Orthopaedic & Sports

Hello Rocky, sounds like you sustained an injury to the Achilles which may have led to some persistent tendinitis in the tendon. Treatment is certainly available and can range from physiotherapy, injections to surgery depending on the severity. Would be good to get it checked out by a sports or ankle specialist. 

Hi

It is common to lose range of the shoulder or the neck (cervical spine) after a sprain injury due to muscular spasm, pain or tightness. 

It will be advisable to have an orthopaedic surgeon evaluate you by way of clinical examination to ascertain if the problem is with the shoulder or the cervical spine. The loss of strength and inability to raise your arm above shoulder level seems to point to a rotator cuff injury. If there was a suspicion of rotator cuff injury or tear, or a slipped disc of the cervical spine, a MRI scan of the affected region would be highly recommended. 

These issues can be addressed with analgesia and physiotherapy. If the scans reveal a rotator cuff tear or a significant nerve compression from a slipped disc - only then is surgery advised. 

It's been 3 years since the surgery. If there is pain and crepitus, you should get an Xray and MRI of the wrist to evaluate the current situation. 

Hi Jsmum,
Thanks for sharing this interesting case. Lesser toe deformities in children can be quite common as they grow. Deviation of the toe is usually referred to as curly toe deformities and typically get better as the child grows and wears more closed shoes. Of course, it is important to exclude other causes like a local growth pushing the toe out or a fracture. If the pain from rubbing on the deviated toe is causing more pain, I would suggest consultation with a foot & ankle specialist. 

Dear @leonida_hegmann There appears to be a displaced fracture of the right clavicle. You should have a discussion with the orthopedics surgeon managing your mother and discuss surgical and non surgical options. You can check with them how long her recovery is likely to take and optimise her sugar control before, during and after surgery. Hope this helps.

Dear Rach

I would suggest getting an Xray of the elbow to rule out a fracture or any possible dislocation. It's not uncommon to have a fracture of the elbow when there is axial loading post fall from a bicycle. Especially since your range of movement is limited, I am concerned about any possible bleeding into the joint and swelling that could arise from a fracture or dislocation or ligament tear. 

It would be recommended to see an orthopaedic surgeon to do a detailed examination of the elbow and evaluate with Xrays or even possibly a MRI scan.

Hi @edgar this is something that needs to be examined! Have you had an injury to the coccyx before, such as a high impact fall directly landing in a seated position on the floor? Mild-moderate Scoliosis itself is not expected to contribute to such symptoms - I recommend that you visit your GP/family physician for a more in-depth review and examination to get to the bottom of this issue.

Hello, it’s not that uncommon to have a bony avulsion fragment from the fibula, like in your ankle. It’s still controversial what’s the best thing to do with the fragment, and this can vary from removal to leaving it alone and just focusing on repairing the ligament. When there’s not enough good quality tissue to work with, yes an augmentation is useful. This can be in the form of a tendon, or a synthetic internal brace device has also become quite popular. How “common” it is to have inadequate tissues can be quite subjective depending on the judgement of the surgeon but usually it is better to augment the repair when in doubt. 

Hello, it looks like the skin scar itself is ok, but that there is a lump internally. This is most likely due to scarring over the tendon repair internally, and is quite common. You may want to work with a hand therapist especially if your motion is still  impeded. It generally should improve with time. Hope that helps!

Dear @jchua ,

I am sorry to hear that you are experiencing tenderness in your knees. Given the chronicity of your symptoms, it would be worth a visit to a GP or the polyclinic for further assessment with regards to your symptoms to ascertain a working diagnosis. The polyclinic doctor or the GP can then refer you to a specialist. Of course, you can book yourself into any private specialist clinic on your own too. I hope this helps. 

Hi Hannan it sounds like you may have developed a paronychia infection of your nail fold. It is good to get this checked by a doctor as sometimes this needs drainage in addition to antibiotics 

Hi @reed I'm sorry to hear about this! Yes you are right, these conditions can interact as the pattern of pain for these joints which are considered "weight bearing" often prompts the individual to adopt adaptive postures when standing/walking/exercising. While these relieve pain temporarily, they deviate from optimal biomechanics and can result in build of "over use"/strain related injuries or progression of underlying problems in other weight bearing joints in severe cases. 

In terms of determining what to do next, the progression in symptoms along with numbness/pain indicate potential worsening nerve impingement and requires a review with a trained orthopaedic specialist for an examination. It would be best to arrange a follow-up with your original doctor as they will be familiar with your condition. In the mean time until your review with them, do minimise strenuous activity and avoid carrying any heavy weights. Hope this helps!

Hi @Lyn_li yes you're right, this could be arthritis and if unprovoked, the commonest cause is age-related changes in the bone and/or cartilage at the joint surface. However, there are many other possible causes that may require further examination and potentially a scan, especially if there was any injury or trigger preceding the onset of symptoms. What therapy would be effective would depend greatly on the underlying cause, and if the pain is bothering you then you may want to consider a review with your physician to determine this. Apart from the level of pain, other features that should prompt you to seek a review are the presence of any preceding injury or accompanying symptoms such as rash, hair loss, or photosensitivity (if you find your skin is unduly sensitive to sun light). Hope this helps!

Hi Victor,  this is usually a symptom of kneecap pain (patellofemoral pain). Running puts a lot of stress on the kneecap. If you are happy to modify your exercises to doing cycling and walking then that’s fine. Otherwise if you would like to return to running it would be good to get your knee checked by an orthopaedic/sports Dr to recommend treatments for kneecap pain.

Hi @alonso, this is a symptom of nerve dysfunction which can have either local or systemic causes. Local causes are more likely given what you describe and especially if there was a particular injury or inciting event you can recall. These include slip disc or nerve impingement. Possible systemic causes include nutrition and metabolism related diseases. The distinction is made based on your previous medical history and a physical examination, followed up with tests if needed. Based on this, my recommendation would be to see a doctor in-person for an examination, and to avoid any strenuous activities or carrying of heavy things until you do so. Hope this helps!

Hi @IvanM24 thank you for the question. Yes that is correct, knee injuries affecting the cartilage and/or meniscus can certainly present in this manner. Persisting pain despite such a long period of rest can indicate a surgery may be required, and for certain injuries,  a trial of physiotherapy may help as well. Between these options, the Orthopaedic specialist would be able to give a definite recommendation based on findings in your MRI. Hope this helps!

Hi Michuang,

Thanks for your query. Kneecap pain is very common in active young people and tends to affect ladies quite commonly too. It’s usually due to increased pressure on the kneecap cartilage as well as slight mal-alignment of the kneecaps. Sometimes, an area of cartilage damage can occur too, and this tends to lead to increased fluid swelling in the knee. From your picture, the knee looks swollen so it might be good to get it checked out at an orthopedic/sports clinic. Generally so long as the cartilage damage is not too bad, treatment will involve some physiotherapy and perhaps some reduction in your jogging for a while. Glucosamine and collagen are common supplements that are taken and you can certainly take some if you like too.

Hope that helps!