FROM OUR EXPERTS
Pain and snapping along the outside border of the knee can be caused by a variety of problems. It could be iliotibial friction syndrome, meniscus tear, degenerative joint disease, or even a loose fragment in the joint. In this report, the case of a 21-year-old female with a painful snapping of the left knee is presented. She had the symptoms for seven years. Evaluation and treatment by a variety of doctors and physical therapists were not helpful. She had to give up all sports and recreational activities. Any activity involving knee flexion or extension seemed to set it off. Even walking became a painful process. Her goal to return to running seemed impossible. She was seen by the authors of this case report (an orthopedic surgeon and a physical therapist). After a thorough examination, it was determined she should try another round of physical therapy treatment. The therapist used a trial of manual therapy, taping, icing, and a knee immobilizer. Conservative (nonoperative) care was uns...
Alternative Names Causes of foot pain References Stretanski MF. Achilles tendinitis. In: Frontera, WR, Silver JK, eds. Essentials of Physical Medicine and Rehabilitation. 2nd ed. Philadelphia, Pa: Saunders Elsevier; 2008:chap 72.
In the previous post, we discussed different types of surgeries which are used in patients with rheumatoid arthritis . This week I’d like to talk more about surgeries involving soft-tissue, specifically synovectomy, tendon repair, and carpal tunnel release.
What is a Synovectomy?
The synonium is a membrane surrounded a joint, usually only one or two cell layers thick, which produces synovial fluid to help lubricate the joint. In rheumatoid arthritis, the synovium becomes inflamed and may grow excessively, producing too much synovial fluid containing an enzyme that can eat away at the cartilage on the joint surface. Disease-modifying anti-rheumatic drugs (DMARDs) are used to control the abnormal growth of synovium.
If DMARDs do not work, a patient’s rheumatologist may suggest steroid injections into a joint or a needle aspiration of excess synovial fluid. If these strategies do not work, then the patient may be referred to an orth...
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