Specialists

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Small Tears Less Than 1 Centimeter

Smaller tears are easily missed as patients present with findings and symptoms consistent with impingement. Occasionally weakness is present, but even following the Neer test, significant weakness may not be detected.

These tears usually involve the supraspinatus tendon insertion, and pain is the primary presenting complaint. Examination usually reveals normal motion and strength.

After the […]

Capsular Lesions

Traumatic intra-substance injury of the joint capsule is commonly associated with anterior dislocation. Depending on the magnitude of the anterior shear force, either plastic deformation or a complete tear of the joint capsule can occur.

The recognition of a concomitant posttraumatic capsular laxity or rupture and a Bankart lesion is essential in order to select […]

Management-Nonoperative Management

The initial management of suprascapular nerve injuries usually is nonoperative. Most authors have found that resolution of symptoms occurs within 6 to 12 months after diagnosis. This is particularly true if the patient has no evidence of a space-occupying lesion (cyst). Because most of these injuries in athletes are thought to be related to traction […]

SPECIFIC TESTS-Medial shearing

Significance

This test is used to detect internal derangement at the inner side of the knee. Pain on jerk is suggestive for a minor lesion at the tibial insertion of the anterior cruciate ligament.

Positioning.

The subject lies in the supine position with the knee flexed to a right angle, and the heel resting […]

Palpation of soft tissues at the medial side

Medial collateral ligament

The medial collateral Hgament is a broad, flat and almost triangular band, with a large insertion on the posterosuperior aspect of the medial femoral epicondyle, dose to the insertion of the adductor magnus tendon. Its fibres run obliquely, anteriorly and inferiorly, to insert at the medial aspect of the tibia, just behind […]

Palpation of the extensor mechanism

This is performed on an extended knee.First the muscular structures are ascertained. Ask the patient to extend the slightly bent knee and resist the movement.This movement usually outlines the vastus medialis, vastus lateralis, rectus femoris and the patellar ligament. Then the patellar border with its tendinous insertions are palpated. With the hip in flexion and […]

Palpation of soft tissue

Feel for the pisiform bone and place the palpating finger against its proximal aspect. Ask the subject to actively abduct the little finger. The tightening of the flexor carpi ulnaris can be felt.The tendon can now be followed distal to the pisiform until its insertion on the base of the fifth metacarpal bone. The pisiform […]

Passive pronation

Positioning.

The subject stands with the arm hanging and the elbow bent to a right angle. The examiner stands in front of the subject. Both hands encircle the distal forearm in such a way that the heel of the contralateral hand is placed against the volar part of the ulna and the fingers of the […]

Palpation of soft tissue

Over the olecranon lies the olecranon bursa,which is only really palpable when it becomes inflamed and swollen.Keep the subject’s elbow flexed. Palpate for the upper border (apex) of the olecranon. Feel just lateral to this apex for the insertion of the tendon of the triceps muscle. Move the fingers upwards: a broad and flat tendon […]

Specific Tests-Passive horizontal adduction

Significance.

This test stresses the acromioclavicular and sternoclavicular joints and ligaments. It also squeezes the subcoracoid bursa and the upper part of the insertion of the subscapularis tendon into the lesser tuberosity of the humerus.

POSitioning.

The subject stands with the arms hanging alongSide the body. The examiner stands level with the subject’s arm. […]