Showing posts with label pain. Show all posts
Showing posts with label pain. Show all posts

14 Dec 2014

Common causes of foot pain

Foot pain  is a common complaint, it is important because it will interfere with mobility. There are a variety of causes for foot pain. Common  causes are given here.
1. Ankle or foot injury - It is very common after sudden twisting of ankle. This is associated with pain and swelling in the foot. Differentiation between ankle sprain and fracture is difficult.
2. Achilles tendinitis - Achilles tendon is situated in the back of ankle, inflammation may be associated with overuse or spondyloarthropathy.It present as painful swelling of tendon.
3. Rupture of Achilles tendon - There will be sudden pain in the back of ankle joint during activity,Patient walk with a limb.Patient cannot raise the heel from floor.
4. Plantar fasciitis - Present as pain under the foot, it is a common cause of foot pain. Patient experience maximum pain immediately after getting up from the bed. It usually resolves in 6 weeks.
5. Tender heel pad - Present as throbbing sensation in the foot. This is seen a few months after truma to heel.
6. Flat foot - Common in children,this can be painful or painless, treatment is required only if it produce pain.
7. High arched foot.
8. Forefoot pain - Is secondary to fracture, synovitis, or mechanical dysfunction.
9. Toe fracture - Due to fall of heavy weight object on the toe.
10. Arthritis of joints of foot.
11. Ingrowing of toe nail - As a  result of ill fitting shoes and poor nail cutting cause the nail to grow in to toe skin.
12. Hammer toe, clawing of toe or hallus valgus.

12 Jul 2014

Clinical features of osteoarthritis

Most common manifestation of osteoarthritis is joint pain and it is activity related pain occur during activity or immediately after the use of joint and it decreases gradually.
Site of pain - example
1. Hip and knee pain going up and down stairs.
2. Pain in weight bearing joints  while walking.
3. Hand osteoarthritis - pain while cooking.
Nature of pain.
Early in the disease, pain is present only when the affected joint is overused, but later the pain become constant and present even at night. This is associated with stiffness of joint. If early morning stiffness is present, it is very brief usually less than 30 minutes.
Osteoarthritis of knee joint.
In osteoarthritis of knee joint, pain occur on bending the knee. Some people experience buckling, catching and locking of the knee joint. Osteoarthritis of knee joint is the most common cause of chronic knee pain in persons over 45 yrs. In hip osteoarthritis restriction of hip movements will occur.
Investigation in osteoarthritis.
No blood test is required for evaluation of patients with osteoarthritis.
Tests that may be done.
1. Synovial fluid analysis.
2. Xray of joint.
3. MRI test.
Synovial fluid analysis.
If the WBC count more than 1000 it indicate inflammatory arthritis or gout
Xray
Correlate poorly with disease activity and joint pain .It may be normal in the early disease.It is indicated if the joint pain does not respond to usual management.
White arrow indicates joint space reduction compared to opposite side
MRI
Not a routine part of osteoarthritis evaluation.

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