Physiotherapy In Orthopedic Conditions II

The statement is true. Pott's disease is another term for tuberculosis of the spine, which is a form of tuberculosis that affects the vertebrae in the spine. It is characterized by symptoms such as back pain, spinal deformities, and neurological complications. The disease is named after Sir Percivall Pott, an English surgeon who first described the condition in the 18th century.

Reisser's sign and Cobb's angle are both associated with scoliosis. Reisser's sign is a clinical finding in scoliosis that indicates rotation of the spine, while Cobb's angle is a measurement used to quantify the degree of spinal curvature in scoliosis. Therefore, the correct answer is scoliosis.

Hip osteoarthritis (OA) can indeed be classified into three types based on radiographic appearance. Radiographic imaging, such as X-rays, can help identify the extent and severity of hip OA. The three types of hip OA classification are: 1) mild or early-stage OA, where there may be minimal joint space narrowing and small osteophytes (bone spurs), 2) moderate OA, characterized by more significant joint space narrowing and larger osteophytes, and 3) severe or end-stage OA, where there is substantial joint space narrowing, extensive osteophytes, and possible joint deformity. This classification system helps in determining the appropriate treatment approach for hip OA patients.

Placing hand over head relieves symptoms is not a symptom of CTS. CTS, or carpal tunnel syndrome, is a condition that causes pain, numbness, and paresthesias (tingling or burning sensations) in the hand and fingers. These symptoms are often worse at night and may disrupt sleep. However, placing the hand over the head does not have any direct effect on relieving CTS symptoms.

The statement is true because tuberculosis (T.B) of bone and joints is always a result of the spread of the disease from other parts of the body. Tuberculosis typically starts in the lungs and can spread to other organs, including the bones and joints. Therefore, T.B of bone and joints is always considered secondary to the primary infection in the lungs or other organs.

Step deformity is seen in spondylolisthesis. Spondylolisthesis is a condition where one vertebra slips forward over the vertebra below it. This can result in a step-like appearance in the spine, where there is a noticeable misalignment between adjacent vertebrae. This step deformity can cause pain, stiffness, and reduced mobility in the affected area. Other conditions listed such as spondylosis, sacralization, and PIVD do not typically present with a step deformity.

Enthesopathy is not associated with R.A. Enthesopathy refers to the inflammation or degeneration of the entheses, which are the sites where tendons or ligaments attach to the bone. Rheumatoid arthritis (R.A) is an autoimmune disease that primarily affects the joints, causing symptoms such as joint pain, swelling, and erosion. Raised ESR (erythrocyte sedimentation rate), joint erosion, and polyarthralgia (pain in multiple joints) are all commonly associated with R.A. However, enthesopathy is not a characteristic feature of R.A.

The statement is true because the spine is indeed the most common site for bone and joint infections. This is mainly due to the structure and function of the spine, which consists of multiple bones (vertebrae) and joints that can be susceptible to infection. Infections in the spine can occur through various means, such as bacteria entering the bloodstream or spreading from nearby infected tissues. Additionally, conditions like discitis or osteomyelitis can also contribute to spinal infections. Therefore, it is accurate to say that the spine is the most common site for bone and joint infections.

The given statement is false. The correct information is that the human leucocyte antigen of Rheumatoid Arthritis (RA) is DR4, not B27. Additionally, the human leucocyte antigen of Ankylosing Spondylitis (AS) is B27, not DR4. Therefore, the correct answer is false.

Osteopenia is not a primary sign of Complex Regional Pain Syndrome (CRPS). CRPS is a chronic pain condition characterized by severe hyperalgesia (increased sensitivity to pain), edema (swelling), and stiffness. Osteopenia refers to low bone density, which may be a secondary consequence of CRPS due to decreased use of the affected limb. However, it is not considered a primary sign of the condition.

Spondylolysis is a condition characterized by a defect or fracture in the pars interarticularis, a small bridge of bone connecting the facet joints in the spine. On an oblique view radiograph of the spine, a Scottish dog appearance refers to a specific appearance of the defect resembling the shape of a Scottish terrier dog. Therefore, the presence of a Scottish dog appearance on the radiograph suggests spondylolysis as the most likely diagnosis.

On radiographic examination for the diagnosis of T.B, abscesses may be seen in various locations such as paravertebral, retropharyngeal, and psoas regions. These abscesses can be visualized through radiographic imaging techniques. Therefore, the correct answer is "All of the above" as all of these locations can show abscesses in cases of tuberculosis.

The rehabilitation protocol for frozen shoulder is usually of 16 weeks and beyond duration. This is because frozen shoulder is a condition characterized by stiffness and pain in the shoulder joint, which can take a long time to recover fully. The rehabilitation process involves a combination of exercises, physical therapy, and sometimes medication to help improve range of motion and reduce pain. Due to the complexity and severity of frozen shoulder, it typically requires an extended period of rehabilitation to achieve optimal results.

The Trendelenberg gait is characterized by a drop of the pelvis on the opposite side of the weakened gluteus medius muscle. This drop occurs because the gluteus medius is responsible for stabilizing the pelvis during walking. Therefore, the correct answer is "Pelvic drop on the same side" because it contradicts the characteristic drop seen in Trendelenberg gait.

Primary repair of a flexor tendon injury is typically done within 12-24 hours after the injury occurs. This immediate repair helps to restore the integrity and function of the tendon. However, in some cases where the injury is not severe or the patient is not able to undergo immediate surgery, a delayed primary repair may be performed. This is typically done around 10 days after the injury, allowing for some healing and reduction of swelling before the repair is carried out.

In the management of CTEV (Congenital Talipes Equinovarus), the tendon of tibialis anterior is transferred to the outer side of the foot, not the tendon of tibialis posterior. This is done to correct the deformity and provide stability to the foot. The transfer of the tibialis anterior tendon helps in correcting the inward rotation of the foot and brings it into a more normal position. The peronei muscles are not involved in this procedure. Therefore, the statement in the question is incorrect, and the correct answer is False.

The correct answer is "Involucrum is the dead sclerotic bone." This statement is not true because involucrum is not dead bone, but rather a new layer of bone that forms around an infected bone in response to osteomyelitis. It acts as a protective barrier and can be seen on imaging studies.

The given answer is false because CRPS type I is a syndrome that develops without a specific nerve injury. It is typically triggered by a minor injury or surgery, but the pain and symptoms experienced are disproportionate to the initial injury. CRPS type I is believed to be caused by a dysfunction in the central and peripheral nervous systems, rather than a direct nerve injury.

The given statement is false. The correct capsular pattern for the GH joint is abduction, external rotation, and internal rotation. This means that when there is a restriction in the joint's range of motion, the first movements to be affected are abduction, followed by external rotation and internal rotation.

The correct sequence of movements for correcting foot deformity in CTEV is abduction, eversion, and dorsiflexion. Abduction refers to moving the foot away from the midline of the body, eversion refers to turning the foot outward, and dorsiflexion refers to flexing the foot upward. This sequence of movements helps to correct the deformity and realign the foot into its proper position.

The classical test for hip arthritis involves performing internal rotation of the hip in flexion. This test is used to assess the range of motion and detect any restrictions or pain in the hip joint. By internally rotating the hip while it is flexed, any discomfort or limited mobility can indicate the presence of hip arthritis. This test helps in diagnosing and evaluating the severity of hip arthritis, allowing for appropriate treatment and management.

When the posterior capsule of the glenohumeral (GH) joint becomes tight, it restricts the movement of the joint. This tightness specifically affects internal rotation, making it difficult for the arm to rotate inward towards the body. The other movements listed (flexion, extension, and external rotation) are not directly affected by the tightness of the posterior capsule.

The statement in the question is incorrect. In wry neck, also known as torticollis, the sternomastoid muscle spasms and causes tilting of the head towards the opposite side, not the same side. Additionally, the neck is rotated towards the same side, not the opposite side. Therefore, the correct answer is false.

To produce composite wrist and digital flexion, a certain amount of flexor tendon excursion is required. The correct answer is 9 cm, indicating that 9 centimeters of flexor tendon excursion is needed for this movement.

False. Type I acromion morphology is not a predisposing factor for primary shoulder impingement. Primary shoulder impingement is typically caused by repetitive overhead activities or structural abnormalities in the shoulder joint, such as rotator cuff tears or bony spurs. Acromion morphology refers to the shape of the acromion bone in the shoulder, which can vary between Type I, II, and III. While Type III acromion morphology has been associated with a higher risk of impingement, Type I morphology is not considered a predisposing factor.

The non-functioning extensor mechanism is not an absolute contraindication for total knee arthroplasty (TKA). TKA is a surgical procedure to replace the damaged knee joint with an artificial implant. Absolute contraindications are conditions or factors that make the surgery too risky or ineffective. Neuropathic arthropathy, painful solid knee fusion, and sepsis or systemic infection are all absolute contraindications for TKA because they can significantly impact the success of the surgery or increase the risk of complications. However, a non-functioning extensor mechanism can be addressed during the surgery and does not necessarily prevent the use of TKA.

During the second stage of adhesive capsulitis, the patient usually experiences pain at rest, motion restriction in all planes, and pain at night. However, the given answer states that this stage can last from 3 - 6 months, which is incorrect. The second stage of adhesive capsulitis typically lasts for 4 - 12 months.

The statement is false because the A2 pulley is actually the most important to the mechanical function of fingers. The A2 pulley is responsible for maintaining the flexor tendons close to the bones, allowing for efficient movement and grip strength. The A1 and A3 pulleys also play a role in finger function, but they are not as crucial as the A2 pulley.

The given answer states that the femoral neck is excessively retroverted. However, all of the other statements in the question are true about CDH, which stands for Congenital Dislocation of the Hip. CDH is characterized by the dislocation of the femoral head upwards and laterally, a shallow acetabulum, and hypertrophied ligamentum teres. Excessive retroversion of the femoral neck is not a characteristic feature of CDH.

Pott's paraplegia is classified into four grades based on the extent of motor involvement. This means that the severity of paralysis or weakness in the lower limbs determines the grade. The other options, sensory involvement and both motor and sensory involvement, are not the criteria for grading Pott's paraplegia. Therefore, the correct answer is motor involvement.

A positive modified Trendelenberg test in lumbar spine assessment indicates nerve root pathology of S1. The Trendelenberg test is used to assess the strength of the gluteus medius muscle, which is innervated by the superior gluteal nerve (L4-S1). A positive test result indicates weakness or dysfunction of the gluteus medius muscle on the side of the affected nerve root. Since the question specifically mentions a positive test result, it suggests that the nerve root pathology is at the level of S1.