Rotator Cuff Tear |
- Acute injury (e.g., fall or heavy lifting)
- Chronic degeneration (common in older adults)
- Repetitive overhead activity (e.g., sports or manual labor)
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- Shoulder pain, especially at night
- Weakness in shoulder abduction and external rotation
- Pain with overhead activities
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- X-ray to rule out fractures
- Ultrasound or MRI to confirm the tear and assess the extent
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- Non-surgical: Rest, NSAIDs, physical therapy, and corticosteroid injections
- Surgical: Rotator cuff repair for large or complete tears, especially in younger patients
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Tennis Elbow (Lateral Epicondylitis) |
- Repetitive wrist extension or gripping activity
- Common in racquet sports, painters, carpenters, or manual laborers
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- Pain and tenderness over the lateral epicondyle of the elbow
- Worsened by gripping or wrist extension activities
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- Clinical examination with tenderness over the lateral epicondyle
- Ultrasound to assess for tendinosis or tears
- MRI for chronic or refractory cases
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- Rest, activity modification, and NSAIDs
- Physical therapy (eccentric strengthening exercises)
- Corticosteroid injections or platelet-rich plasma (PRP) therapy in refractory cases
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Medial Epicondylitis (Golfer’s Elbow) |
- Repetitive wrist flexion and forearm pronation
- Common in golfers, pitchers, and manual laborers
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- Pain and tenderness over the medial epicondyle of the elbow
- Pain worsens with wrist flexion and forearm pronation
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- Clinical examination with localized tenderness
- Ultrasound to assess for tendinosis or tears
- MRI for persistent or severe cases
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- Rest, NSAIDs, and activity modification
- Physical therapy with focus on stretching and strengthening exercises
- Corticosteroid injections or PRP therapy for refractory cases
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Carpal Tunnel Syndrome |
- Repetitive wrist flexion (e.g., typing, assembly line work)
- Pregnancy or rheumatoid arthritis can predispose to this condition
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- Pain, numbness, and tingling in the thumb, index, and middle fingers
- Worsened by wrist flexion (e.g., at night)
- Weakness in thumb abduction
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- Nerve conduction studies (to confirm median nerve compression)
- Ultrasound to assess for structural abnormalities
- MRI in cases of severe compression or failed conservative management
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- Wrist splinting at night and during repetitive tasks
- NSAIDs or corticosteroid injections
- Surgical release of the transverse carpal ligament in severe cases
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De Quervain's Tenosynovitis |
- Repetitive thumb or wrist motion (e.g., lifting, grasping)
- Common in new mothers or people who lift heavy objects
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- Pain and swelling near the base of the thumb
- Positive Finkelstein's test (pain with thumb flexion and ulnar deviation of the wrist)
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- Clinical diagnosis based on history and physical exam
- Ultrasound to assess tendon sheath thickening
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- Rest, thumb spica splint, and NSAIDs
- Corticosteroid injections for persistent pain
- Surgical release of the first dorsal compartment in refractory cases
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Trigger Finger (Stenosing Tenosynovitis) |
- Repetitive gripping or flexing activities
- Common in diabetes and rheumatoid arthritis
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- Locking or catching sensation in the affected finger when flexed
- Tenderness over the A1 pulley (palmar side of the hand)
- In severe cases, the finger may get stuck in a bent position
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- Clinical diagnosis based on symptoms and physical examination
- Ultrasound to assess tendon thickening and sheath narrowing
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- Rest, splinting, and NSAIDs
- Corticosteroid injections for moderate cases
- Surgical release of the A1 pulley in refractory cases
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