Case Studies

Shoulder pain: remember the exceptions. Part 3

Does Teres minor muscle atrophy matter?   In the previous two posts, we introduced a case of shoulder pain in a competitive swimmer, and picked off the first of two questions we had posed ourselves, discussing some ideas regarding what might cause the teres minor...

Shoulder pain: remember the exceptions. Part 2

What causes isolated teres minor atrophy?    In the last post we introduced a case of shoulder pain in a competitive swimmer. Here's a recap of what we found when we scanned her shoulder:   "The examination indicated:  Subdeltoid/subacromial bursal fluid may...

Shoulder pain: remember the exceptions. Part 1

Which findings explain the symptoms? The case of teres minor.   A 21-year-old woman presented with ongoing shoulder pain. She was a high-level competitive swimmer, and found her pain increased during sets, or was a constant, low-level ache. She experienced pain...

Tendon injury and the continuum. What hurts, and why?

Tendon injury: multiple findings within the same tendon.   A 62 year old competitive badminton player presented having injured his left Achilles while playing approximately 6 weeks earlier. He had been sore since the injury despite conservative management and was...

How to tendinopathy 3: using the ultrasound report

A guide to using the findings in an ultrasound report indicating tendinopathy.   In the previous two posts we have talked about the continuum model of tendinopathy according to Jill Cook’s research group. The idea that tendinopathy is a process of injury, the...

How to tendinopathy: 2

Ultrasound in the clinical picture of tendinopathy: guiding management decisions.   In the previous post, we left you with the idea that ultrasound imaging can visualise the stages of the tendon continuum according to Cook et al.,1,2 and that management of tendon...

How to tendinopathy: 1

About tendon injury.   Tendinosis is tendinitis that can’t be proven to be associated with inflammation, but tendinitis is.  Or maybe tendinosis might be failed repair of a previously inflamed tendon, so might be tendinitis then not tendinitis. Also, tendinosis...

The ankle 3: consider the foot?

Ankle or foot: consider both?   An 18-year-old man presented having injured his left ankle approximately four days earlier. He required a wheelchair for two days, and was using crutches after that. In addition to obvious pain on weightbearing, he also had...

The ankle 2: medial and lateral pain

Ankle injury: normal findings are still helpful.   A 27-year-old woman presented having suffered an injury to her left ankle. Approximately a week earlier she had been out running and had hurt her ankle, which was tender both medially and laterally. An X-ray did...

The ankle 1: inversion injury

Ankle inversion injury: includes the lateral ligaments.   A 19-year-old woman presented having suffered an injury to her left ankle. Two-weeks earlier she had tripped on a medicine ball and forcefully inverted her ankle. An X-ray at ED taken on the day of the...

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