The term stenosis means a narrowing of the caliber of an orifice or a tube. Spinal stenosis, therefore, defines a narrowing of the bone channel occupied by the spinal nerves or the spinal cord. This is usually […]

Vertical Fracture Distal Radius

Wrist Injuries X-rays and Photographs

The wrist is a very commonly injured organ. In this article wrist injuries, x-rays and clinical photographs are being presented. Wrist injuries can involve distal radius, ulna and wrist bones or carpal bones.  Here is a normal x-ray of the wrist.   Image 1 – Xray of Wrist Showing Fracture of Distal Radius [Colles Fracture] […]

Anatomy of Elbow Joint

Elbow Pain Causes and Treatment

Elbow pain can be due to the problem in elbow joint, bones forming the joint or the tissues surrounding it. Elbow joint is formed by humerus bone above, and radius and ulna bones below. Most elbow pain results from overuse injuries. Relevant Anatomy of the Elbow Lower End of Humerus The lower end of the […]

Normal bone and Bone in Paget Disease

Paget Disease Symptoms, Diagnosis & Treatment

Paget disease of bone was first described by James in 1877 who described it as chronic inflammation of the bone and called it osteitis deformans. The term osteitis deformans is now considered technically incorrect, and the preferred term is osteodystrophia deformans. Paget disease is a localized disorder of bone remodeling that typically begins with excessive […]

Simulation photograph of tennis elbow to depict point of pain

Tennis Elbow or Lateral Epicondylitis

Tennis elbow or lateral epicondylitis is a term for a painful condition of elbow because of tendinosis of extensors of the wrist at the attachment on the lateral epicondyle. Lateral epicondyle is part of the distal humerus on the lateral or outer side of the elbow. Extensor carpi radialis brevis tendon is most commonly involved […]

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