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/Proximal Humerus Fracture

Basics Description The proximal humerus consists of the articular surface of the shoulder joint and the attachments of the rotator cuff to the greater and lesser tuberosities. Most of the blood supply to the humeral head comes from the anterior humeral circumflex branch of the axillary artery. >90% of proximal humeral fractures result from […]

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 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 […]

Shoulder Dislocation

Basics Description The shoulder joint has the greatest ROM of all joints in the body and, thus, is at high risk for dislocations. Shoulder joint stability depends on various dynamic and static anatomical restraints. Dynamic restraints include: Tendon of the long head of the biceps Scapular stabilizers Rotator cuff muscles and tendons Static restraints […]

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 […]

Scoliosis

Basics Description Scoliosis is a 3D curvature of the spine, best appreciated on an AP radiograph and physical examination. Both thoracic and lumbar segments of the spine may be affected. It is defined as a curve >10°. Classification: Etiology: Idiopathic Congenital Neuromuscular Connective tissue Degenerative Location (of the apex or middle of the curve): […]

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% […]