Le Elima: Avanoa Faʻamatalaga Mataʻutia | El Paso, TX.

Aloaia o le Elbow Trauma

• I tagata matutua: Ulu Radial Fx o le m / c (33%) ma faʻamaumauga mo 1.5-4% o faʻalavelave uma. Etiology: FOOSH faʻatasi ai ma le faʻataʻitaʻiga. Manua faʻatasi: o loimata o le faʻamaufaʻailoga o tulivae e tagi. EssexLoprestiFx faʻatasi ai ma le faʻatautaia o le membrane i le vevelaina ma le faʻasalaga o le Distal Radio-Ulnar Joint (DRUJ)
• Talofa mataʻutia: o le ulu Radial Fx, tosoina o le tulivae ma le faagasologa o le Coronid Fx (e masani lava ona osofaia e le Brachialis M)
• Ata: 1st laasaga o le x-radiography ma le tulilima, o le numera CT e mafai ona fesoasoani i mataupu faigata, MRIif faʻaleaga manuʻa.
• I tamaiti: Supracondylar Fx o le distal humerus numera mo le 90% o matuitui tiga. E masani lava d / t lavea faʻafuaseʻi ma FOOSH ma tulilima faʻalauteleina, seasea <5% ma tulilima tulilima. TeleSupracondylar Fx tupu i tamaiti <10 yo Males> Fafine. Faʻalavelave: faʻamaʻi i le cubitus varus aka Gunstock faʻaletonu, afaina o le tino ma le ogaoga o le toto ischemic compart syndrome ma le Volkmann contracture
• Ata: 1st laasaga x-radiography e mafai ona lava. CT faʻaaoga i nisi taimi i mataupu faigata.

 

 

• Ulu Radial (RH) Fx: O le tuʻufaʻatasia Mason e fesoasoani e fuafua le tikeri o le faigata ma le faiga o togafitiga
• Tusa 1- e le o iai le m / c ma le meaʻai e aofia ai ligaments. I luga o leitiola e mafai ona matua iloga ma iloiloga o paʻu o le faga o le totilima le taua ma e na o le pau lava le faʻamatalaga o le faʻamaonia
• Ituaiga 2- aveʻese e 2-mm po o> ma rotational poloka
• Ituaiga 3- amataina> 2-3 fasi ma
• Type4 o loʻo tuʻuina atu i le RH fx, le vavaega o le tulivae ma o nisi taimi o faʻasologa masani o le Coronid often f / t Brachialis M siitia
• Rx: Tausaga 1 faʻatautaia le le faʻaaogaina e le immobilization ma le toe faʻaleleia o mea. Taʻu 2-ORIF pe a fai o poloka poloka. Pusa 3 ma le 4, ORIF ma le HR poʻo le RH arthroplasty

 

• Faʻailoa le masani ai ona aveʻesea nofoa pito i luma gaʻo (moli lanumoli) ma le tulaʻi mai o le posterior fat pad (lanumeamata uʻamea) e masani ona loloto i le olecranon fossa ma e le vaʻaia seʻi vagana hemarthrosis matuitui poʻo isi aoga tulivae Fx

 

 

• Mason type 1 RH Fx mafai ona v. maaleale ma misia. E tatau ona iai se faʻataʻitaʻiga ole faʻataʻitaʻiga ole faʻamaoniga ole gaʻo lelei ole gaʻo. Faʻaaliga luma gaʻo pad gaʻoga o Sail saini ma le i ai o le pou gaʻo pad d / t matuitui toto

 

 

 

• Monteggia vavaeʻeseʻesega: vii 1 / 3ulnar o le Fx. faʻatasi ai ma le faʻalavelave faʻaleagaina o le PRUJ (ulu susulu). Faʻaleagaina FOOSH. Tamaiti4-12 yo E le masani i tagata matutua.
• X-ray faigofie ona faʻaalia ulnar Fx, ae o le radial head dislocation atonu e faʻaoleole ma e iai taimi e misia ai. O se manuʻa tuga lea e oʻo atu ai i le tulilima le atoatoa pe a fai e tuai tolopo le 2-3 vaiaso pe a le faia togafitiga. X-ray e masani ona lava: Rx: lafo vs. faʻagaioiga.

 

 

 

• Supracondylar Fx: o le M / C kuli Fx i tamaiti.
• Aemaise lava, o le 1 (pito i luga taumatau) e leʻo faʻaaogaina e faigata ile Dx. O le le atoatoa o "fat fat" ma le pito i luma o le moemoega ma le radiocapitella line disturbance e masani ona sili ona faatuatuaina
• Ituaiga 3 o loʻo tauʻavea se maualuga maualuga lamatiaga mo Volkmann koneteina (vascular ischemic-nekrosis o le pito i luma alava maso potu

 

 

 

Faʻasalaga o le kuli i se tagata taaalo

 

• Epicondyle Fx: taatele o manuaga o tamaiti, e tusa ma le 10% .E faʻamaonia le osofia Fx ma le loimata MUCL. Medial epicondyle o le m / c Fx. FOOSH o le m / c mechanism.> F. Afai e fai si paʻu pe leai foi e mafai ona togafitia i le lafoina o esp. i totonu o le lima e le o se pule. Afai e vavae ese e pei ona i ai i lenei tulaga, manaʻomia le ORIF.
• Medial epicondyle avulsive Fx i totonu o se tamaʻi pesipolo pesipolo na faiaina se 'ligilima liki' i le 60sand i le taimi nei e tatau ona aloese mai le le mautonu
• OCD o le Capitellum o se masani afeleti manuʻaga faʻamalosia e ala i le faʻateleina compression / flexion. OCD tatau ona DDx mai Panner's faʻamaʻi poʻo osteochondritis masani faʻaalia i talavou gasegase
• Faigata i le faʻamaoniga ono mafua mai-- mai le teleapophysis e uiga i le tulilima (vaʻai CRITOE)
• Ata: 1st sitepu: x-ave mulimuli ai MRI ma MRarthrogramme pe a faʻailoa.
• E ono fesoasoani le CT i le iloiloina o manuʻa faigata. MRI ma MSKUS ono fesoasoani i se '' manua manuʻa.

Elbow Arthritis

 

• DJD o le tulilima e le masani ma e masani lava 2nd i le faʻalavelave, galuega, CPPD, OCD o le Capitellum poʻo isi togafitiga. Falemaʻi: tiga, faʻaititia le ROM. i le pule malosi, faʻaitiitia o le ADL. Faʻasolosolo o le fesuiaiga ma le faʻaopoopoga. 50% faʻalauteleina le neuropathy o le Ulnarcompressive. Rx: faʻamalositino, aveeseina o le debridement arthroscopic / osteophytes, faʻasalaga faʻapipiʻi. I tagata matutua matutua ma e le o gasegase o le tino Elbow Arthroplasty (TEA) e mafai ona faʻaaogaina
• Ata: x-radiography ua lava, CT fesoasoani i le fuafuaina muamua

 

 

• Inflammatory Arthritis: RA o le tulilima e masani (20-50%) ma faʻaleagaina d / t synovitis, pannus, ponaivi / cartilage, ma ligamentous faʻafanoga / laxity. Togafitiga: amata i le maeʻa ai o le amataga o lima faʻailoga ma, symmetrical fulafula, tiga, faʻaititia ROM, fetuʻunaʻiga contracture. O le iai o nodules rheumatoid e mafai ona maitauina ile olecranon ma tua i lalo. Rx: DMARD, faʻagaioiga tendons toe faʻaleleia.
• Ata: x-radiography ma vave le faʻapitoa effusion (gaʻo pads), mulimuli ane: erosions, symmetric JSL, osteopenia. MSK US fesoasoani vave Dx. MRI faʻaalia synovitis; ponaivi edema faʻatasi ma muamua-erosive x-ray sailiiliga, synovial faʻaleleia atili i le FS T1 + C.
• Gasegase o le oona: ono aʻafia ai le tulilima ae laʻititi ifo i le pito pito i lalo. Olecranon bursitis mafua ai le oso aʻe o le la luga o x-ave ma poʻo le i ai o ponaivi o le tafia. Aspiration ma polarized microscopy faʻaalia faʻaaogaina nila-foliga leaga birefringent monosodium urate tioata. Rx: colchisin, isi vailaʻau.
• Septic Arthritis: mafaufau i tagata e maua i le maʻisuka, IV tagata faʻaogaina fualaʻau, tutusa RA, tagata mamaʻi e maua i le TB, gonococcal i talavou matutua. Togafitiga o loʻo avea ma monoarthritis ma poʻo w / o faʻavae faʻailoga. X-ray: le lelei mauaina i le amataga o laʻasaga. US mafai ona faʻaalia effusion ma maualuga Doppler.MRI: effusion, osseous edema. E mafai foi ona fesoasoani le sconeigraphy ivi. Labs: CBC, ESR, CRP. Diagnostic arthrocentesis ma le susunuina o le kalama ma le aganuu e taua tele. Rx: Faamalosi IV vailaʻau

 

 

• Juvenile Idiopathic Arthritis (JIA) mafaufauina M / C faʻamaʻi tumau o le tamaititi ma muamua IBD le masani ai. O le Dx e faʻataʻitaʻi ma faʻataʻitaʻi: Faʻataʻitaʻiga: tiga soʻoga ma le fulafula o se tamaititi 0-16-tausaga mo le 6-vaiaso pe sili atu foʻi. Tele fomu o iai--M / C pauciarticular (oligoarticular) 40%, F> M, e fesoʻotaʻi ma ocular aafia ai (iridocyclitis) ma ono tauaso. Polyarticular ma faiga Faʻavae.
• E masani ona aʻafia le tulilima faʻatasi ai ma tulivae, tapulima, ma lima, aemaise i le polyarticular dz.
• Labs: ESR / CRP RF-VE i le tele o mataupu
• Ata: vave foliga o le ray-ray e le o ni mea patino. Mulimuli ane: faʻaleagaina o le eleele, faʻaumatiaga o le gaosiga o le cartilage, faʻasolosolo o tala faʻapitoa, vave tapunia o le tino. Taimi e tolopoina: 2nd DJD, faʻatasi ankyloses.DDx: o le limophilic arthropathy. O le televise e taua tele.
• Rx: DMARD, tausiga tausi

Eseesega faʻaleaga

 

• Supracondylar faagasologa: 2% o le faitau aofaʻi. Na faamatalaina e Sir JohnStruthers i le 1854. Paʻu faʻamalosi (Ligament o Struthers) e mafai ona oʻo atu ai i le faʻamalosi o le Median N. DDx maiOsteochondroma lea e masani ona vaʻai ese mai le sooga
• Chondrometaplasia synovial muamua(Reichel Syndrome): abnormalmetaplasia o sela sinovial sasaa cartilage i soʻoga ono mafua ai DJD, extrinsic ponaivi eria, synovitis, neura taofiofi ma isi Aveesea. Faʻataʻitaʻiga: tele osseocartilaginous tatalaina tino o tutusa tutusa tele i le soʻoga cavityDDx ma DJD ma 2ndosteochondromatosis. MRI-maualalo faʻailo onT1 ma T2 ma ono faʻatasi galulue. Ina fufusi soʻoga faʻatasi e pei o le tulilima ono i ai ma le tele soʻoga faʻasoesa. '
• Panner's Disease: osteochondrosis o le Capitellum masani i le 5-10 yo talavou afeleti DDX mai le OCD o Capitellum (talanoaina) e tupu i talavou. Faʻataʻitaʻi: tiga i gaioiga. O le toe faʻaleleia e tupu i le tele o tulaga e ala i le faʻamaloloina e aunoa ma se taimi. Ata: x-ave faʻaalia sclerosis ma sina vaega o leCapitellum w / o faʻaletonu tino. MRI: maualalo T1 ma maualuga T2 faʻailoga i le atoaCapitellum.
• Myositis Ossificance:

Tisu malulu & Bone Neoplasms e uiga i le tulilima

• Lipoma: intramuscular, subcutaneous. O le tele o mea masani e vaivai le neoplasms. O le gaʻo o le gaʻo ae tele le numera e mafai ona maua ai le gaʻo-calcification-fibrosis. E tumau lava le pala. O nisi taimi e faigata ai ile DDx mai le liposarcoma vaʻaia lelei. Ata: x leitio: laina eletise ua uma ona faʻasalalau ma le w / o fuafuaina. US ma MRI e taua. I luga o MRIT1high, T2 low SI.
• Hemangioma: lesi vavae lelei, masani ona aofia ai le tele o auala vascular. Capillary vs. ana. Sili atu taʻatele i tamaiti, ae maua i soʻo se tausaga. Atonu e masani ona fausia ai phleboliths (faʻafomaʻiina). Ata: x-ave faʻaalia o mea vaivai o loʻo i ai meaola i totonu. MRI: T1-maualuga pe fesuiaʻi faʻailo. T2-maualuga faʻailo i vaega o lemu tafe. 'Ato o anufe' saini. Sili ona 'aloʻese mai le paiopopo. Rx: faigata: faʻalotoifale excision vs. embolization vs. maitauina. Maualuga tupu.
• Potoifale Tuma o le gaosiga o le gaʻo (PNST): faʻaleagaina ma faʻamalosi. Faʻalavelave tele i le NF1 ma le maualuga atu o le lamatiaga o le maʻi PNST. Benign PNST: Schwannoma vs.Neurofibroma. Spinal vs. gasegase lautele. Faʻasolopito: Schwann sela e pipii i le fibroblast ma ipu. Faʻamatalaga: pts i 20s ma 30s, faʻasalalauga faʻasalalau ma poʻo le w / o le aʻafiaga i le lotoifale. Ata: MRI: T1: faailoga vavae-gaʻo, T2: faʻailoga faʻamaonia. T1 + C faaleleia
• Suga Suʻa Sarcomas: MFH, Synovial sarcoma, (talanoaina), Liposarcoma (sili atu i le retroperitoneum) Dx: MRI. Clinical: O le Dx e tuai le tuai o le tele o le tele o mea e le amanaiaina. Ole maualuga o le siakiina o le tino e talafeagai ma le MRI, e mafai ona fesoasoani le US. O le vailaʻau o loʻo faʻamaonia le Dx.
• Ovi ponaivi Neoplasms: Tamaiti: OSA, Ewing's sarcoma (talanoaina) Matutua: Mets, Myeloma (talanoaina)

O le Tulilima