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Category: Rehabilitation

Spondylolysis and Spondylolisthesis

Spondylolysis and Spondylolisthesis

Spondylolysis is a defect in the pars interarticularis, commonly involving the L5 and occasionally the L4 vertebrae. Most spondylolysis is thought to be produced by repetitive stress. The gravitational and muscular loads acting across the steep incline of the upper surface of the sacrum can be resolved into a shearing component, which tends to displace the L5 vertebral body forward on S1, and a compressive component at right angles to the superior surface of S1 (Fig. 6-63). In accordance with…

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Interphalangeal Joint Injection

Interphalangeal Joint Injection

Tiếng Việt >> Indications Interphalangeal joint injection is used as a therapeutic procedure to treat inflammation of the metacarpal phalangeal and interphalangeal joints due to rheumatoid arthritis and other inflammatory arthritides. Techniques After informed consent is obtained, the patient is placed in the sitting position with the arm resting on the examination table. The hand is placed with the joint extended for approach from the lateral or medial aspect, with slight traction applied to the finger. The patient is prepared…

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Lumbar Spinal Stenosis and Foraminal Stenosis

Lumbar Spinal Stenosis and Foraminal Stenosis

Like cervical stenosis, lumbar spinal stenosis is frequently precipitated by disc degeneration with subsequent marginal osteophytosis of the vertebral body ends, hypertrophic degeneration of the facet joints, and bulging of the ligamenta flava. Lumbar stenosis may be lateral, central, or combined. The lower lumbar vertebrae normally have shorter pedicles that cause the superior articular processes to intrude into the spinal canal to cut off narrow lateral recesses (Fig. 6-61A–E). The lateral nerve roots of the next spinal nerve to exit…

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Contusions and Intraparenchymal Hemorrhage

Contusions and Intraparenchymal Hemorrhage

Focal parenchymal injuries such as contusions and intraparenchymal hemorrhage usually develop as a result of contact of the brain with the osseous walls of the cranial cavity. The coup-type injuries occur at the point of contact, and the contrecoup injuries occur on the opposite side of the brain. Contusions often occur in areas where the walls of the cranial cavity are irregular, such as the anterior and middle cranial fossae. Therefore, frontal and temporal lobe contusions are common as the…

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Other Knee Abnormalities

Other Knee Abnormalities

Patellar tendinitis (jumper’s knee) is demonstrated by MRI as an area of edema within the patellar ligament (i.e., tendon) at its patellar (Fig. 6-28) or tibial tuberosity attachment. There is also associated edema in the adjacent subcutaneous fat or the infrapatellar fat pad. FIGURE 6-28. Sagittal T2-weighted fat suppressed image of patellar tendinitis. The arrow points to the increased signal intensity within the proximal tendon fibers and the adjacent infrapatellar fat pad. . Ischemic necrosis about the knee most commonly…

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Subdural Hematoma

Subdural Hematoma

Subdural hematoma is most commonly caused by acceleration- deceleration shearing stresses that rupture the bridging veins that extend from the movable brain to the fixed dural venous sinuses. The blood accumulates in a pre-existing but essentially volumeless subdural space. Normally, the pressure of the CSF holds the arachnoid in contact with the dura, thereby creating a real interval that is without significant volume. Because the subdural space is a real space surrounding all external surfaces of the brain, subdural hemorrhage…

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Collateral Ligament Injuries

Collateral Ligament Injuries

The collateral ligaments are best visualized by coronal MR images (Fig. 6-27). The medial collateral ligament appears as a narrow low–signal-intensity band extending from the medial epicondyle of the femur to an attachment on the anteromedial aspect of the tibia 5 to 6 cm below the joint line. It is overlaid at its tibial attachment by the tendons of the pes anserinus, which are separated from it by an intervening anserine bursa that is not visualized unless it is inflamed….

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Lumbar Disc Herniation

Lumbar Disc Herniation

The correlation of lumbar disc herniation with a patient’s complaints of low back pain or sciatica is not always clearly established. It has been estimated that as many as 20% of patients with radiologic findings of disc herniation are asymptomatic (67). Furthermore, when disc herniation occurs in symptomatic patients, other findings are often present that also could explain the clinical findings. Lumbar disc herniations occur most frequently posterolaterally because the annulus is thinnest in the posterior quadrants but reinforced in…

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First Metacarpal Joint Injection

First Metacarpal Joint Injection

Tiếng Việt >> Indications First metacarpal joint injection is used to treat pain and inflammation secondary to osteoarthritis. Techniques After informed consent is obtained, the patient is placed in a sitting position with the arm resting on the examination table. The forearm is placed on the ulnar side midway between supination and pronation, with the thumb adducted and held in flexion with the palm. The first metacarpal along the dorsal aspect to the groove at its proximal end is palpated….

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Abductor Tendon Injection of the Thumb

Abductor Tendon Injection of the Thumb

Indications Abductor tendon of the thumb injection is a useful therapeutic procedure for tenosynovitis of extensor pollicis brevis and abductor hallicus longus (de Quervain’s syndrome) usually associated with repetitive trauma disorder. This procedure involves injection of common tendon sheath of the long abductor and short extensor tendons of the thumb. Techniques After informed consent is obtained, the patient is placed in the sitting position with the arm resting on the examination table. The forearm is placed on the ulnar side…

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