Presentation
Case 1 This 45 year old lady presented to the Emergency Department after falling onto her wrist. Case 2 This 38 year old male presented to the Emergency Department with a right forearm injury after a steel pipe fell on his arm. [wikiradiography.net]
Grade 2: Patient has a Horizon Sign present; however, some supporting structures are still attached. Grade 3: Patient has a Horizon Sign present; however, the vast majority of supporting structures are unattached. [canadianchiropractor.ca]
We present a very unusual case of subluxation of the fifth MTP joint following a postboil skin contracture. The case was treated with the release of contracture by Z-plasty. It resulted in concentric reduction of the joint and normal skin healing. [ncbi.nlm.nih.gov]
Entire Body System
- Pain
SC Subluxation Symptoms A sternoclavicular joint subluxation typically causes an onset of sudden pain at the time of injury. [drmillett.com]
In the non-RSD group, 78.6% of the patients with subluxation and 38.1% of the patients without subluxation reported shoulder pain (p = .019). [ncbi.nlm.nih.gov]
The displacement causes severe pain, weakness, joint instability and loss of motion in patients. Subluxations and dislocations often emulate one another. [drjeffpadaleckimd.com]
Pain in the Back or Neck This is one of the most obvious symptoms of a subluxation of the spine. Pain often creeps up either in the back or neck, or sometimes it shows up in both areas. [thejoint.com]
- Arm Pain
In the case whereby the first rib is subluxated or subluxated first rib, symptoms may include neck pain, shoulder pain, arm pain and numbness, headaches, and chest pain. [dislocatedrib.org]
Musculoskeletal
- Shoulder Pain
In the non-RSD group, 78.6% of the patients with subluxation and 38.1% of the patients without subluxation reported shoulder pain (p = .019). [ncbi.nlm.nih.gov]
Swimmer’s shoulder Swimmer's shoulder is the term used to describe the problem of shoulder pain in the competitive swimmer. [physio-pedia.com]
Dislocation of the long head of biceps tendon out of the bicipital groove is an uncommon cause of shoulder pain. [docslide.us]
In other cases, patients may initially experience shoulder pain or an ache either during, or following, certain activities. In post-traumatic shoulder instability the patient usually reports a specific painful incident that caused the problem. [physioadvisor.com.au]
- Knee Pain
Consistent frequent knee pain, symptomatic knee osteoarthritis, and knee pain severity increased the risk of developing widespread body pain, independently of structural pathology. [caringmedical.com]
pain in the front of the knee and around the kneecap. [webmd.com]
For example, a runner with knee pain may be engaged in too much activity too early in training. (A general rule for runners is to not increase mileage more than 10 percent per week.) [dynamicchiropractic.com]
The patient’s instability resolved, but she had persistent knee pain and occasional swelling postoperatively. [ncbi.nlm.nih.gov]
- Wrist Pain
Symptoms of a scaphoid fracture include pain in the wrist at the time of injury and rapid swelling at the back of the wrist. Pain may settle down soon after the fall but the patient will have difficulty gripping things. [sportsinjuryclinic.net]
Feeling of tenderness while touching the wrist is also one of the symptoms of Distal Radioulnar joint subluxation or DRUJ subluxation. Pain with turning over of the hand. Pain during movements of the hand. Wrist may become deformed. [epainassist.com]
- limited & painful rotation; - supination is block by dorsal dislocation; - pronation is block by palmar dislocation; - ECU subluxation: - is elicited when wrist is held in ulnar deviation and wrist is supinated; - references: - The “Ulnar Fovea Sign [wheelessonline.com]
All wrist motions are often painful. Medical Management [6] Soft-tissue reconstruction: surgery Chronic instability with none malunion can be treated with soft-tissue reconstruction. [physio-pedia.com]
- Ankle Pain
He reported increasing pain in all weight-bearing joints, particularly the ankles and knees. His history was significant for migraine headaches, depression, and palpitations with atypical chest pain. [ncbi.nlm.nih.gov]
- Hip Pain
Among the 21 patients who did not have surgery, 18 still had hip subluxation at the last follow-up interview and only one of those had hip pain. [livestrong.com]
Workup
An EEG is an essential part of the workup for LGS. Neuroimaging is an important part of the search for an underlying etiology (see Workup). [emedicine.medscape.com]
But unlike Rosenbloom’s other patients, a workup showed they were not lacking growth hormone; instead, they had a rare form of dwarfism known as Laron syndrome, caused by a genetic mutation that prevents the body from respondingto growth hormone. [discovermagazine.com]
Treatment
Although numerous surgical techniques have been described, there is little clear consensus on operative treatment. Moreover, there is insufficient evidence to support operative over nonoperative treatment for mallet fractures. © The Author(s) 2014. [ncbi.nlm.nih.gov]
Treatment The treatment can be conservative or surgery may be needed. The conservative treatment consists of inducing a sclerosing agent inside the joint capsule. [phaa.com]
Treatment Early treatment of a joint subluxation should begin by ensuring the joint is in the proper position. [verywellhealth.com]
Prognosis
Prognosis Prognosis seems good but with age, patients may develop obesity, hypercholesterolemia and have increased risk of fractures due to osteopenia. The documents contained in this web site are presented for information purposes only. [orpha.net]
The long-term prognosis varies, yet overall it's felt to be unfavorable. Psychosocial needs of patients and families are important to address. Safety and educational resources are key to helping people with LGS. [epilepsy.com]
[…] coracoclavicular distance normal: 10-13 mm greater than 5 mm asymmetry (compared to the contralateral side) superior displacement of the distal clavicle the inferior edge of the acromion should be level with the inferior edge of the clavicle Treatment and prognosis [radiopaedia.org]
Long-term prognosis of Lennox-Gastaut syndrome. Epilepsia. 1996. 37 Suppl 3:44-7. [Medline]. Ohtsuka Y, Amano R, Mizukawa M, Ohtahara S. Long-term prognosis of the Lennox-Gastaut syndrome. Jpn J Psychiatry Neurol. 1990 Jun. 44(2):257-64. [Medline]. [emedicine.medscape.com]
Classification of AC separation The importance of identifying the injury type cannot be overemphasised because the treatment and prognosis hinge on an accurate diagnosis. [sportsinjurybulletin.com]
Etiology
Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology. [icd10coded.com]
Causes: Structural brain abnormalities (most common cause, 70% of cases) Genetic etiologies (de novo mutations) are expected to account for many of the currently unexplained cases [epilepsydiagnosis.org]
Etiology The disease is due to mutations in the GHR gene (5p14-p12). [orpha.net]
Etiology LGS can be classified according to its suspected etiology as either idiopathic or symptomatic. [emedicine.medscape.com]
Etiology congenital os odontoideum Down syndrome (20%) Morquio syndrome spondyloepiphyseal dysplasia osteogenesis imperfecta Marfan disease neurofibromatosis type 1 (NF1) arthritides rheumatoid arthritis psoriatic arthritis Reiter syndrome (reactive arthritis [radiopaedia.org]
Epidemiology
Patient Population: Prevalence and Epidemiology Knee // Shoulder & Elbow // Hip // Spine // Foot & Ankle // Hand & Wrist Fragility Fractures: Diagnosis and Treatment Shoulder & Elbow The Characteristics of Surgeons Performing Total Shoulder Arthroplasty [amjorthopedics.com]
[…] synonyms: atraumatic sternoclavicular subluxation Spontaneous Sternoclavicular Subluxation ICD-9 Spontaneous Sternoclavicular Subluxation Etiology / Epidemiology / Natural History Generally adolescent or early adulthood. [eorif.com]
"The Epidemiology of Finger Dislocations Presenting for Emergency Care Within the United States". HAND. 11 (2): 192–6. doi : 10.1177/1558944715627232. PMC 4920528. [en.wikipedia.org]
Pathophysiology
[…] pathological changes which occur to the spinal tissues such as abnormal bony growths off the vertebral bodies and joints, fibrosis and adhesions of spinal muscles and ligaments, inflammation of the joints as well as dehydration and degeneration of spinal discs Pathophysiology [corespineandsportscenter.com]
These risk factors are not absolute and certainly there seems to be an underlying unknown pathophysiological mechanism that gives these patients a higher probability of subluxation. [reviewofophthalmology.com]
Stability of the distal radioulna joint: biomechanics, pathophysiology, physical diagnosis, and restoration of function what we have learned in 25 years. Original Text by Clifford R. Wheeless, III, MD. [wheelessonline.com]
See the following articles for more information: Pathophysiology The pathophysiology of LGS is not known. No animal models exist. A variety of possible pathophysiologies have been proposed. [emedicine.medscape.com]
[…] the acromioclavicular (AC) joint with disruption of the AC ligaments with or without coracoclavicular (CC) ligament disruption Epidemiology incidence common injury making up 9% of shoulder girdle injuries demographics more common in males and athletes Pathophysiology [orthobullets.com]
Prevention
Therefore, prevention and appropriate treatment of glenohumeral joint subluxation should be included in rehabilitation of hemiplegic patients. [ncbi.nlm.nih.gov]
Keeping the muscles surrounding the joint strong will also help prevent dislocations. Long-term problems may also be prevented by allowing an adequate amount of time for an injured joint to rest and heal prior to resuming full activity. [medical-dictionary.thefreedictionary.com]
Ligaments – holding the bones together and providing stability by preventing them from moving when they shouldn’t be. Muscles – Work alongside the ligaments in preventing unwanted movement, but also initiate and create a movement of the joint. [sportsinjuryclinic.net]