PERTHES DISEASE

PERTHES DISEASE - Perthes disease is a rare childhood condition that affects the hip. It occurs when the blood supply to the rounded head of the femur (thighbone) is temporarily disrupted. Without an adequate blood supply, the bone cells die, a process called avascular necrosis.

Although the term "disease" is still used, Perthes is really a complex process of stages that can last several years. As the condition progresses, the weakened bone of the head of the femur, gradually begins to break apart. Over time, the blood supply to the head of the femur returns and the bone begins to grow back.

Perthes disease also known as Legg-Calve-Perthes, named for the three individual doctors who first described the condition — typically occurs in children who are between 4 and 10 years old. It is five times more common in boys than in girls, however, it is more likely to cause extensive damage to the bone in girls. In 10% to 15% of all cases, both hips are affected.

Symptoms - 

One of the earliest signs of Perthes is a change in the way your child walks and runs. This is often most apparent during sports activities. Your child may limp, have limited motion, or develop a peculiar running style. Other common symptoms include:

• Pain in the hip or groin, or in other parts of the leg, such as the thigh or knee (called "referred pain.").
• Pain that worsens with activity and is relieved with rest.
• Painful muscle spasms that may be caused by irritation around the hip.

Depending upon your child's activity level, symptoms may come and go over a period of weeks or even months before a doctor visit is considered.

POSTEROLATERAL CORNER (PCL)

POSTEROLATERAL CORNER (PCL) - Injuries to the posterolateral corner of the knee are most commonly associated with athletic traumas, motor vehicle accidents and falls. PLC injuries account for bit of all knee ligament injuries and often occur in combination with other cruciate ligament injuries. PLC provides both static and dynamic stabilisation to the knee joint. The static structures include the lateral collateral ligament (LCL or FCL), popliteus tendon, the popliteofibular ligament and the posterolateral capsule. Together these structures prevent varus collapse at the knee and external rotation of the tibia on the femur. Dynamic structures of the PLC play similar roles as the static structures but through movement. These structures include the popliteus muscle, iliotibial band, bicep femoris and the lateral gastroc tendon. 

Injuries affecting the PLC may or may not occur in conjunction with injuries to other structures in the knee. Symptoms of a PLC injury commonly include:

• Pain and/or swelling over the posterolateral surface of the knee
• Pain which is aggravated by weight-bearing activities, especially those involving high loads going through the lower limb such as walking up a hill, quick direction changes or jumping
• Feeling of weakness or ‘giving way’ around the knee

If you have an injury to the PLC and the peroneal nerve is affected, you may also experience pins and needles and/or numbness in the lower leg and foot. You may also experience foot or ankle weakness.

ANTERIOR CRUCIATE LIGAMENT INJURY

ANTERIOR CRUCIATE LIGAMENT INJURY  - The anterior cruciate ligament can be injured in several ways:

• Changing direction rapidly
• Stopping suddenly
• Slowing down while running
• Landing from a jump incorrectly
• Direct contact or collision, such as a football tackle

Several studies have shown that female athletes have a higher incidence of ACL injury than male athletes in certain sports. It has been proposed that this is due to differences in physical conditioning, muscular strength, and neuromuscular control. Other suggested causes include differences in pelvis and lower extremity (leg) alignment, increased looseness in ligaments, and the effects of estrogen on ligament properties.

When you injure your anterior cruciate ligament, you might hear a "popping" noise and you may feel your knee give out from under you. Other typical symptoms include:

• Pain with swelling. Within 24 hours, your knee will swell. If ignored, the swelling and pain may resolve on its own. However, if you attempt to return to sports, your knee will probably be unstable and you risk causing further damage to the cushioning cartilage (meniscus) of your knee.
• Loss of full range of motion
• Tenderness along the joint line
• Discomfort while walking

HERNIATED NUCLEUS PULPOSUS (SLIPPED DISK)

HERNIATED NUCLEUS PULPOSUS (SLIPPED DISK) - A herniated nucleus pulposus is a slipped disk along the spinal cord. The condition occurs when all or part of the soft center of a spinal disk is forced through a weakened part of the disk. The bones (vertebrae) of the spinal column run down the back, connecting the skull to the pelvis. These bones protect nerves that come out of the brain and travel down the back and to the entire body. The spinal vertebrae are separated by disks filled with a soft, gelatinous substance, which provide cushioning to the spinal column. These disks may herniate or rupture from trauma or strain. Radiculopathy refers to any disease affecting the spinal nerve roots. A herniated disk is one cause of radiculopathy. 

SYMPTOMS OF HERNIATED LUMBAR DISK
Severe low back pain
Pain radiating to the buttocks, legs, and feet
Pain made worse with coughing, straining, or laughing
Tingling or numbness in legs or feet
Muscle weakness or atrophy in later stages
Muscle spasm

SYMPTOMS OF HERNIATED CERVICAL DISK
Neck pain, especially in the back and sides
Deep pain near or over the shoulder blades on the affected side
Pain radiating to the shoulder, upper arm, forearm, and rarely the hand, fingers or chest
Pain made worse with coughing, straining, or laughing
Increased pain when bending the neck or turning head to the side
Spasm of the neck muscles
Arm muscle weakness