By James R D Murray; Erskine J Holmes; Rakesh R Misra
Sensible, easy-to-use reference for examining musculoskeletal problems, with high quality pictures and multidisciplinary writer team.
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Extra info for A-Z of Musculoskeletal and Trauma Radiology
Symptomatic relief with NSAIDs is the mainstay of treatment. In recurrent attacks and particularly in the elderly consider intra-articular steroid injection. Arthroscopic retrieval of loose bodies (if causing mechanical symptoms) and lavage of the joint have also been described with some success. 38 I Crystal deposition disorders Calcium pyrophosphate dihydrate deposition: advanced degenerative changes seen at the radiocarpal and distal radioulnar joints, with scapholunate separation and a large degenerative geode within the adjacent radial metaphysis.
Femoral-head osteonecrosis Femoral-head osteonecrosis Characteristics Occurs most commonly in the 20–50 age group. Bilateral: 50% of idiopathic cases, or 80% in steroid-induced cases. Commonly seen following intracapsular fractures of the femoral neck. Increased risk if displaced (up to 80%). g. g. deep sea divers – caisson disease), venous thromboembolism and bone-marrow transplant. I Clinical features Classically present with pain of insidious onset. Pain often worse at night. Pain is usually severe but may become more bearable after several weeks.
Idiopathic scaphoid AVN is rare. 14 I Avascular necrosis – osteonecrosis Freiberg’s osteonecrosis of the second metatarsal head. Management Pain relief with analgesics and immobilisation. g. drugs, alcohol, occupation. Surgery, if indicated, is generally reparative or reconstructive in nature. Core decompression and vascularised bone graft aims to restore vascularity and prevent further collapse. In severe collapse, reconstructive surgery should be considered. 15 I A–Z of Musculoskeletal and Trauma Radiology 16 Lateral view of a 55-year-old male with medial tibial plateau SONK.