Specialists

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Slipped Capital Femoral Epiphysis

Basics Description SCFE is a disorder of the hips of adolescents or preadolescents in which the femoral head is displaced relative to the rest of the femur. The femoral head remains in the acetabulum. Most notable features: The outward rotation of the lower femur and leg and a limp Classification: Stable versus unstable (1): […]

Shoulder/Glenohumeral Arthritis

Basics Description Progressive loss of glenohumeral joint space with thinning of articular cartilage, formation of osteophytes, and progressive deformity Epidemiology Females are more likely than males to have primary glenohumeral osteoarthritis. Patients >60 years old are more likely to have it than are younger patients. Incidence ~0.4% in the general population Can reach 4.6% […]

Shoulder Instability

Basics Description Because of the shoulder’s extensive ROM, it is prone to instability. The term encompasses a spectrum of disorders of varying degree, direction, and cause. Instability should be distinguished from laxity. Laxity is the symmetric translation of the humeral head over the surface of the glenoid without symptoms. Instability occurs when the degree […]

Shoulder Impingement Syndrome

Basics Description Shoulder pain with overhead activities is a common musculoskeletal complaint. Impingement syndrome: Inflammatory condition of the soft tissues of the subacromial space Most common cause of presentation for shoulder complaints to a physician’s office (>50% of all shoulder complaints) Represents a continuum, progressing from acute bursitis, to chronic bursitis, to partial-thickness tears […]

Seronegative Spondyloarthropathies

Basics Description Also called enthesopathies, these inflammatory diseases are associated with a negative rheumatoid factor or antinuclear antibody titer that affects the spine and multiple peripheral joints. Included in the seronegative spondyloarthropathies are AS, reactive arthritis (formerly known as Reiter syndrome), psoriatic arthritis, and enteropathic arthritis. Synonym: Reactive arthritis General Prevention Although the disease […]

Septic Hip

Basics Description The incidence of septic hip is increasing, especially in elderly and immunosuppressed individuals. This condition may occur in infants, children, adults, and the elderly, but it is more common in the pediatric population. Risks factors include hip surgery (most common cause), intravenous drug abuse, alcoholism, and steroid use. Epidemiology Incidence In children, […]

Septic Arthritis

Basics Description Septic arthritis is an infection of the joint. In infants, the capillaries penetrating the physeal plate into the epiphysis persist until age 18 months, so spread of infection may occur from the metaphysis indirectly to the epiphysis and then to the joint. Possible irreparable damage to growth plate occurs. Classification: Polyarticular septic […]

Scaphoid Fracture

Basics Description Fracture of the most radial (thumb side) of the carpal bones, usually as a result of a dorsiflexion injury to the wrist The most common of the carpal fractures, estimated at 60% Frequent problems include delayed diagnosis and nonunion. Classification: Chronologically: Acute or chronic Anatomically: In the proximal, middle, or distal third […]

Sarcoma (Epitheloid and Synovial)

Basics Description Epithelioid sarcoma: A high-grade soft-tissue sarcoma that is prone to local recurrence, lymph node invasion, and pulmonary metastases. Most common soft-tissue sarcoma of the upper extremity Often confused with granulomatous processes Occurs often in young patients (15-40 years old) Synovial sarcoma: A high-grade malignancy on the soft tissue Occurs in para-articular regions […]

Sacral Insufficiency Fracture

Basics Description Sacral Insufficiency fractures occur in the sacral ala between the SI joints and the neural foramina (Denis Zone 1). The fracture pattern adopts a characteristic H-shape, which is pathonemonic of the condition. It is postulated that the vertical limbs of the H occur 1st, followed by the transverse fracture line. In ~50% […]