Collection of orthopedic conditions

Last updated: May 6, 2022

Summarytoggle arrow icon

This article covers various orthopedic conditions, including bursitis, orthopedic cysts, stress fractures, genu valgum and genu varum, forearm fractures, and plantar fasciitis.

Rupture of a popliteal cyst may mimic a deep vein thrombosis!

  • Definition: complete bone fracture caused by repetitive stress without underlying bone pathology or disease affecting the bone
  • Etiology: Increased load or frequency of physical activity can facilitate bone resorption.
  • Risk factors
    • Repetitive high-intensity physical activity
    • Improper technique during physical activity
    • Ill-fitting footwear
    • Caloric restriction, especially in patients with anorexia nervosa
    • Decreased bone density (e.g., bisphosphonates use)
    • Calcium deficiencies
    • Female sex
  • Clinical features
  • Diagnostics
  • Treatment

  • Definition: valgus (lateral) misalignment of the knee, resulting in a knocked knee deformity
  • Etiology
  • Clinical features of pathological valgus
    • Unilateral valgus that is progressive (after 4–5 years of age) or persistent (after 7 years of age)
    • Severe valgus
    • Gait abnormalities and congenital flat feet
    • Features suggestive of an underlying disease (e.g., unilateral deformity, short stature, fever, knee or foot pain, abnormal swelling)
  • Diagnostics: if pathological valgus is suspected, imaging and/or metabolic evaluation to determine underlying disease
  • Treatment
    • Physiological valgus may improve by the age of 7 years and should be managed with close observation and reassurance.
    • Medical treatment of the underlying pathology
    • For persistent symptoms in patients older than 10 years, surgery is indicated.

  • Definition: varus (medial) misalignment of the knee, resulting in a bowleg deformity
  • Epidemiology: common in children
  • Etiology
  • Clinical features of pathological varus
    • Bowing that is progressive or persistent (after 3 years of age)
    • Severe bowing
    • Gait abnormalities
    • Features suggestive of an underlying disease (e.g., unilateral deformity, short stature, fever, knee or foot pain, abnormal swelling)
  • Diagnostics: if pathological varus is suspected, imaging and/or metabolic evaluation to determine underlying disease
  • Treatment
    • Physiological varus usually improves by 24 months and should be followed by close observation.
    • Treatment of the underlying pathology
    • For persistent symptoms; that do not respond to medical management, surgery is indicated.

Colles and smith fractures

Monteggia fracture

Galeazzi fracture

Other forearm fractures

References:[5]

  • Definition: a condition characterized by damage to the fatty and fibrous tissue in the heel
  • Etiology: typically caused by inflammation but can also be due to damage or atrophy of the heel pad
    • Acute trauma
    • Repetitive overload (e.g., running, prolonged standing or walking)
  • Risk factors
    • Age (usually > 40 years old)
    • Corticosteroid injections
    • Improper footwear
    • Cavus feet
    • BMI > 30
  • Clinical features
    • Deep, mid-heel pain that increases with activity and when walking on hard surfaces
    • Tenderness in the mid-portion of the heel
  • Diagnostics
  • Differential diagnosis
  • Treatment: mainly conservative
    • Rest (decrease/avoid pressure to the affected area)
    • Ice packs
    • Oral NSAIDs for pain
    • Heel taping
    • Heel pads or cups
    • Use of proper footwear

References:[6]

Overview of special types of avascular necrosis
Condition

Localization

Epidemiology

Etiology

Clinical features

Osgood-Schlatter disease

  • Age of onset: 9–14 years

  • >

Panner disease [7]

  • Age of onset: 5–10 years

  • Typically associated with repetitive strain injury due to overuse of the elbow (e.g., from pitching baseballs)

Kienbock disease

  • Age of onset: 20–30 years

  • Typically associated with repetitive impact trauma (e.g., from playing volleyball)

Legg-Calvé-Perthes disease

  • Femoral head

  • Age of onset: 4–10 years

  • >

  • Idiopathic disease

  • Mismatch between the rapid growth of the femoral epiphyses and the slower development of adequate blood supply to the area

Subchondral insufficiency fracture (Ahlback disease)

  • Age of onset: 55–70 years

  • >

  • Acute knee pain without significant trauma

Blount disease

  • Infantile age of onset: 1–3 years

  • Juvenile age of onset: 4–10 years

  • Adolescent age of onset: > 10 years

Sinding-Larsen-Johansson disease

  • Inferior pole of the patella

  • Age of onset: 10–14 years

  • More common in physically active adolescents (e.g., those who play sports)
  • Tenderness at the inferior end of the patella
  • Pain increases with exercise, kneeling, jumping, or running.

Sever disease

  • Age of onset: 8–12 years

  • >

  • Typically due to overuse in children who play sports involving running and jumping

Kohler disease

  • Age of onset: 5–10 years

  • >

Freiberg disease

  • Metatarsal head (most often II, but also III–V)

  • Age of onset: 10–18 years

  • >

  • More common in children with a long metatarsal II
  • Pain in the forefoot

References:[8][9][10]

  1. Wong K, Trudel G, Laneuville O. Noninflammatory Joint Contractures Arising from Immobility: Animal Models to Future Treatments.. BioMed research international. 2015; 2015 : p.848290. doi: 10.1155/2015/848290 . | Open in Read by QxMD
  2. Claessen FMAP, Louwerens JKG, Doornberg JN, van Dijk CN, Eygendaal D, van den Bekerom MPJ. Panner’s disease: literature review and treatment recommendations. Journal of Children's Orthopaedics. 2015; 9 (1): p.9-17. doi: 10.1007/s11832-015-0635-2 . | Open in Read by QxMD
  3. Zhao D, Zhang F, Wang B, et al. Guidelines for clinical diagnosis and treatment of osteonecrosis of the femoral head in adults (2019 version). Journal of Orthopaedic Translation. 2020; 21 : p.100-110. doi: 10.1016/j.jot.2019.12.004 . | Open in Read by QxMD
  4. Matthews AH, Davis DD, Fish MJ, Stitson D. Avascular Necrosis. StatPearls. 2021 .
  5. Firestein GS. Kelley and Firestein's Textbook of Rheumatology. Elsevier ; 2017
  6. Ganglion cysts. https://handcare.assh.org/Anatomy/Details-Page/articleId/27970. Updated: January 1, 2018. Accessed: March 18, 2020.
  7. Williams BS, Cohen SP. Greater trochanteric pain syndrome: A review of anatomy, diagnosis and treatment. Anesth Analg. 2009; 108 (5): p.1662-1670. doi: 10.1213/ane.0b013e31819d6562 . | Open in Read by QxMD
  8. Long SS, Surrey DE, Nazarian LN. Sonography of greater trochanteric pain syndrome and the rarity of primary bursitis. Am J Roentgenol. 2013; 201 (5): p.1083-1086. doi: 10.2214/ajr.12.10038 . | Open in Read by QxMD
  9. Reid D. The management of greater trochanteric pain syndrome: A systematic literature review.. Journal of orthopaedics. 2016; 13 (1): p.15-28. doi: 10.1016/j.jor.2015.12.006 . | Open in Read by QxMD
  10. Jeong HJ, Lee SH, Ko CS. Meniscectomy. Knee Surg Relat Res. 2012; 24 (3): p.129-136. doi: 10.5792/ksrr.2012.24.3.129 . | Open in Read by QxMD
  11. Stone CK, Humphries R. CURRENT Diagnosis and Treatment Emergency Medicine. Lange ; 2011

3 free articles remaining

You have 3 free member-only articles left this month. Sign up and get unlimited access.
 Evidence-based content, created and peer-reviewed by physicians. Read the disclaimer