Orthopedics is a medical specialty focused on the musculoskeletal system, which encompasses bones, muscles, joints, ligaments, tendons, and nerves. Orthopedic hospitals and specialists diagnose, treat, and prevent injuries and diseases affecting these parts of the body. The goal is to restore function, alleviate pain, and improve the overall quality of life for individuals with musculoskeletal issues. Orthopedic care involves both surgical and non-surgical approaches, tailored to each patient’s specific needs.
Acute Musculoskeletal Injuries
Acute musculoskeletal injuries result from sudden trauma, leading to immediate symptoms like pain, swelling, and difficulty moving the affected area. Fractures, which are partial or complete breaks in a bone, are common examples. Orthopedic specialists diagnose fractures through physical examination and imaging tests such as X-rays, CT scans, or MRIs. X-rays clearly show bone structures.
Dislocations, where bones are displaced from their normal joint alignment, require prompt diagnosis. Physical examination reveals obvious deformity, and X-rays confirm the displacement. Sprains involve injuries to ligaments, the strong bands of tissue connecting bones, while strains affect muscles or tendons. These soft tissue injuries are diagnosed through a physical exam, assessing tenderness, swelling, and range of motion. An MRI may be used for a more detailed assessment of ligament or muscle damage, especially when X-rays appear normal but symptoms suggest significant injury.
Chronic and Degenerative Orthopedic Conditions
Chronic and degenerative orthopedic conditions develop gradually due to wear and tear, aging, or underlying medical conditions. Osteoarthritis, a common form of arthritis, involves the breakdown of cartilage in joints, leading to pain and stiffness. Diagnosis involves a physical exam, reviewing symptoms, and sometimes X-rays to visualize joint space narrowing or bone spurs. Blood tests may be conducted to rule out other forms of arthritis, such as rheumatoid arthritis.
Osteoporosis is characterized by reduced bone density, making bones weak and susceptible to fractures. A specialized X-ray test called a DEXA scan (dual-energy X-ray absorptiometry) is the primary diagnostic tool, measuring bone mineral density in areas like the spine, hip, and forearm. Chronic tendinopathies, such as Achilles tendinitis or rotator cuff tendinitis, involve persistent pain and dysfunction in tendons. Diagnosis relies on a physical examination, assessing pain with movement and palpating the affected tendon. Imaging like ultrasound or MRI can also be used to evaluate tissue changes within the tendon.
Spinal Disorders
Spinal disorders are a significant area of focus in orthopedics, causing back pain, nerve compression, and mobility challenges. A herniated disc occurs when the soft inner part of a spinal disc pushes through its outer ring, potentially compressing nearby nerves. Diagnosis begins with a physical exam and medical history, assessing pain patterns, muscle reflexes, and sensation. Imaging tests such as MRI are the primary method for confirming a herniated disc, providing detailed images of the spinal cord and nerves. CT scans can also offer detailed views.
Spinal stenosis involves the narrowing of the spinal canal, which can put pressure on the spinal cord and nerves. Scoliosis is a condition characterized by an abnormal sideways curvature of the spine. X-rays are used to diagnose scoliosis, showing the degree and pattern of the spinal curve. Spondylolisthesis is a condition where one vertebra slips forward over another. X-rays reveal the slipped vertebra. MRI or CT scans can further assess nerve involvement or fracture details in these spinal conditions.
Pediatric and Other Specialized Orthopedic Concerns
Pediatric orthopedic conditions address musculoskeletal issues unique to children. Clubfoot, a congenital deformity where the foot turns inward and downward, is diagnosed during prenatal ultrasound or immediately after birth through a physical exam. Hip dysplasia, where the hip joint does not develop properly, is screened for in newborns through physical exams. Ultrasound is used for diagnosis in infants under six months, while X-rays are more effective for older babies. Growth plate injuries, affecting the areas where bones grow in children, are diagnosed with imaging like X-rays.
Nerve compression syndromes, such as carpal tunnel syndrome (affecting the wrist) and cubital tunnel syndrome (affecting the elbow), involve pressure on nerves leading to numbness, tingling, and weakness. Diagnosis includes a physical exam and nerve conduction studies or electromyograms (EMG) to measure nerve function. Bone infections, like osteomyelitis, and bone tumors also fall under orthopedic care. Diagnostic approaches for these conditions can be complex, involving advanced imaging like MRI, CT scans, and sometimes biopsies.