Knowledge Hub

Here you will find information on various conditions and treatments

Please note that the Knowledge Hub is purely for reference and that you do need to enquire with either your medical practitioner or a certified doctor for proper diagnosis.

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Knowledge Hub Index

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Ankle

Definition:

Fractures of the bones of the ankle (tibia, fibula and talus). This usually occurs acutely with a traumatic event (e.g., a fall).

Diagnosis:

Ankle pain, swelling, deformity and an inability to weight bear. Xrays, CT scan, MRI scan.

Treatment:

Non-surgical:
Reserved for un-displaced, stable fractures. Analgesia, Anti-inflammatories, walking aids, cast, splint, moonboot and physiotherapy.
Surgical:
Open reduction and internal fixation of the broken bones (with plates, screws, rods and wires). If the fracture is associated with wounds and significant swelling, the surgeon may elect to stabilise the fracture with an external fixator.

Definition:

Loss of cartilage of the ankle joint (cartilage of the tibia and/or talus). This results in ankle pain, swelling, clicking, deformity and instability. The cartilage loss is due to an underlying inflammatory condition such gout, rheumatoid arthritis, psoriasis and infection.

Diagnosis:

Ankle pain, swelling, tenderness and instability. Painful weight-bearing. Xray’s, CT scan or MRI scan.

Treatment:

Non-surgical:
Analgesia, Anti-inflammatories, physiotherapy, walking aids, ankle brace and intra-articular ankle steroid injections. Medical management of the underlying inflammatory condition.
Surgical:
Ankle arthroscopic debridement, ankle fusion, ankle replacement.

Definition:

Loss of cartilage of the ankle joint (cartilage of the tibia and/or talus). This results in ankle pain, swelling, clicking, deformity and instability. The cartilage loss is usually from cartilage ‘wear & tear’.

Diagnosis:

Ankle pain, swelling, tenderness and instability. Painful weight-bearing. Xrays, CT scan or MRI scan.

Treatment:

Non-surgical:
Analgesia, Anti-inflammatories, physiotherapy, walking aids, ankle brace and intra-articular ankle steroid injections.
Surgical:
Ankle arthroscopic debridement, ankle fusion, ankle replacement.

Definition:

Injuries to the tendons of the ankle. This can occur acutely with a traumatic event of over time due to a repetitive activity. The most common tendon injuries around the ankle are the Achilles tendon, Peroneus tendons (Peroneus Brevis & Peroneus Longus) and the Posterior Tibialis tendon.

Diagnosis:

Pain, swelling and an inability to weight bear. Xray’s, Ultrasound and MRI scan

Treatment:

Non-surgical:
Analgesia, Anti-inflammatories, walking aids, ankle brace, steroid injections and physiotherapy.
Surgical:
Ankle arthroscopy, tendon debridement’s, and tendon repairs.

Elbow

Definition:

Also known as ulnar nerve neuropathy. This is a compression of the ulnar nerve around the inner aspect of the elbow (most commonly at the elbow medial epicondyle – the bony prominence on the inner aspect of the elbow). This results in pain, numbness and ‘pins & needles’ along the ulnar nerve distribution in the forearm and hand (inner aspect of forearm and pinkie and ring fingers).

Diagnosis:

Classic neurological symptoms along the ulnar nerve in the forearm and hand (inner aspect of the forearm, pinkie and ring fingers). Symptoms include pain, numbness and ‘pins & needles’. Referral to a neurologist for Ulnar nerve conduction studies and EMG (electromyography).

Treatment:

Non-surgical:
Analgesia, Anti-inflammatories, hand therapy, and splinting.
Surgical:
Ulnar nerve decompression and Ulnar nerve transposition.

Definition:

The distal biceps tendon is pulled off its attachment on the radial tuberosity of the forearm. The patient will have weakness with elbow flexion and forearm supination. This is an acute injury and is associated with elbow swelling and bruising.

Diagnosis:

Elbow bruising and elbow swelling. Weak elbow flexion and elbow supination. Ultrasound and MRI scan

Treatment:

Surgical:
Distal biceps tendon repair.

Definition:

Fractures around the elbow are very common, especially in children.

Diagnosis:

Fractures are diagnosed with Xray’s and/or CT scan.

Treatment:

Non-surgical:
Undisplaced, stable fractures are usually treated in a splint or cast.
Surgical:
Displaced, unstable fractures are treated surgically (open reduction and internal fixation with plates and/or screws).

Definition:

Also known as medial epicondylitis. This is an overuse injury of the flexor tendons of the wrist & fingers resulting in pain over the medial epicondyle of the humerus (the bony prominence on the inner aspect of the elbow).

Diagnosis:

Pain and tenderness over the medial epicondyle (bony prominence on the inner aspect of the elbow). Ultrasound

Treatment:

Non-surgical:
Analgesia, Anti-inflammatories, physiotherapy, wrist brace and steroid injections.
Surgical:
Debridement of the common extensors of the wrist and fingers at the medial epicondyle.

Definition:

Also known as lateral epicondylitis. This is an overuse injury of the extensor tendons of the wrist & fingers resulting in pain over the lateral epicondyle of the humerus (the bony prominence on the outer aspect of the elbow).

Diagnosis:

Pain and tenderness over the lateral epicondyle (bony prominence on the outer aspect of the elbow). Ultrasound

Treatment:

Non-surgical:
Analgesia, Anti-inflammatories, physiotherapy, wrist brace and steroid injections.
Surgical:
debridement of the common flexors of the wrist and fingers at the lateral epicondyle.

Foot

Definition:

Acute and chronic inflammation of the Achilles tendon. This may cause pain, swelling and thickening of the Achilles tendon. Pain may be worsened when walking on the toes of the affected foot.

Diagnosis:

Achilles tendon pain, tenderness and swelling. Ultrasound

Treatment:

Non-surgical:
Analgesia, Anti-inflammatories, physiotherapy, splints.
Surgical:
Achilles tendon debridement, lengthening and reconstruction.

Definition:

A bunion is a bony bump on the outside of the big toe. This occurs when some of the bones of the forefoot move out of place. The big toe deviates to the lesser toes and the big toe joint forms a bony bump on the outside. The skin over this bump may be stretched and inflamed causing pain/tenderness.

Diagnosis:

Clinical features. Xrays

Treatment:

Non-surgical:
Analgesia, anti-inflammatories, comfortable shoes. Referral to an Orthotist for custom shoes pads, cushions and inserts.
Surgical:
Surgical correction of a bunion includes straightening the foot bones and removing the bony bump.

Definition:

Usually affects the big toe. The sides of the toe nail grows into its soft tissue edge. This can cause significant inflammation of the soft tissue surrounding the nail (redness, warmth and tenderness).

Diagnosis:

Inflammation of the toe in the presence of an ingrown toenail.

Treatment:

Non-surgical:
Analgesia, Anti-inflammatories, lifting the nail and taping the nail. Maintaining good hygiene. Treating infections.
Surgical:
Partial or complete nail excision and/or nailbed ablation.

Definition:

A thickening of the digital nerve (neuroma) in the forefoot, most often in the 3^rd This may cause a sharp pain in the forefoot with weight bearing. The pain may be associated with toe numbness and/or pins & needles most often in the 3rd forefoot web space.

Diagnosis:

Sharp pain in the forefoot webspace. The pain is worsened with compression of the forefoot. Ultrasound and MRI scan.

Treatment:

Non-surgical:
Analgesia, Anti-inflammatories, comfortable shoes. Steroid injection directly into the affected webspace.
Surgical:
Excision of the Mortons neuroma.

Definition:

The plantar fascia is a thick fibrous band in the sole of the foot that runs from the toes to the heel. Inflammation of the plantar fascia is one of the most common causes of heel pain.

Diagnosis:

Heel pain where the plantar fascia attaches to the heel. Pain is experienced with weightbearing, especially in the morning (first few steps). Xrays often show a bony heel spur where the plantar fascia is attached.

Treatment:

Non-surgical:
Analgesia, Anti-inflammatories, Physiotherapy and night splints. Referral to an orthotist for a custom shoe inserts, pads or cushions.
Surgical:
The Plantar fascia is surgically released from its attachment to the calcaneus.

Hip

Definition:

Bursae are small membranes that lie at muscle-bone interfaces, preventing friction. Bursae can become inflamed and cause significant pain (this is called bursitis). Hip greater trochanteric bursitis is very common.

Diagnosis:

Pain over the hip greater trochanter, Ultrasound or MRI

Treatment:

Non-surgical:
Analgesia, Anti-inflammatories, physiotherapy, walking aids. Steroid injections directly into the bursa
Surgical:
Bursectomy (excision of the bursa)

Definition:

A condition where the femoral head pops out of the socket.

Diagnosis:

Sudden onset acute groin pain and an inability to walk/stand. Xrays, CT scan or MRI

Treatment:

Non-surgical:
Closed reduction of the hip (femoral head pushed back into socket without surgery).
Surgical:
Open reduction of the hip (femur head pushed back into socket with open surgery)

Definition:

Hip development problem at birth. The ball & socket hip joint has not developed correctly resulting in hip pain.

Diagnosis:

Groin pain, Xrays or MRI

Treatment:

Non-surgical:
Analgesia, Anti-inflammatories, physiotherapy, walking aids
Surgical:
Osteotomies, Hip arthoscopy and Hip Replacement

Definition:

A fracture of the femoral head and/or femoral neck and/or femoral socket.

Diagnosis:

Sudden acute pain and inability to walk/stand. X-rays, CT scan or MRI scan

Treatment:

Surgical:
Open reduction and internal fixation (fixation with screws and/or plates) or Hip Replacement

Definition:

Also known as Femoro-acetabular impingement. A condition where the femoral head makes contact with the acetabulum (socket). The head and socket impinge. This can cause significant hip pain with hip movement.

Diagnosis:

X-rays or MRI arthrogram

Treatment:

Non-surgical:
Analgesia, Anti-inflammatories, physiotherapy, walking aids, Steroid injections
Surgical:
Hip arthroscopy, Hip replacements

Definition:

Loss of cartilage of the hip joint (cartilage of the femoral head and/or socket). This results in groin pain with hip movements. The cartilage loss is due to an inflammatory condition such as gout, rheumatoid arthritis, psoriasis and infection. Medical management of the underlying inflammatory condition.

Diagnosis:

Groin pain, Blood tests (inflammatory markers, X-rays or MRI)

Definition:

The hip labrum is a thick cartilage structure circumferentially on the rim of the hip socket. The main function of the labrum is to provide hip stability, protect the cartilage of the socket and femoral head, increase the socket surface area and provide a ‘suction’ effect on the femoral head. When the labrum tears or detaches from the socket rim this is called a labral injury.

Diagnosis:

Groin pain/clicking, MRI Arthrogram

Treatment:

Non-surgical:
Activity modification, Analgesia, Anti-inflammatories, physiotherapy, walking aids
Surgical:
Hip Labral repair

Definition:

Ligament injury of the hip. Injuries can be acute (sport injuries or accidents) or chronic (degenerative tears). Most common hip ligament injuries are the Ligamentum Teres and the Ilio-femoral ligaments.

Diagnosis:

Groin pain, hip muscle weakness. MRI scan

Treatment:

Non-surgical:
Analgesia, Anti-inflammatories, physiotherapy, walking aids
Surgical:
Hip ligament repair

Definition:

Muscle injury of the hip. Injuries can be acute (sport injuries or accidents) or chronic (degenerative tears). Most common hip muscle injuries are the abductor muscles (Gluteus Medius and Gluteus Minimus) and hip flexor muscles (iliopsoas muscle).

Diagnosis:

Groin pain, hip muscle weakness. MRI scan

Treatment:

Non-surgical:
Analgesia, Anti-inflammatories, physiotherapy, walking aids
Surgical:
Hip muscle repair

Definition:

Loss of cartilage of the hip joint (cartilage of the femoral head and/or socket). This results in groin pain with hip movements. The cartilage loss is due to ‘wear & tear’.

Diagnosis:

Groin pain, Xray or MRI

Treatment:

Non-surgical:
Analgesia, Anti-inflammatories, physiotherapy, walking aids
Surgical:
Hip arthroscopy, Hip replacement

Knee

Definition:

Bursae are small membranes that lie at muscle-bone interfaces, preventing friction. Bursae can become inflamed and cause significant pain (this is called bursitis). The most common knee bursitis is prepatellar bursitis (housemaids knee), suprapatellar bursitis, infrapatellar bursitis and pes anserine bursitis.

Diagnosis:

Knee pain and swelling with direct palpation. Ultrasound, MRI

Treatment:

Non-surgical:
Analgesia, Anti-inflammatories, physio, walking aids and steroid injections.
Surgical:
Open or arthroscopic bursectomy.

Definition:

Fractures around the knee (distal femur, proximal tibia and knee cap). This occurs as a result of a traumatic event (e.g., fall).

Diagnosis:

Significant knee pain and swelling and an inability to walk. X-rays, CT scan, MRI scan

Treatment:

Non-surgical:
Reserved for un-displaced stable fractures. Analgesia, Anti-inflammatories, physiotherapy, walking aids, knee brace and knee cast.
Surgical:
Open reduction and internal fixation of the fracture (plates, screws, wires and rods can be used). If the fracture is associated with open wounds and severe swelling, the surgeon may consider using an external fixator.

Definition:

Loss of Cartilage from the articulating knee surfaces (patella, femur and/or tibia). This can result in knee pain, swelling, deformity, crepitations and locking. This is usually due to an underlying inflammatory condition such as gout, rheumatoid arthritis, psoriasis and infection.

Diagnosis:

Knee pain, swelling, deformity, locking and instability. X-rays.

Treatment:

Non-surgical:
Analgesia, Anti-inflammatories, physiotherapy, walking aids and intra-articular knee steroid injections. Medical management of the underlying inflammatory condition.
Surgical:
Knee arthroscopy, Knee peri-articular osteotomies and Knee replacement

Definition:

Injury to the knee ligaments. This usually occurs as an acute event after an accident or sport injury. The most common knee ligament injuries are ACL (anterior cruciate ligament), PCL (posterior cruciate ligament), MCL (medial collateral ligament) and LCL (lateral collateral ligament) injuries. Knee ligament injuries result in knee pain, swelling and instability.

Diagnosis:

Knee pain, swelling and instability following a traumatic event. Xrays, Ultrasound, MRI

Treatment:

Non-surgical:
Analgesia, Anti-inflammatories, physiotherapy, walking aids and knee brace.
Surgical:
Knee ligament reconstruction.

Definition:

Muscle injuries adjacent to the knee. Most common muscle injuries around the knee are quadriceps, hamstring and Iliotibial band injuries (ITB). This is usually associated with sport or trauma.

Diagnosis:

Knee pain and weakness usually associated with an identifiable event. Ultrasound, MRI

Treatment:

Non-surgical:
Analgesia, Anti-inflammatories, physiotherapy, walking, steroid injections, knee brace.
Surgical:
Muscle debridement’s or muscle repair.

Definition:

Diagnosis:

Knee pain, swelling, deformity, locking and instability. X-rays.

Treatment:

Non-surgical:
Analgesia, Anti-inflammatories, physiotherapy, walking aids and intra-articular knee steroid injections
Surgical:
Knee arthroscopy, Knee peri-articular osteotomies and Knee replacement

Definition:

Injury to tendons in the knee. This can be as a result of a sudden acute traumatic event or can be due to a repetitive sprain injury. The most common knee tendon injuries are patella tendon injuries, MPFL (medial patella-femoral ligament) and quadriceps tendon injuries.

Diagnosis:

Knee pain, swelling and tenderness. Pain with direct tendon palpation. Ultrasound, MRI

Treatment:

Non-surgical:
Analgesia, Anti-inflammatories, physiotherapy, walking aids, steroid injections and knee brace.
Surgical:
Surgical debridement and/or reconstruction.

Definition:

Destruction of cartilage under the kneecap. This may be due to an acute traumatic event or as a result of a chronic patella disorder (see above). The cartilage destruction is often described as having a ‘crab meat’ appearance.

Diagnosis:

Pain, swelling and crepitations under the knee cap, this may be associated with swelling. Xrays, MRI scan

Treatment:

Non-surgical:
Analgesia, Anti-inflammatories, physio, walking aids, knee brace and steroid injections.
Surgical:
Arthroscopic debridement of the knee cap and surgical correction of the underlying patella disorder (see above).

Definition:

Abnormal development of the patella. The most common patella disorders are poor patella tracking, abnormal patella shape (dysplasia), a patella that lies too far above the knee joint (patella alta) and a patella that lies too far below the knee joint (patella baja).

Diagnosis:

Pain and clicking under the knee cap and knee swelling. X-rays, CT scan and MRI scan

Treatment:

Non-surgical:
Analgesia, Anti-inflammatories, physio, walking aids and knee brace.
Surgical:
Surgery is aimed at correcting the underlying abnormal position. This may include knee and patella osteotomies, knee arthroscopy and knee replacements.

Pelvis

Definition:

Fractures of the pelvic region. This includes fractures of the 3 pelvic bones (ilium, ischium and pubis). The acetabulum is also known as the hip socket (pelvic socket). Acetabulum fractures occur with significant traumatic forces. These fractures require urgent attention as neglect can result in hip osteoarthritis.

Diagnosis:

Pelvic Xray’s, CT scan

Treatment:

Non-surgical:
Bedrest, physiotherapy, walking aids, Analgesia, Anti-inflammatories.
Surgical:
Open reduction and internal fixation of the fracture with plates and screws.

Shoulder

Definition:

Dislocation of the acromio-clavicular joint. This is due to a traumatic event (sport/accident). The relationship between the acromion and the clavicle is disturbed.

Diagnosis:

An identifiable traumatic event. Acute onset pain in the AC joint. Xrays.

Treatment:

Non-surgical:
Analgesia, Anti-inflammatories, physiotherapy and a sling.
Surgical:
Acromio-clavicular joint reconstruction.

Definition:

Also known as Rotator cuff impingement. The rotator cuff is the name given to the group of muscles of the shoulder. The rotator cuff may impinge on the acromion (the bone just above the shoulder). This will result in pain with shoulder movement and may cause rotator cuff tears.

Diagnosis:

Shoulder pain with range of motion (especially overhead activity). Xray’s, Ultrasound and MRI scan.

Treatment:

Non-surgical:
Analgesia, Anti-inflammatories, Steroid injections, physiotherapy.
Surgical:
Rotator cuff debridement, Acromioplasty, and Rotator cuff repair.

Definition:

Loss of cartilage from the articular surface of the shoulder (humeral head and glenoid). This loss of cartilage may be due to an underlying inflammatory condition like gout, rheumatoid arthritis, psoriasis and infection.

Diagnosis:

Progressive shoulder pain, swelling, stiffness and crepitations. Xrays & MRI scan.

Treatment:

Non-surgical:
Analgesia, Anti-inflammatories, Steroid injections, physiotherapy. Treating the underlying inflammatory condition.
Surgical:
Shoulder debridement and Shoulder replacement.

Definition:

An unstable shoulder that dislocates (pops out of its socket). Patients avoid certain shoulder positions for fear of dislocation.

Diagnosis:

Patient reports serial shoulder dislocations. Xrays, CT scan, MRI scan.

Treatment:

Non-surgical:
Analgesia, ant-inflammatories, physiotherapy.
Surgical:
Shoulder stabilisation surgery (e.g., Laterjet procedure).

Definition:

Loss of cartilage from the articular surface of the shoulder (humeral head and glenoid). This loss of cartilage is usually due to ‘wear & tear’.

Diagnosis:

Progressive shoulder pain, stiffness and crepitations. Xrays & MRI scan

Treatment:

Non-surgical:
Analgesia, Anti-inflammatories, Steroid injections, physiotherapy.
Surgical:
Shoulder debridement and Shoulder replacement.

Wrist

Definition:

Carpal tunnel syndrome is compression of the median nerve in the wrist (the wrist is also known as carpus). This results in pain, numbness and a tingling sensation in the thumb, index, middle and ring fingers). Patients may be kept awake at night with the above-mentioned symptoms. This may be associated with, hypothyroidism and pregnancy.

Diagnosis:

Referral to a neurologist for Ulnar nerve conduction studies and EMG (electromyography).

Treatment:

Non-surgical:
Analgesia, Anti-inflammatories, Steroid injection in the carpal tunnel.
Surgical:
Carpal tunnel release surgery.

Definition:

A painful condition affecting the thumb. The tendons on the thumb side of the wrist are inflamed, this causes pain with thumb activities such as opening a bottle/tap and wringing a cloth.

Diagnosis:

Pain and swelling along the tendons of the thumb at the wrist. Passive flexion of the thumb is painful. Ultrasound

Treatment:

Non-surgical:
Analgesia, Anti-inflammatories, wrist splint, hand therapy and steroid injections.
Surgical:
Debridement and freeing of the thumb tendons at the wrist.

Definition:

A cyst that originates from a joint or tendon. The cyst is filled with a gel-like fluid. A ganglion is a non-cancerous. Ganglions are most commonly found around the wrist.

Diagnosis:

Clinical appearance of the ganglion (soft fluid filled sac). Ultrasound

Treatment:

Non-surgical:
Analgesia, Anti-inflammatories, Cyst aspiration and steroid injections.
Surgical:
Formal surgical excision of the ganglion.

Definition:

Ulnar nerve compression at the pinkie side of the wrist. This may cause wrist pain and numbness or tingling in the pinkie and ring fingers.

Diagnosis:

Numbness and/or tingling of the pinkie and ring finger. Referral to a neurologist for Ulnar nerve conduction studies and EMG (electromyography).

Treatment:

Non-surgical:
Analgesia, Anti-inflammatories, wrist splint, hand therapy and steroid injections.
Surgical:
A decompression of the ulnar nerve.

Definition:

The flexor tendon of a finger is stuck when the finger is flexed (bent into the palm). The finger is then straightened with a snap (like releasing a trigger).

Diagnosis:

The diagnosis is made clinically but can be confirmed with an Ultrasound.

Treatment:

Non-surgical:
Steroid injection.
Surgical:
Surgical release of the finger flexor tendon.