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RSI in Knees and Thighs

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Disorders of the thigh include:
acute osteomyelitis; chronic osteomyelitis, syphilitic infection.

Tumours
benign tumours and malignant bone tumours.

Articular disorders of the knee include:
pyogenic arthritis; rheumatoid arthritis; tuberculous arthritis; osteoarthritis; haemophilic arthritis; neuropathic arthritis and anterior knee pain.

Mechanical disorders include:
Tears of the menisci; cysts of the menisci; discoid lateral meniscus; osteochondritis dissecans; intra-articular loose bodies and recurrent dislocation of the patella.

Injuries include:
Rupture of the quadriceps apparatus; apophysitis of the tibial tubercle (Osgood Schlatter’s disease).

Cystic swellings include:
Prepatellar bursitis and popliteal cysts.

Post-traumatic ossification
Pellegrini-Stieda’s disease of the medial femoral condyle.

Disorders of the thigh
The femur is one of the bones most commonly affected by pyogenic osteomyelitis.  The infection is carried to the femur either through the blood stream when it usually affects the lower metaphysic; or it is introduced through an external wound, especially in cases of compound fracture.

Articular disorder of the knee
Pyogenic arthritis is commoner in the knee than in most other joints, partly because the knee is so exposed to injury and partly because of the close relationship of the joint cavity to the lower metaphysic of the femur, which is one of the commonest sites of swelling, and loss of function. 

Rheumatoid arthritis of the knee
The knees are among the joints most frequently affected by rheumatoid arthritis, and they often suffer severe permanent disability.  Both knees are often affected simultaneously with several other joints. Operative treatment- four types of operation are employed in suitable cases:
Synovectomy; upper tibial osteotomy; replacement arthroplasty and arthrodesis.

Osteoarthritis of the knee
The knee is affected by osteochondritis more often than any other joint.  The condition is particularly common in overweight women.  It is caused by wear and tear; but nearly always some factor is present that has caused the joint to wear out sooner than usual.  Overweight is the commonest factor; for some reason it seems to impose harmful stress upon the knee whereas it does not adversely affect the hip or ankle.

Pathology – the articular cartilage is worn away and the underlying bone becomes eburnated.  There is hypertrophy of bone at the joint margins with the formation of osteophytes.  The changes may affect predominantly the femoro-tibial joint or the patello-femoral joint; but usually the whole joint is affected; operative treatment – removal of loose bodies; upper tibial osteotomy; excision of patella; arthroplasty and arthrodesis.



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