Meniscal Tears

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A torn meniscus is an injury to one or more of the two meniscal cartilages within the the knee. The two menisci consist of medial and lateral mensicus. A tear to the meniscal cartilage is often the result of an any activity that causes forceful twisting or rotating of the knee joint. These activities can include aggressive pivoting, sudden stops, sudden turns, kneeling, deep squatting, of lifting something heavy. In older adults, degenerative changes associate with age can result in in torn meniscus.

Symptoms that may be present with torn meniscus:

A popping sensation

Swelling or stiffness

Knee instability

Pain, especially with twisting or rotating the knee

Difficulty fully extending the knee

Feeling of as if the knee was locked in place.

In athletes, a torn meniscus can also be accompanied with a tear or injury to the ACL.

Test and Diagnosis:

A physical exam by a physician can often be the first sign of a torn meniscus. This exam will likely be followed by a radiograph of the knee, and even an MRI of the knee joint. MRI is the preferred imaging modality to evaluate the extent of a previously determined meniscal tear.

Treatment Options:

Treatment for meniscal tears often start with a conservative approach of rest, ice, OTC pain relievers, physical therapy, and/or orthotic devices such as arch supports and shoe inserts. If symptoms persist, surgical intervention maybe necessary. This can involve either an arthroscopic repair of the torn menisci, or trimming of the menisci. The surgery usually allows patients to go home the same day, with full recovery taking several weeks or months.

Prevention:

Regular exercises to strengthen the knee joint is beneficial.

Use proper protective gear during athletic activity.

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Carpal Tunnel Syndrome

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The Carpal Tunnel is a passageway on the palmer surface of the wrist that allows for and protects the Median nerve as it passes through the wrist into the hand. Carpal Tunnel Syndrome is caused by anything or aspect that causes the space within the tunnel to become reduced; thus compressing the Median nerve. This compression can be a result of the tunnel getting smaller, or contents within the tunnel getting bigger.

Some known risk factors associated with Carpal Tunnel Syndrome are:

Heredity - inherited physical conditions such as shape of the wrist may make an individual more susceptible to having the condition, as well as having other members in the family having had the condition too.

Gender - women are 3 times more likely to have the condition.

Health Condition - thyroid problems, diabetes, obesity, rheumatoid arthritis, end stage kidney disease, pregnancy, oral contraceptives or menopause can all increase the risk of having Carpal Tunnel Syndrome

Compression of the Median nerve can stem from:

rheumatoid arthritis, diabetes, thyroid disorders, menopause, pregnancy, trauma to the hand and wrist, genetic disposition, and prolonged repetitive flexing and extending of the bones/tendons within the hand and wrist.

Symptoms that accompany Carpal Tunnel Syndrome include:

Tingling and numbness in the fingers and hand (especially thumb, index, middle, and ring fingers), pain radiating or extending up the arm into the shoulder or down into the palm of the hand, (usually occurs on the palmer surface of the hand), and weakness in the hand. As the condition worsens, the symptoms increase with severity as well.

In efforts to diagnosis Carpel Tunnel Syndrome a physician might order:

Electromyogram - Electromyography measures the tiny electrical discharges produced in muscles. A thin-needle electrode is inserted into the muscles your doctor wants to study. An instrument records the electrical activity in your muscle at rest and as you contract the muscle.

Nerve conduction study - two electrodes are taped to your skin. A small shock is passed through the median nerve to see if electrical impulses are slowed in the carpal tunnel.

Routine diagnostic imaging exams such as x-rays, MRI, and/or CT aren't commonly used to diagnosis Carpal Tunnel Syndrome, but might be ordered to rule out any other diseases related to the patients symptoms.

Treatment for Carpal Tunnel Syndrome include:

Anti-inflammatory medications, Rest, Immobilization, Corticosteroid injections, and possible even surgery to "release" the ligament impingement on the Median nerve.

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