Page 6 - MSK assignment

6 F. Elahi

stiffness and loss of motion, which relates to spurring,
swelling due to synovitis, and local pain (Alcid et al.,
2014). Loose bodies seen with osteoarthritis may travel
to the dependent portions of the joint, specifically the
olecranon fossa, creating symptoms such as intermittent
locking and loss of extension (Alcid et al., 2014). In the
absence of synovial effusion, the loose bodies can be
seen in between the articular cartilage and the anterior
and posterior intracapsular fat pads. When conducting
the ultrasound of the anterior aspect, the patient's arm
should be extended. The posterior aspect is well seen
when the patient’s elbow is flexed (Bianchi & Martinoli,
2007). Figure A and B contain sonograms from a patient
who has osteoarthritis. In the first image the humeral
capitellum is labelled, along with the brachialis. The
white arrows point to the intra-articular bodies. The star
notes the elevation of the fat pad. There is also some
articular cartilage seen anterior to the humeral
capitellum.
Dynamic assessment with flexion and
extension of the elbow is used. This mobilizes the
loose fragments and joint fluid which can conclude if it
is local heterotopic ossification and spurring (Bianchi &
Martinoli, 2007). In late stages of the pathology there
may be disintegration of the articular surfaces seen.
Treatment of osteoarthritis in the elbow include synovectomy and removal of loose bodies.
(Bianchi & Martinoli, 2007)

Tendinosis
Tendinosis involves the degeneration of the internal
make of the cells and matrix of a tendon. This disruption of the
structure is a chronic process which occurs over a long period
of time due to overuse. There is an increased amount of
fibroblasts, vascular hyperplasia, and disorganized collagen
(Kraushaar & Nirschl, 1999). To differentiate tendinitis and
tendinosis, tendinitis portrays hyperemia and an increased
secretion of synovial fluid.

Tendinosis of the elbow is also known as tennis elbow
or lateral epicondylitis (Kraushaar & Nirschl, 1999). The
overuse of the common extensor tendon at the origin of the extensor carpi radialis brevis tendon
is the area affected with tennis elbow. The etiology of this pathology is repetitive activities
involving weight, repeated gripping, and extension. It is commonly seen in tennis players, or