"MRI Atlas: Orthopedics and Neurosurgery, The Spine" by Martin Weyreuther, Christoph E. Heyde, Michael Westphal, and Jan Zierski
Springer | 296 pages | English | 2006 | ISBN: 3540335331 | File type: PDF | 16,8 mb
This MRI atlas of the spine is the fruit of interdisciplinary cooperation among radiologists, orthopedic surgeons, traumatologists, and neurosurgeons. It is a clinically oriented atlas that covers all important diseases and injuries of the spine. Ample illustrations are supplemented by concise descriptions of anatomy and pathophysiology, the normal and abnormal MRI appearance, diagnostic pitfalls, and the clinical significance of MRI. The clear and didactic style enables readers to revise the fundamentals of spinal anatomy and disease states as a basis for understanding the diagnostic strategies and surgical management. By combining descriptions of the clinical manifestation of spinal disorders with the corresponding MRI findings, the authors hope to help readers develop a meaningful approach to the interpretation of MRI of the spine.
Broughton, Nigel S. Broughton, "A Textbook of Paediatric Orthopaedics"
W.B. Saunders Company | 1997 | ISBN: 0702019623 | 336 pages | File type: PDF | 25,4 mb
B. Saunders. Royal Children's Hospital, Melbourne, Australia. Textbook for orthopedic surgeons in training. Covers the basic principles of the field, investigation, and management. Halftone illustrations.
Synopsis
Paediatric orthopaedics is an important subspecialty for the orthopaedic surgeon in training. A good understanding of the principles is essential for examination success and subsequent practice. This concise textbook presents all the essential topics in a clear and readable form, from the level of basic principles, covering presentation, investigation and management, in a logical and ordered fashion. Superbly and liberally illustrated, this text is an essential learning and revision resource for all orthopaedic surgeons in training.
Table of Contents
Contributors Foreword Preface Acknowledgements Ch. 1 Orthopaedic assessment 1 Ch. 2 General approach to paediatric orthopaedics 13 Ch. 3 Normal and pathological gait 21 Ch. 4 Lower limb deficiencies 27 Ch. 5 Skeletal dysplasias 39 Ch. 6 Metabolic bone disease 65 Ch. 7 Bone and soft tissue tumours 75 Ch. 8 The orthopaedic management of cerebral palsy 101 Ch. 9 Spina bifida 115 Ch. 10 Neuromuscular disorders of childhood 131 Ch. 11 Bone and joint infection 149 Ch. 12 Juvenile chronic arthritis 165 Ch. 13 Osteochondritic conditions 175 Ch. 14 Normal variants: intoeing, bow legs and flat feet 183 Ch. 15 The upper limb 193 Ch. 16 Developmental dysplasia of the hip 203 Ch. 17 Perthes disease 219 Ch. 18 Slipped upper femoral epiphysis 229 Ch. 19 The knee 239 Ch. 20 The foot 251 Ch. 21 The spine 267 Ch. 22 Upper limb trauma 283 Ch. 23 Lower limb trauma 299 Ch. 24 Limb length inequality 313 Index 327
The third edition of the Essentials ofOrthopedic Surgeryprovides a concise overview oforthopedic surgerydirected toward third- and fourth year medical etudents. In this edition, physical diagnosis is a subsection in each chapter, which we believe gives better continuity. Additionally, at the end of each chapter we have created a number of multiple-choice questions considered appropriate for medical students to be able to answer.
Each chapter has been revised to reflect updated material and, as in previous editions, we have kept to a standardized format as much as possible. The topics are presented from a straightforward practical point-ofview, with the material being condensed to its most salient features. Algorithms are at the heart of each chapter, with the decision points being based on practice standards and guidelines. This format allows the student, when confronted with a specifi c clinical problem, to formulate both a diagnostic plan and a treatment plan. Also, we have enjoyedworkingwith our new publisher-Springer-and with Robert Albano as well as Sadie Forrester, who have guided this text to publication. Finally, and most importantly, it has been again a very exciting andstimulatingexperience to work with all the members of the Department of Orthopaedics of Georgetown University Medical Center. Since the last edition we have welcomed seven new members to the faculty, each a subspecialist. Everyone has given very generously of their time. We are most appreciative of each contribution and are proud of the final text.
Chad Cook, "Orthopedic Manual Therapy: An Evidence-Based Approach"
Prentice Hall | 2006 | ISBN: 0131717669 | 624 pages | File type: PDF | 103 mb
Orthopedic Manual Therapy is an evidence based textbook designed to provideexamination, treatment and reassessment measures for orthopedic clinicians. The textbook examines current manual therapy approaches, literature associated withexaminationand treatment techniques involving manual therapy, and evidence regarding diagnostic accuracy of clinical special tests. Each procedure is presented in a step-by-step method with a visual aide or photograph for ease of reproduction.
Mark D. Miller, Mark R. Brinker, quot;Miller's Review of Orthopedicsquot;
W.B. Saunders Company | English | 2000 | ISBN: 0721681530 | 621 pages | File type: PDF | 164 mb
Dr. Miller and more than a dozen expert contributors have fully revised andupdatedthe review - distilling the broad body of literature on orthopaedics into a single easy to understand volume. Readers will find the very latest contributors from review courses, textbooks, current journal articles, Academy publications, videos, computer products and examinations - all presented in an easy-to-review outline format. The result is an indispensable aid for residents and practicingorthopaedicsurgeons preparing for board exams. It also serves as a succinct but thorough synopsis of key concepts and procedures - making it a central reference for the entire field.
Giles R. Scuderi, Alfred J. Tria, Richard A. Berger, quot;MIS Techniques in Orthopedicsquot;
Springer | 2005-08-25 | ISBN: 0387242104 | 433 pages | File type: PDF | 42,5 mb
The technique-based text is geared for the orthopedic surgeon who is familiar with the features of MIS and now wants to master the approach. Thebook coversthe shoulder andelbow, the hip, unicondylarknee arthroplasty, and MIS totalknee arthroplasty, which are the four main focus areas for MIS joint replacement surgery. Chapters written by leading authorities in the field include usage techniques for the latest instrumentation, and they guide surgeons step-by-step through procedures. In addition, a section is devoted to computer-guided total hip andknee arthroplasty. More than 300 detailed line drawings and photographs supplement the discussion by clearly illustrating how the techniques are performed.
This practical resource is a great tool for orthopedic surgeons, residents, and fellows who want to confidently learn and apply cutting-edge MIS techniques. Although the text has value as a stand-alone reference, it also complements Drs. Scuderi and Tria’s MIS of the Hip and Knee: A Clinical Perspective.
Osteomalacia is the softening of the bones in adults due to defective bone mineralization.
The causes of adult osteomalacia are varied, but ultimately result in a vitamin D deficiency:
* Insufficient sunlight exposure, especially in dark-skinned subjects
* Insufficient nutritional quantities or faulty metabolism of vitamin D or phosphorus
* Renal tubular acidosis
* Malnutrition during pregnancy
* Malabsorption syndrome
* Chronic renal failure
* Tumor-induced osteomalacia
* Long-term anticonvulsant therapy
* Coeliac disease
Osteomalacia in adults starts insidiously as aches and pains in the lumbar region and thighs, spreading later to the arms and ribs. The pain is symmetrical, non-radiating and is accompanied by sensitivity in the involved bones. Proximal muscles are weak, and there is difficulty in climbing up stairs and getting up from a squatting position.Due to demineralization bones become less rigid. Physical signs include deformities like triradiate pelvis and lordosis. The patient has a typical “waddling” gait. Pathologic fractures due to weight bearing may develop.
Nutritional osteomalacia responds well to administration of 10,000 IU weekly of vitamin D for four to six weeks. Osteomalacia due to malabsorption may require treatment by injection or daily oral dosing of significant amounts of vitamin D.
Arthritis is a group of conditions involving damage to the joints of the body.The most common form, osteoarthritis (degenerative joint disease) is a result of trauma to the joint, infection of the joint, or age. Other arthritis forms are rheumatoid arthritis, psoriatic arthritis, and related autoimmune diseases. Septic arthritis is caused by joint infection.
Osteoarthritis can affect both the larger and the smaller joints of the body, including the hands, feet, back, hip or knee. The disease is essentially one acquired from daily wear and tear of the joint. Osteoarthritis begins in the cartilage and eventually leads to the two opposing bones eroding into each other.
Rheumatoid arthritis is a disorder in which, for some unknown reason, the body’s own immune system starts to attack body tissues. The attack is not only directed at the joint but to many other parts of the body. In rheumatoid arthritis, most damage occurs to the joint lining and cartilage which eventually results in erosion of two opposing bones. Rheumatoid arthritis affects joints in the fingers, wrists, knees and elbows.
SLE is a common collagen vascular disorder that can be present with severe arthritis. Other features of lupus include a skin rash, extreme photosensitivity, hair loss, kidney problems, emotional lability, lung fibrosis and constant joint pain.
Gout is caused by deposition of uric acid crystals in the joint, causing inflammation. There is also an uncommon form of gouty arthritis caused by the formation of rhomboid crystals of calcium pyrophosphate known as pseudogout.
Infectious arthritis is another severe form of arthritis. It presents with sudden onset of chills, fever and joint pain.Infectious arthritis must be rapidly diagnosed and treated promptly to prevent irreversible and permanent joint damage.Psoriasis is another type of arthritis.
Osteoarthritis of the knee is common in people over 50 years of age, in particular in women. It can affect unilaterally or bilaterally however it occurs more commonly on the inner (medial) aspect of the knee. More than 10 million Americans are suffering from knee joint osteoarthritis. It is also the most common cause of disability in the United States. Early diagnosis and treatment help manage knee osteoarthritis symptoms.
Knee osteoarthritis pain is usually worse following activity, especially overuse of the affected knee. Stiffness can worsen after sitting for prolonged periods of time. As knee osteoarthritis progresses, symptoms generally become more severe. Pain can become continuous rather than only when weight-bearing.
Treatment of Knee Osteoarthritis
* Knee supports/braces – Valgus unloader braces have been proven to provide pain relief in some cases of medial compartment osteoarthritis, by reducing the load on that compartment. Buy knee supports and braces online – UK / – USA
* NSAID’s- Non-Steroidal Anti-Inflammatory Drugs such as ibuprofen can provide some temporary pain relief.
* Weight Loss – As obesity is associated with the onset of osteoarthritis, weight loss, if needed, can have a significant effect on slowing the disease progression.
* Exercise Program –A specific exercise program can help to maintain healthy cartilage and range of motion of the joint. In addition, keeping the attaching muscles and tendons conditioned and strong will aid in the joint’s stability.
* Muscle relaxants- These are usually administered in low doses and can relieve pain that arises from muscles strained in an attempt to support osteoarthritic joints.
* Heat and Cold Treatments – Local application of heat and cold can help with relief from pain and inflammation after exercise.
* Viscosupplementation – A viscosupplement can be administered as an injection by a clinician. This substance helps to lubricate the knee joint and can decrease the amount of inflammation.
* Knee Replacement – both half and total knee replacements are available in very advanced osteoarthritic knees.
Osteoarthritis of the spine (spondylosis) is a degenerative disease affecting the facet joints and the intervertebral discs.Osteoarthritis usually doesn’t begin until after the age of 45 and is the most common after the of age 60, but may occur at any age. Spinal osteoarthritis can affect different areas of the spine.The locations can vary from person to person.The lower back is the most common location for back pain due to spinal osteoarthritis. This is not surprising since the lower back carries most of the weight of the body and is the area of the body that is subject to the most mechanical stress. Excess stress on the lower back can cause back muscle strain and irritate spinal joints already damaged by osteoarthritis.Advanced cases of spinal osteoarthriits may result in spinal stenosis. Spinal stenosis is a compression of the spinal cord and/or nerve roots due to narrowing of the spinal canal. Inflammation may occur in advanced osteoarthritis, causing a narrowing of the spinal canal.
Balneotherapy is generally applied to everything relating to spa treatment, including the drinking of waters and the use of hot baths and natural vapor baths, as well as of the various kinds of mud and sand used for hot applications. Balneotherapy refers to the medical use of these spas, as opposed to recreational use. Common minerals found in spa waters are sodium, magnesium, calcium and iron, as well as arsenic, lithium, potassium, manganese, bromine, and iodine. All these may be contained in the peat that is commonly used in preparation of spa waters. Resorts may also add minerals or essential oils to naturally-occurring hot springs. Though balneotherapy commonly refers to mineral baths, the term may also apply to water treatments using regular hot or cold tap water.Mud-baths are also included in balneotherapy, and the dirt and water used to mix mud baths may also contain minerals which are thought to have beneficial properties.Balneotherapy may be recommended for wide range of illnesses, including arthritis,skin conditions and fibromyalgia.
Osteoarthritis is a chronic arthropathy characterized by disruption and potential loss of joint cartilage along with other joint changes, including bone hypertrophy (osteophyte formation),subchondral sclerosis and subchondral cysts formation .
Osteoarthritis begins with tissue damage from mechanical injury (eg, torn meniscus), transmission of inflammatory mediators from the synovium into cartilage, or defects in cartilage metabolism. The tissue damage stimulates chondrocytes to attempt repair, which increases production of proteoglycans and collagen. However, efforts at repair also stimulate the enzymes that degrade cartilage, as well as inflammatory cytokines, which are normally present in small amounts. Inflammatory mediators trigger an inflammatory cycle that further stimulates the chondrocytes and synovial lining cells, eventually breaking down the cartilage. Chondrocytes undergo programmed cell death (apoptosis). Once cartilage is destroyed, exposed bone becomes eburnated and sclerotic.
Articular as welll as the periarticular tissues are involved in OA. Subchondral bone stiffens, then undergoes infarction, and develops subchondral cysts. Attempts at bony repair cause subchondral sclerosis and osteophytes at the joint margins. The osteophytes seem to develop in an attempt to stabilize the joint. The synovium becomes inflamed and thickened and produces synovial fluid with less viscosity and greater volume. Periarticular tendons and ligaments become stressed, resulting in tendinitis and contractures. As the joint becomes less mobile, surrounding muscles thin and become less supportive. Menisci fissure and may fragment.
Carpal Tunnel Syndrome is the compression of the median nerve travelling through the carpal tunnel. Carpal.The carpal tunnel is an anatomical compartment located at the base of the wrist. Nine flexor tendons and the median nerve pass through the carpal tunnel that is surrounded on three sides by the carpal bones that form an arch.Compression of the median nerve as it runs deep to the transverse carpal ligament causes atrophy of the thenar eminence, weakness of the flexor pollicis brevis, opponens pollicis, abductor pollicis brevis, as well as sensory loss in the distribution of the median nerve distal to the transverse carpal ligament.
Clinical assessment by history taking and physical examination can support a diagnosis of CTS.But diagnosis of carpal tunnel syndrome is confirmed by electrophysiological testing.
* Phalen’s maneuver is performed by flexing the wrist gently as far as possible, then holding this position and awaiting symptoms.A positive test is one that results in numbness in the median nerve distribution when holding the wrist in acute flexion position within 60 seconds. • Phalen’s sign is defined as pain and/or paresthesias in the median-innervated fingers with one minute of wrist flexion.
*Tinel’s is performed by lightly tapping the skin over the flexor retinaculum to elicit a sensation of tingling or “pins and needles” in the nerve distribution.• Tinel’s sign (pain and/or paresthesias of the median-innervated fingers with percussion over the median nerve) is less sensitive, but slightly more specific than Phalen’s sign.
To aid in the prevention of Carpal Tunnel Syndrome, stretching exercises of the wrist, hand, and fingers have been used to combat against the pain and numbness caused by repetitive actions. Other than using recommended stretches and exercises, useful treatments for CTS include use of night splints, corticosteroid injections and ultimately surgery.
Muscular dystrophy refers to a group of hereditary muscle diseases that weaken the muscles.Muscular dystrophies are characterized by progressive skeletal muscle weakness, defects in muscle proteins, and the death of muscle cells and tissue.Commonly identified muscular dystrophies are Duchenne Muscular dystrophy, Becker Muscular dystrophy, limb girdle,Congenital, facioscapulohumeral, myotonic, oculopharyngeal, distal, and Emery-Dreifuss. Most types of MD are multi-system disorders with manifestations in body systems including the heart, gastrointestinal and nervous systems, endocrine glands, skin, eyes and other organs, namely the brain. The condition may also lead to mood swings and learning difficulties.
Duchenne muscular dystrophy (DMD) is the most common childhood form of muscular dystrophy, becoming clinically evident when a child begins walking.The gene for the protein dystrophin is absent in DMD. Since the gene is on the X chromosome, this disorder affects primarily males.Becker muscular dystrophy (BMD) is a less severe variant of Duchenne muscular dystrophy.
The diagnosis of muscular dystrophy is based on the results of a muscle biopsy and increased creatine phosphokinase (CpK3).There is no known cure for muscular dystrophy. Inactivity can worsen the disease. Physical therapy, occupational therapy, orthotic intervention, speech therapy and orthopedic instruments may be helpful.
Osteomyelitis is an acute or chronic inflammatory process of the bone and its structures secondary to infection with pyogenic organisms.There are two forms of acute osteomyelitis – hematogenous osteomyelitis and direct or contiguous osteomyelitis.Hematogenous osteomyelitis is an infection caused by bacterial seeding from the blood. Acute hematogenous osteomyelitis primarily occurs in children. The most common site is the rapidly growing and highly vascular metaphysis of growing bones.Direct or contiguous inoculation osteomyelitis is caused by direct contact of the tissue and bacteria during trauma or surgery.The overall prevalence is 1 case per 5,000 children. Neonatal prevalence is approximately 1 case per 1,000.
Hematogenous osteomyelitis usually presents with a slow insidious progression of symptoms. Direct osteomyelitis generally is more localized, with prominent signs and symptoms.Hematogenous long-bone osteomyelitis characterized by Abrupt onset of high fever (fever is present in only 50% of neonates with osteomyelitis),Fatigue,Irritability,Malaise,Restriction of movement (pseudoparalysis of limb in neonates),Local edema, erythema, and tenderness.
As many as 30% of pediatric patients with long-bone osteomyelitis may develop deep venous thrombosis (DVT).
Craniosynostosis consists of premature fusion of 1 or more cranial sutures, often resulting in an abnormal head shape. It may result from a primary defect of ossification (primary craniosynostosis) or, more commonly, from a failure of brain growth (secondary craniosynostosis).
Primary craniosynostosis – One or more sutures fuse prematurely, skull growth can be restricted perpendicular to the suture. If multiple sutures fuse while the brain is still increasing in size, intracranial pressure can increase.
* Scaphocephaly – Early fusion of the sagittal suture
* Anterior plagiocephaly – Early fusion of 1 coronal suture
* Brachycephaly – Early bilateral coronal suture fusion
* Posterior plagiocephaly – Early closure of 1 lambdoid suture
* Trigonocephaly – Early fusion of the metopic suture
Secondary craniosynostosis – More frequent than the primary type, secondary craniosynostosis can result from early fusion of sutures due to primary failure of brain growth. Since brain growth drives the bony plates apart at the sutures, a primary lack of brain growth allows premature fusion of all the sutures.Typically, failure of brain growth results in microcephaly.Intrauterine space constraints may play a role in the premature fusion of sutures in the fetal skull.
In an infant, the skull is not one solid bone, it is bony plates separated by fibrous sutures. The infant’s skull consists of the metopic suture, coronal sutures, sagittal suture, and lambdoid sutures. These sutures allow the skull to expand as an infant’s brain develops.Craniosynostosis is a condition in which one or more of the fibrous sutures in an infant skull prematurely fuses. This results in restricted skull and brain growth.It is estimated that craniosynostosis affects 1 in 2,000 live births.It can be the result of an inherited syndrome or sporadic. The most common causes of syndromic craniosynostosis are Crouzon syndrome and Apert syndrome.
Deformational plagiocephaly or flathead syndrome,is a condition most commonly found in infants and is characterized by a flat spot on the back or one side of the head caused by remaining in one position for too long.
