Review of literature Article 1: Positive effect of an autologous platelet concentration in lateral epicondylitis in a double-blind randomized controlled trial: platelet-rich plasma versus corticosteroid injection with a 1-year follow-up. The first study (Peerblooms et al) is a double-blind randomized control study trail with a 1 year follow-up in order to compare the efficacy of platelet-rich plasma injections against the efficacy of corticosteroid injections in the treatment of chronic lateral epicondyltitis The primary goal of the study was to assess the reduction of pain and disability scores following treatment using VAS and DASH self-assessment questionnaires. One hundred consecutive patients that met the inclusion/exclusion criteria were selected for participation in the study. The study was conducted at 2 teaching hospitals in the Netherlands. In order to be selected patients had to have a 6-month minimum history of diagnosed lateral epicondylitis -“tenderness over the head of the extensor carpi radialis brevis, and pain with resisted wrist extension” (Peerblooms et al), a minimum score of 50 on the VAS (0 = no pain, 100 = Maximum), and diagnostic imaging (usually x-ray) that confirmed no other mechanical reason for their symptoms. In addition to these criteria participants had to have been treated with at least one of the following; immobilization, physiotherapy, and/or corticosteroid injections. Patients were excluded if they met any of the following criteria: less
Course Description : Lateral Epicondylitis is a condition that accounts for between 1-3 % of all musculoskeletal complaints in an MDs office. To date limited research exists to explain the efficacy of a clear approach in its assessment and management. This course will expose the participant to current concepts in the literature surrounding the etiology of the condition, the limited evidence surrounding the special tests for lateral epicondylitis and the role of proximal structures in these tests. Further discussion will focus on the importance of ruling out proximal conditions and the roles that each plays in elbow pain. The instructors will then shift focus to current
Based on the medical report dated 12/22/16, the patient was last seen on 10/13/16, and was recommended to have continued therapy. He has not had therapy secondary to insurance issues over the last month or so. He presents with ongoing right elbow pain status post cubital tunnel release and medial epicondylitis debridement, worsening with motion and activity, lifting, reaching, bending, upper extremity dressing, household
In the article there was a case study that they were studying a twenty-seven year old patient came in with some mild to server pain. The patient was an amateur golfer who had developed symptoms like developing some small pain in her left arm shortly after the pain developed she changed jobs were she was required to type for long periods of time. She then began to notice that the pain became more sever when she was at the driving range. Shortly following this incident she noticed that she had trouble lifting heavy items. A week prior to her visit she was experiencing shooting pains down her arm. The doctor did a physical exam on the patient and did not notice any color change or swelling. The diagnosis with left lateral epicondylosis. With the
Tenderness is noted over the left lateral epicondyle. IW is still very tender over left bicipital tendon. IW has difficulty with left elbow flexion. Surgical scar well-healed and noted anteriorly, laterally, and posteriorly. Active shoulder range of motion (ROM) is limited with forward flexion to 70% of normal and abduction to 30% of normal. Internal rotation is 0% of normal.
(2012) reviews four difference case studies involving DTF, One randomised study applies DTF with corticosteroid injection to see if there is a significant difference in grip strength again lateral epicondylitis, the results prove there is a significant difference in improved maximum grip strength with injections compared to DTF. However, Joseph et al,. 2012) states that DTF alone showed overall advanced strength. Senbursa et al (2007) also uses a randomised study involving DTF in conjunction with exercises to treat supraspinatus impingement of the tendon, the study proves to be a success by increasing the strength and decreasing pain of the patients. Another advantageous study was carried out by Nagrale et al,. (2009), the study assessed DTF with electro laser therapy and concluded that the patients were able to complete a pain-free grip strength test and functional status once the treatment has been
DOI: 12/14/2015. Patient is a 36- year-old male FIELD TECHNICIAN II who sustained a work related injury when he LOST FOOTING & FELL while WORKING ON SLIPPERY BUILDING LADDER.
He underwent a repeat corticosteroid injection to the lateral epicondyle on this visit, with the 1st injection helped for several weeks. Possible surgical intervention was discussed if there will be no improvement after cortisone.
Tennis elbow which is known as lateral epicondylitis medically is a condition where the elbow’s outer part becomes tender and soft at the elbow (lateral epicondyle). The tendon and the muscles of the forearm usually become damaged due to its repetitive or continuous overuse and this condition leads to the tenderness and pain on the outer part of your elbow. This medical condition usually happens to people in the age brackets of 30 and 50 who are involved in activities like table tennis, carpentry, golfing, plumbing, gardening, painting, rowing and other kinds of racquet games that require a continuous or repetitive use of the elbow through the act of swinging.
Also, to refer the patient to the Spondylitis Association of America or the Arthritis Foundation for additional support and information.
Assessent criteria: Remission: <2.6 points; significant response: reduction ≥1.2 points; continued improvement: reduction <1.2 points, and the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) in patients with AS (remission: <2.0; significant response: reduction ≥2.0 points; continued improvement: reduction <2.0 points. CT-P13 demonstrated comparable effectiveness to its RP. All patients who switched to the biosimilar maintained or improved their clinical response, including two who remained in remission and three who moved into remission. Switching from the RP to CT-P13 did not affect the safety or effectiveness of treatment in patients with different inflammatory diseases in this study.
Per the medical report dated 03/10/16, the patient was prescribed with ibuprofen 800 mg as needed. Patient was also advised to massager the left elbow with Voltaren gel and to engage in home exercises and stretching. EMG of the right upper extremity is recommended to rule out carpal tunnel syndrome and to rule out ulnar neuropathy.
Rheumatoid arthritis is a chronic inflammatory disease characterize by symmetric polyarthritis and joint changes including erythema, effusion and tenderness. Its course is characterize by remission and exacerbations. Rheumatoid arthritis can affect several organ, but usually involve synovial tissue changes in the freely movable joints like the wrist, the PIP joint, the metacarpophalangeal joints. This article provide a comprehensive review of the etiology, pathophysiology, epidemiology, clinical presentation, pharmacological therapy and the nursing implication.
A defect in the pars interarticularis of the spine is defined as spondylolysis (Debnath et al., 2009). Spondylolysis is commonly known as a stress or fatigue fracture and it appears to be more frequent in children and adolescents. The first sign of spondylolysis starts with subtle stress reaction within the bone of the posterior arch of the lumbar spine which my develop and lead to a stress fracture. The frequency of this injury in the youthful athletic populace is much higher than the overall public also varies somewhere around 15% and 47% in children athletes. Apparently, repetitive lumbar hyperextension and excessive loading may predispose the youngest sporting population for this type of injury. In addition, genetic inheritance weakness
This helps keep the spine from being able to fuse together. This can also be coupled with physical therapy, which could have many benefits. Physical therapy can provide pain relief, increased physical strength and flexibility, and help with upright posture. There are also medications that can be taken that help with relieving pain and stiffness in joints. These are most commonly recommended by doctors and are called NSAID’s (Nonsteroidal anti-inflammatory drugs). These are made to target inflammation and relieve pain and stiffness. Examples of these are Naprosyn and Indocin. However a drawback of these medications are that they can cause gastrointestinal bleeding. Gastrointestinal bleeding is bleeding that occurs in the organs in the digestive tract such as the stomach, esophagus and small and large intestines. Bleeding can occur anywhere along this tract. If the NSAID’s don’t help a TNF (tumor necrosis factor) can be prescribed. TNF’s are given through injections or shots. They are cell proteins that are inflammatory agents and target rheumatoid arthritis. They reduce pain, stiffness, and swollen joints by targeting the protein. Examples of these medications are Humira, Enbrel, Simponi, and Remicade. Finally is the case is serious enough surgery can be performed. This does not happen often, seeing as most cases never get that
In the United States, arthritis has become the second most common disorder, in the past years. Moreover, the condition affects more than 34 million Caucasians, 4.6 million African-Americans and nearly 3.1 million Hispanics with women being the most affected (Helmick, 2008). 28.3% of people suffering from arthritis are women whereas 18.2% are men (Helmick, 2008). By the year 2030, it is predicted that the number of patients with arthritis will double if prevalence rates remain the same. Apart from being cost-intensive, Osteoarthritis (OA) affects nearly twenty seven million Americans, which effectively limits their work (Reid, Shengelia & Parker, 2012). The statistics show that Caucasians are the most affected and the Hispanics to be the less affected from Caucasians, Hispanics, and African Americans. It also shows how women also have greater possibilities of getting arthritis than man ever did.