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Contracture
In pathology, a contracture is a shortening of muscles, tendons, skin, and nearby soft tissues that causes the joints to shorten and become very stiff, preventing normal movement. A contracture is usually permanent, but less commonly can be temporary (such as in McArdle disease), or resolve over time but reoccur later in life (such as in Bethlem myopathy 1). It is usually in response to prolonged hypertonic spasticity in a concentrated muscle area, such as is seen in the tightest muscles of people with conditions like spastic cerebral palsy, but can also be due to the congenital abnormal development of muscles and connective tissue in the womb. Contractures develop usually when normally elastic tissues such as muscles or tendons are replaced by inelastic tissues ( fibrosis). This results in the shortening and hardening of these tissues, ultimately causing rigidity, joint deformities and a total loss of movement around the joint. Most of the physical therapy, occupational th ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Muscle Contracture
Muscle contractures can occur for many reasons, such as paralysis, muscular atrophy, and forms of muscular dystrophy. Fundamentally, the muscle and its tendons shorten, resulting in reduced flexibility. Various interventions can slow, stop, or even reverse muscle contractures, ranging from physical therapy to surgery. Cause Immobilization Joints are usually immobilized in a shortened position resulting in changes within the joint connective tissue, and the length of the muscle and associated tendon. Prolonged immobilization facilitates tissue proliferation which impinges on the joint space. Maintaining a shortened position for a prolonged period of time leads to: fibrous adhesion formation, loss of sarcomeres, and a loss of tissue extensibility. For example, after a fracture when immobilization is done by casting the limb in plaster of paris, the muscle length shortens because the muscle is not used for a large span of time. A common cause for having the ankle lose its f ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Bethlem Myopathy
Bethlem myopathy is predominantly an autosomal dominant myopathy, classified as a congenital form of limb-girdle muscular dystrophy. There are two types of Bethlem myopathy, based on which type of collagen is affected. Bethlem myopathy 1 (BTHLM1) is caused by a mutation in one of the three genes coding for type VI collagen. These include COL6A1, COL6A2, and COL6A3. It is typically autosomal dominant, though uncommonly can be autosomal recessive. Bethlem myopathy 2 (BTHLM2), formerly known as myopathic-type Ehlers–Danlos syndrome, is caused by a mutation on the COL12A1 gene coding for type XII collagen. It is autosomal dominant. In 2017, an international workshop proposed a redefined criteria and naming system for limb-girdle muscular dystrophies. Bethlem myopathy 1 (collagen VI) was included into the proposed list and renamed LGMDD5 for autosomal dominant mutations and LGMDR22 for recessive mutations. Bethlem myopathy 2 (collagen XII) was not addressed. Gowers's sign, to ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Arthrogryposis
Arthrogryposis (AMC) describes congenital joint contracture in two or more areas of the body. It derives its name from Greek, literally meaning 'curving of joints' (', 'joint'; ', late Latin form of late Greek ', 'hooking'). Children born with one or more joint contractures have abnormal fibrosis of the muscle tissue causing muscle shortening, and therefore are unable to perform active extension and flexion in the affected joint or joints. AMC has been divided into three groups: amyoplasia, distal arthrogryposis, and syndromic (is a syndrome or part of a syndrome). Amyoplasia is characterized by severe joint contractures and muscle weakness. Distal arthrogryposis mainly involves the hands and feet. Types of arthrogryposis with a primary neurological or muscle disease belong to the syndromic group. Signs and symptoms Often, every joint in a patient with arthrogryposis is affected; in 84% all limbs are involved, in 11% only the legs, and in 4% only the arms are involved. Every joint ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Burn Scar Contracture
Burn scar contracture is the tightening of the skin after a second or third degree burn. When skin is burned, the surrounding skin begins to pull together, resulting in a contracture. It needs to be treated as soon as possible because the scar can result in restriction of movement around the injured area. This is mediated by myofibroblasts. Diagnosis Treatment The treatment of burn scar contracture and deformity begins upon hospitalization. Wound care and functional outcomes can be predicted from the initial assessment of wound depth and location. Epidermal and partial thickness wounds heal in 1 to 3 weeks through epithelial migration from the wound edges and epithelial budding from the appendages of the sweat and hair glands. These wounds pose only a small risk of contracture and hypertrophic scarring. Full-thickness (FT) injuries cause dermal wound healing, which is characterized by maturation (contraction and increased tensile strength), proliferation (collagen synthesis l ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Volkmann's Contracture
Volkmann's contracture is a permanent flexion contracture of the hand at the wrist, resulting in a claw-like deformity of the hand and fingers. Passive extension of fingers is restricted and painful. Signs and symptoms The most important signs and symptoms of compartment syndrome are observable before actual contracture. What is known as the five Ps of compartment syndrome include: pain, generally the initial symptom, accompanied by pulselessness, pallor, paralysis, and paraesthesias. Pain will likely also increase upon extension of the affected limbs hands and fingers, which is one of the earliest signs of compartment syndrome and should urgently be followed up by an exam to look for potential development of Volkmann contracture itself. Palpating for tissue firmness in the forearm, and the pulse volume and character of the radial artery, also reflects the degree of compartment syndrome. Causes Any fracture in the elbow region or upper arm may lead to Volkmann's ischemic contractu ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Wound Contraction
Wound contracture is a process that may occur during wound healing when an excess of Wound healing#Contraction, wound contraction, a normal healing process, leads to physical deformity characterized by skin constriction and functional limitations. Wound contractures may be seen after serious burns and may occur on the palms, the soles, and the anterior thorax. For example, scars that prevent joints from extending or scars that cause an ectropion are considered wound contractures. See also * Wound healing * Burn scar contracture References Skin physiology Traumatology Physiology {{disease-stub ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Marden–Walker Syndrome
Marden–Walker syndrome (MWS) is a rare autosomal recessive congenital disorder. It is characterized by blepharophimosis, microcephaly, micrognathia, multiple joint contractures, arachnodactyly, camptodactyly, kyphoscoliosis and delayed motor development and is often associated with cystic dysplastic kidneys, dextrocardia, Dandy–Walker malformation and agenesis of corpus callosum. Signs and symptoms Most of the signs of MWS are present during the neonatal period. The most common signs at this state are multiple congenital joint contractures, dysmorphic features with mask-like face, blepharophimosis, ptosis, micrognathia, cleft or high arched palate, low-set ears, arachnodactyly, chest deformation as pectus, kyphoscoliosis and absent deep tendon reflexes are frequent minor malformations have also been described and consist of renal anomalies, cardiovascular abnormalities, hypospadias, omphalomesenteric duct, hypertrophic pyloric stenosis and duodenal bands, hypoplastic ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Spasticity
Spasticity () is a feature of altered skeletal muscle performance with a combination of paralysis, increased tendon reflex activity, and hypertonia. It is also colloquially referred to as an unusual "tightness", stiffness, or "pull" of muscles. Clinically, spasticity results from the loss of inhibition of motor neurons, causing excessive velocity-dependent muscle contraction. This ultimately leads to hyperreflexia, an exaggerated deep tendon reflex. Spasticity is often treated with the drug baclofen, which acts as an agonist at GABA receptors, which are inhibitory. Spastic cerebral palsy is the most common form of cerebral palsy, which is a group of permanent movement problems that do not get worse over time. GABA's inhibitory actions contribute to baclofen's efficacy as an anti-spasticity agent. Pathophysiology Spasticity is usually caused by damage to nerve pathways within the brain or spinal cord that control muscle movement. This can cause an imbalance in the inhibitory ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Glycogen Storage Disease Type V
Glycogen storage disease type V (GSD5, GSD-V), also known as McArdle's disease, is a metabolic disorder, one of the metabolic myopathies, more specifically a muscle glycogen storage disease, caused by a deficiency of myophosphorylase. Its incidence is reported as one in 100,000, roughly the same as glycogen storage disease type I. The disease was first reported in 1951 by British physician Brian McArdle of Guy's Hospital, London. Signs and symptoms Onset of symptoms and diagnostic delay In the classic phenotype, the onset of this disease is usually noticed in childhood, but often not diagnosed until the third or fourth decade of life, frequently due to misdiagnosis and dismissal of symptoms. The median age of symptom onset is 3 years, with the median diagnostic delay being 29 years. Misdiagnosis is overwhelmingly common, with approximately 90% of patients being misdiagnosed, and approximately 62% receiving multiple misdiagnoses before a correct diagnosis. The prolonged diagno ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Freeman–Sheldon Syndrome
Freeman–Sheldon syndrome (FSS) is a very rare form of multiple congenital contracture (MCC) syndromes ( arthrogryposes) and is the most severe form of distal arthrogryposis (DA). It was originally described by Ernest Arthur Freeman and Joseph Harold Sheldon in 1938.James, William; Berger, Timothy; Elston, Dirk (2005). ''Andrews' Diseases of the Skin: Clinical Dermatology''. (10th ed.). Saunders. . As of 2007, only about 100 cases had been reported in medical literature. Signs and symptoms The symptoms of Freeman–Sheldon syndrome include drooping of the upper eyelids, strabismus, low-set ears, a long philtrum, gradual hearing loss, scoliosis and walking difficulties. Gastroesophageal reflux has been noted during infancy, but usually improves with age. The tongue may be small, and the limited movement of the soft palate may cause nasal speech. Often there is an H- or Y-shaped dimpling of the skin over the chin. Cause FSS is caused by genetic changes. Krakowiak et al. (1998) ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Clubfoot
Clubfoot is a congenital or acquired defect where one or both feet are rotated inward and downward. Congenital clubfoot is the most common congenital malformation of the foot with an incidence of 1 per 1000 births. In approximately 50% of cases, clubfoot affects both feet, but it can present unilaterally causing one leg or foot to be shorter than the other. Most of the time, it is not associated with other problems. Without appropriate treatment, the foot deformity will persist and lead to pain and impaired ability to walk, which can have a dramatic impact on the quality of life. The exact cause is usually not identified. Both genetic and environmental factors are believed to be involved. There are two main types of congenital clubfoot: idiopathic (80% of cases) and secondary clubfoot (20% of cases). The idiopathic congenital clubfoot is a multifactorial condition that includes environmental, vascular, positional, and genetic factors. There appears to be hereditary component ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
