Anatomy for problem solving in sports medicine

F Harris Prof Philip

Description

When examining patients with sports-related and exercise-related injuries, a thorough knowledge of anatomy is vital in order to make an accurate diagnosis and work out an effective treatment plan. In this helpful, practical book, a professional anatomist, an orthopaedic surgeon and a sports physiotherapist have combined their expertise to give a detailed explanation of the structural and functional anatomy of the knee. The book includes descriptions and images of the relevant anatomy, and sample clinical problems (with model answers) throughout. Although each problem is different, practitioners will always follow a similar pattern in arriving at a differential diagnosis. In every case, four main areas need to be covered: the type of sport; the clinical history; physical assessment; and appropriate investigations. By taking a logical, step-by-step approach to solving clinical problems, this book offers a valuable resource for the wide range of health professionals who manage knee injuries.

Sujets

• Médecine
• Physical therapy

Informations

• Publié par: M&K Publishing
• Date de parution: 07 mars 2014
• Nombre de lectures: 0
• EAN13: 9781907830891
• Langue: English
• Poids de l'ouvrage: 11 Mo

Extrait

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Clinical Examination Skills for Healthcare Professionals ISBN: 9781905539710

Routine Blood Results Explained 3/e ISBN: 9781905539888

The ECG Workbook 2/e ISBN: 9781905539772

Anatomy for problem solving in sports medicine

The Knee

Philip Harris Craig Ranson Angus Robertson

Title Anatomy for problem solving in sports medicine: The knee AuthorProfessor Philip Harris, Dr Craig Ranson and Mr Angus Robertson ISBN: 9781905539-89-5 First published 2014

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Any person who does any unauthorised act in relation to this publication may be liable to criminal prosecution and civil claims for damages.

British Library Cataloguing in Publication Data A catalogue record for this book is available from the British Library

Notice Clinical practice and medical knowledge constantly evolve. Standard safety precautions must be followed, but, as knowledge is broadened by research, changes in practice, treatment and drug therapy may become necessary or appropriate. Readers must check the most current product information provided by the manufacturer of each drug to be administered and verify the dosages and correct administration, as well as contraindications. It is the responsibility of the practitioner, utilising the experience and knowledge of the patient, to determine dosages and the best treatment for each individual patient. Any brands mentioned in this book are as examples only and are not endorsed by the publisher. Neither the publisher nor the authors assume any liability for any injury and/or damage to persons or property arising from this publication.

To contact M&K Publishing write to: M&K Update Ltd · The Old Bakery · St. John’s Street Keswick · Cumbria CA12 5AS Tel: [phone] · Fax: [phone] [e-mail] www.mkupdate.co.uk

Designed and typeset by Mary Blood Printed in Scotland by Bell & Bain, Glasgow

Contents

List of figures Foreword About the authors Section 1 Introduction to solving sports injury problems and the role of anatomy Section 2 Introduction to the anatomy of the knee Section 3 Anterior structures Section 4 Posterior structures Section 5 Medial structures Section 6 Lateral structures Section 7 Blood supply Section 8 Synovial membrane and synovial fluid Section 9 Major intra-articular structures Section 10 Extra-articular ligaments and corner complexes Section 11 The patella and patellofemoral joint Section 12 Fracture patterns of proximal tibia and knee epiphyses References Index

Figures

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The three articulating bones of the knee j oint Articulating surfaces of the femur Articulating surfaces of the tibia Patella The in-vivo appearance of articular carti lage Arthroscopic view of the medial compartme nt (right knee) Histological structure of articular carti lage The orientation of collagen fibres in art icular cartilage Operative photograph of a left knee follo wing lateral patellar dislocation Arthroscopic view of full thickness femor al condyle articular cartilage defect Antero-posterior weight-bearing radiograp h and articulated skeleton of a normal right knee Lateral weight-bearing radiograph and art iculated skeleton of a normal right knee ‘Skyline’ radiograph and articulated skel eton of a normal left knee Anterior knee external features: muscles, tendons and associated bursae, ligaments Sagittal magnetic resonance image of patel lar tendinopathy Sagittal ultrasound image of a normal pat ellar tendon Sagittal ultrasound image of patellar ten dinopathy Sagittal Doppler ultrasound image of pate llar tendinopathy Lateral radiograph of knee demonstrating Osgood-Schlatter’s disease MRI demonstrating Osgood-Schlatter’s dis ease Bony prominences associated with long sta nding apophysitis of the patellar tendon attachments at the inferior pole of the patella Knee posterior aspect showing popliteal f ossa with boundaries and contents Posterior knee external features showing muscles, tendons with associated bursae, and ligaments Sagittal MRI showing a Baker’s cyst in a skeletally immature knee Arthroscopy of normal popliteus tendon (r ight knee) Posterior knee external features: muscles, tendons and associated ligaments Posterolateral knee features. The capsul e has been removed. Medial knee external features: muscles, t endons with associated bursae, and ligaments Iliotibial band friction syndrome Lateral knee external features: muscles, ligaments, tendons and associated bursae Genicular anastomosis Knee joint synovial membrane and anterior bursae Patella and anterior part of capsule rem oved to show plica Transverse section through suprapatellar bursa to show medial plica Sagittal section through the knee (medial compartment) Knee joint sagittal section Sagittal section of knee showing anterior bursae Anterior subcutaneous bursae of the knee Sagittal MRI of knee showing prepatellar bursitis Knee joint coronal section Tibial plateau with menisci, cruciate lig aments and related adjacent ligaments and tendons viewed from above Frontal view of interior of knee joint Blood vessels in the peripheral part of t he meniscus Blood supply to peripheral ‘red zone’ of meniscus that may be amenable to repair if torn Meniscal tear mechanism

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There are two types of meniscal tear mech anism – vertical and radial. Circumferential vertical tears may develop into bucket-handle type tears Coronal MRI of the knee Arthroscopic view of a peripheral lateral vertical meniscal tear (right knee) Arthroscopic view of a displaced ‘bucket handle’ tear of the lateral meniscus (left knee) causing loss of extension MRI showing a large medial meniscal cyst of right knee Frontal view of the cruciate ligaments Menisci relationships on tibial plateau a nd to the cruciate ligaments and synovial membrane Arrangement of cruciate ligaments and mec hanism of tears; anterior cruciate ligament Arrangement of cruciate ligaments and mec hanism of tears; posterior cruciate ligament Sagittal MRI of knee showing normal cruci ate ligaments Sagittal MRI of the knee showing ruptured posterior cruciate ligament Arthroscopic view of a normal anterior cruciate ligament running from infero- medial to posterolateral in the femoral notch (righ t knee) Ruptured anterior cruciate ligament (rig ht knee) with ‘empty lateral wall sign’ Coronal MRI of the knee showing the menis cofemoral ligament Structures forming posteromedial corner c omplex Effect of flexion and extension on collat eral ligaments of the knee Medial collateral and the two oblique lig aments The posterolateral complex The iliotibial tract (ITT) reinforces the lateral side of the capsule Popliteus muscle and tendon Popliteus tendon attachment on lateral fe moral condyle The posteromedial complex Extensions of semimembranosus insertion a nd adjacent ligaments The posteromedial complex Semimembranosus tendon and posterior obl ique ligament Tear of semimembranosus tendon and poste rior oblique ligament Articulation of the patella with the femu r Movement of the trochlea of the femur in relation to the patella Calculation of the Q-angle Bilateral skyline X-ray view of left and right patella showing asymmetry Muscular and bony mechanisms resisting la teral displacement of the patella Medial side of the knee Ossification of the patella with formatio n of bipartite patella Types of patellar instability Pattern of patella maltracking Normal patella alignment on the trochlea MRI of a laterally positioned and tilted patella T2 MRI of a laterally positioned (sublux ed) patella Sites of disruption of the knee extensor mechanism Separation of epiphyses associated with t he patellar tendon Transverse patella fracture Mechanism of proximal-lateral tibial abdu ction fracture Examples of fracture patterns in the prox imal tibia and tibial plateau MRI confirming lateral tibial plateau imp action fracture Location and fusion times of knee epiphys es Lateral radiograph of lower femoral and u pper tibial epiphysis (TE) in a 12-year- old boy

Foreword

When examining patients with sports-related and exercise-related injuries, a thorough knowledge of anatomy has a pivotal role in arriving at a diagnosis and management plan. In this book a professional anatomist, an orthopaedic surgeon and a sports phys iotherapist have combined their expertise to present a series of problems related to the sportin g knee. The accompanying text provides descriptions and images of the relevant anatomy required to solve each problem. The detail of the content, although clearly and simply presented, goes well beyond the usual descriptive anatomy found in many anatomical textbooks. We hope this bo ok will be a valuable resource for the wide range of health professionals who manage sports-related injuries.

Professor Philip Harris, Dr Craig Ranson and Mr Ang us Robertson

The authors would like to thank Dr Peter Mullaney, Consultant Musculoskeletal Radiologist at the Cardiff & Vale NHS Trust for supplying several of the radiological images for the book.

About the authors

Philip Harris Professor Harris is Emeritus Professor of Anatomy, University of Manchester, a Fellow of the Anatomical Society UK and a past examiner in Anatom y to the Royal Colleges of Surgeons of England, Edinburgh and Glasgow. He has extensive ex perience of teaching Anatomy to undergraduates and postgraduates over many years. H is special interests include applied and living anatomy of the locomotor system and he has taught courses in Sports Medicine and Sports Science. With Dr Ranson, Professor Harris is co-author of the bookLiving and Surface Anatomy for Sports Medicine.

Craig Ranson

Dr Ranson is a Senior Lecturer in Sport and Exercise Medicine at Cardiff Metropolitan University and a Sports Physiotherapist with the Wales Rugby Team. His previous posts include UK Athletics Chief Physiotherapist and National Lead Physiotherapist to the England and Wales Cricket Board. Craig is a consultant to a variety of sporting orga nisations including the International Cricket Council and the Sports Medicine Department of the University of the West Indies.

Angus Robertson Mr Robertson is a Consultant in Trauma and Orthopaedics at Cardiff and Vale NHS Trust. He is also managing partner at Cardiff Sports Orthopaedics LLP, an Honorary Senior Lecturer in Sports and Exercise Medicine at Cardiff Metropolitan University and Medical Director at Pontypool RF C. His clinical and research interests include sports inju ries, arthroscopy and reconstruction of the knee, shoulder and elbow.