In the case of knee arthroscopy, it cannot be clearly stated that it will return to full fitness after 7 or 10 days. How long the rehabilitation will take and when the patient will be able to return to work after arthroscopy largely depends on the type of arthroscopy performed and the patient's involvement in the rehabilitation process. Much faster recovery after arthroscopy, which involves the removal of a free body, partial removal of the meniscus or synovial fold, than after repair and reconstructive procedures. Usually, loading the joint is possible already 7 days after the procedure, and the crutches can be put aside after a period of 2-3 weeks. Recovery from arthroscopy usually takes about 3-12 weeks.

Knee arthroscopy is performed as part of a one-day surgery procedure. After coming to the hospital, the patient meets with an anesthesiologist who selects the appropriate method of anesthesia. Most often it is spinal anesthesia, i.e. an injection into the spine that anesthetizes the lower limbs. After local anesthesia, the doctor inserts the arthroscope through a hole approximately 5 mm in diameter. With its help, it is possible to detect, diagnose and "fix" pathological changes in the knee joint. The patient is conscious all the time during the procedure.

After the surgery, you need to undergo rehabilitation, during which the exercises are most often aimed at strengthening the muscles and joints. The physiotherapist, in consultation with the attending physician, selects the appropriate set of exercises so that the patient returns to full fitness as soon as possible.

A few days before the date of arthroscopy, a complete blood count should be performed, electrolyte and sugar levels, liver tests, and an EKG and chest X-ray should be taken. These tests can be done in one day. In the case of chronic diseases, consultation with a specialist is necessary. Before the arthroscopy itself, a short visit to the anesthesiologist should be made in order to exclude contraindications to the use of anesthesia.

You should take with you the current results of examinations and consultations as well as elbow crutches, basic documents - ID card.

Depending on the cause of the procedure, arthroscopy usually takes from half to two hours.

The type of anesthesia is consulted with the anesthesiologist. In most cases, knee arthroscopy is performed under subarachnoid anesthesia, which involves puncturing the spine, thanks to which the patient is conscious during the procedure, and his lower limbs are anesthetized and incapacitated. Very rarely, in exceptional cases, general anesthesia is used.

Rehabilitation after knee arthroscopy should be started as soon as possible. Consultation with a physiotherapist should take place several hours after the procedure. During the first days after the procedure, the patient should exercise under the strict supervision of a physiotherapist.

No, the procedure is performed under anesthesia. During recovery from arthroscopy of the knee, the patient may experience slight pain and discomfort.

Depending on the cause of the procedure, arthroscopy usually takes from 30 minutes to two hours.

Patellar dislocation is an injury in which the kneecap protrudes from the intercondylar furrow. In order for dislocation to occur, there must be an additional cause (trauma) or pathology in the anatomy of the knee joint, which may include, among others, lateral positioning of the tibial tuberosity, bone development disorders (patellofemoral dysplasia), generalized joint laxity, previous knee injury , deformity of the foot or ante-thigh bone ante. The knee joint is most prone to patellar dislocation at the moment of internal rotation of the thigh in relation to the foot set on the ground, as well as flexion and deformation of the knee with simultaneous strong tension of the quadriceps muscle. In this case, the kneecap is most often dislocated laterally (outwards), often causing damage to the soft tissues of the knee joint area.

Surgical treatment of a patellar dislocation is the target treatment for recurrent (habitual) patellar dislocation and when it is damaged:

cartilage-bone fragment of the patella
medial patellar retinaculum,
cartilage surfaces
In the above cases, knee surgery is necessary, because leaving the unstable kneecap and not covering the resulting damage may consequently lead to inflammation of the patellofemoral joint with synovial swelling and numerous exudates, as well as destruction of the articular cartilage by abnormal abrasive forces.

The time of rehabilitation after surgery depends on the extent of the damage, the type of treatment procedures and the patient's level of activity. The use of arthroscopy allows for a significant reduction in postoperative pain, shortening the hospital stay and reducing the risk of postoperative complications and faster return of the patient to daily functioning.

After the surgical treatment of the patellar dislocation, full load on the operated limb, obtaining the correct gait pattern on a varied basis and obtaining the correct deep feeling (prioprioception) and 100% return to the activity of everyday life, work and sports without functional disorders and pain, is achieved just a few weeks after the performance arthroscopy.

The price of the knee arthroplasty depends on many factors, including the type of implant, the materials used in the prosthesis and the health conditions of the patient. The price of an endoprosthesis implantation is from several to twenty thousand zlotys. As part of the costs associated with knee arthroplasty, rehabilitation services should also be taken into account, carried out at least for the first few weeks after the surgery.

Most patients return to their daily activities after about 3 months of rehabilitation. During this period, the physiotherapist mobilizes the postoperative scar and teaches you safe exercises to strengthen the muscles. The progress of rehabilitation depends on the degree of the patient's training before the procedure, the type of endoprosthesis (partial or complete), the presence of comorbidities and the patient's involvement in the rehabilitation process.

The knee joint prosthesis retains its original properties for approximately 12-17 years. In order to maintain its vitality, you should avoid forcing the artificial joint, while maintaining the optimal range of motion of the knee and maintaining the appropriate muscle strength. Do not assume positions in which the knee prosthesis may be mechanically deformed or subluxated (kneeling, squatting). In addition, maintaining a healthy body weight is important (avoiding overweight).

A typical symptom at the moment of acute meniscal damage with a fragment of its fragment torn off is a perceptible crunch or audible click in the knee, severe pain and joint blockage (most often in flexion). Trying to move your knee aggravates the pain. It may be difficult or impossible to stand on the injured leg. In minor injuries of the meniscus, the symptoms are less intense - the pain may appear only during activities that put a lot of strain on the knee (running, jumping), and the feeling of jumping in the knee may be temporary and the patient is able to unblock them by means of manipulations known to him.

Relieving the knee is designed to heal the stitched meniscus. The time of walking on crutches depends on the site, extent and nature of the meniscal damage and is usually 6-8 weeks. During this period, the percentage of weight bearing on the knee is gradually increased after consultation with the orthopedist and provided that it does not cause pain in the patient.

Exercises for the knee after suturing the meniscus should be carried out under the supervision of an experienced physiotherapist who will plan the therapy process and teach exercises that will be safe for the operated meniscus (they will not disturb the healing process). proper activation of the muscles responsible for the stability of the joint and improvement of the strength and endurance of the muscles of the lower limb. The ultimate goal of the exercises is to protect the operated meniscus from excessive strain due to proper control of the knee movements both during daily activities and during sports activities.

The indication for a transplant is damage to the meniscus, which cannot be repaired by suturing. Then it is necessary to remove the meniscus or part of it (meniscectomy). The absence of a meniscus or its partial loss negatively affects the biomechanics of the knee and significantly accelerates the wear of the articular cartilage. The aim of a meniscus transplant is to eliminate knee pain and protect the joint against premature degenerative changes (gonarthrosis) / link /. Meniscal transplants are usually performed in people aged up to 50-55 with good condition of the articular cartilage.

If it is necessary to remove the entire damaged meniscus, the graft is a meniscus obtained from a deceased donor from a tissue bank (the so-called allograft). When only part of the meniscus is damaged, in some cases it is possible to implant a synthetic implant. The implant is biodegradable and gradually overgrows with natural fibrous tissue, replacing the missing part of the meniscus. The procedure of implanting an allograft or a synthetic fragment of the meniscus is performed as part of a minimally invasive arthroscopy / link / procedure without the need to open the joint.

The duration of rehabilitation depends on the type of transplant used, the surgical technique and the level of activity to which the patient would like to return. Most patients are able to return to their daily work in the third month after the procedure. The return to sports training is usually possible 6-10 months after the surgery - depending on the specificity of the sports discipline practiced and the patient's involvement in the rehabilitation process.

The ACL reconstruction procedure is performed when severe knee instability (3rd degree) is found, which makes it difficult for active people to function normally. The aim of the treatment is to improve the quality of life and to prevent the rapid development of knee osteoarthritis. Surgical ACL reconstruction is especially recommended for athletes and blue-collar workers. Less degrees of ACL damage and complete rupture of the ACL ligament in people leading a sedentary lifestyle can be successfully treated conservatively through specialized rehabilitation.

The length of treatment depends on many factors, including: rehabilitation of the patient before the procedure, the type of transplant used (own, donor or artificial implant), the presence of additional damage to the knee and the patient's involvement in the physiotherapy process after the procedure. In the case of the most frequently performed ACL reconstructions with the use of own muscle tendons or the patellar ligament, the time to return to normal activity is about 3 months. You can start practicing sports in the period from 6 to 12 months after the procedure.

The first steps after the procedure can be taken as early as 1-2 days after the surgery. During the first 3-4 weeks after the procedure, walking is possible with the support of the elbow crutches and with the knee brace. Free walking with full load on the limb without additional support is possible when the physiotherapist determines that the knee is fully prepared and trained for it, and moreover, walking does not cause recurrence of swelling or pain in the joint.

Rehabilitation begins on the first day after surgery and should be systematically continued under the supervision of a qualified physiotherapist for at least 3 months. Properly implemented treatment will allow you to restore the full range of motion in the knee in the optimal time, regain the required muscle strength and stability of the joint, and as a result will allow you to safely return to normal activity and sport.

A ruptured posterior cruciate ligament is reconstructed when the identified knee instability significantly impedes daily functioning or makes it impossible to take up physical activity. A factor that should be taken into account is a disturbance in the biomechanics of the lower limb secondary to PCL rupture, which translates into a significant increase in overload and thus acceleration of degenerative changes in the knee. People under 40, active or physically working people benefit most from PCL reconstruction surgery. In the case of a sedentary lifestyle, old age and mild symptoms, systematic rehabilitation is a sufficient method of treatment.

The length of the rehabilitation process after the reconstruction of the posterior cruciate ligament is influenced by many factors, including the functional state of the knee before the procedure, the presence of additional damage to the joint, the type of material used for the graft (from own tendons or muscles, donor or artificial implant), and the patient's involvement in the physiotherapy process after the procedure. In the case of PCL reconstruction using the patient's own tissues, the minimum rehabilitation time is about 3 months. You can start practicing sports 8 months after the treatment. Rehabilitation time may be shorter when using the Internal Bracing method, which consists in repairing broken PCL without the need to collect a graft.

Walking is possible already on the second day after the operation, provided that the operated limb is relieved with elbow crutches. A special orthosis is also placed on the knee to protect the tibia from posterior displacement relative to the femur, which is to prevent the PCL ligament graft from stretching. Free walking with full load on the limb and without an orthosis is possible when the physiotherapist determines that the knee is fully prepared and trained for it, and moreover, walking does not cause recurrence of swelling or pain in the joint. The time of weaning off the crutches and orthosis is usually 6-8 weeks after the surgery.

A popliteal osteotomy is based on the restoration of the correct mechanical axis of the knee joint thanks to the surgical correction of the proximal epiphysis of the tibia. This treatment causes a more even distribution of loads within the articular cartilage, which reduces the pain in the knee. A tibial osteotomy is an effective treatment for knee pain in young people with a disorder of the limb axis and in the early stages of osteoarthritis. In selected cases, tibial osteotomy is an alternative to the implantation of a knee joint endoprosthesis.

The most common indication for osteotomy surgery is pain in the knee joint of degenerative origin accompanied by varus of the tibia. Varus deformity of the tibia can be initially diagnosed when the knees are separated by a minimum of 4 cm with the joint ankle joints. A popliteal osteotomy makes it possible to correct the deformed axis of the limb and thus relieve the painful structures in the medial compartment of the knee.

The required rehabilitation time after a popliteal osteotomy is approximately 3 months. This time may also be shorter or longer depending on the individual anatomical conditions of the knee, procedures performed in parallel during the operation (e.g. reconstruction of the cruciate ligament) and the expected level of patient activity after the procedure.

Arthroscopic synovectomy of the knee is a surgical procedure involving the partial or complete removal of the diseased and enlarged synovial membrane. The purpose of this procedure is to eliminate inflammation in the joint by removing the synovium, which leads to the reduction of joint swelling and pain. The total rehabilitation time for the patient to fully heal and return to full activity after arthroscopic synovectomy is approximately 2 - 6 months.

The synovial membrane is a very delicate structure. As a result of previous knee injuries or various rheumatic diseases, i.e. rheumatoid arthritis, juvenile idiopathic arthritis, gout, lupus erythematosus and systemic sclerosis, or in tumors and tuberculosis, it may overgrow, thus increasing its secretory activity. This leads to an overproduction of synovial fluid with an abnormal chemical composition, so its value as a substance facilitating the glide of the articular surfaces and nourishing the articular cartilage is significantly reduced, which leads to generalized synovitis.

The indication for radioisotope synovectomy is exudative synovitis of the knee joint, which occurs, inter alia, in in the course of rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis, osteoarthritis of the knee and recurrent exudative inflammation of the knee.

A Baker's cyst (Baker's cyst or popliteal cyst) is a change consisting in a non-physiological enlargement of the connective tissue space, which is filled with joint fluid. It resembles a lump that can be palpated through the skin when examining the knee. It is located in the popliteal fossa on the posterior side of the thigh between the medial head tendons of the gastrocnemius muscle and the semimembranous muscle.

Symptoms related to the occurrence of the Baker's cyst itself are very rare, but if they do occur, they may be related to its size and advancement, as well as the underlying disease process and inflammation of the knee joint. The most important symptoms that may indicate the presence of a popliteal cyst are:

clearly palpable lumps under the skin at the back of the knee
knee pain worsening with prolonged walking and during physical activity,
redness and warming in the area of ​​the cyst under the knee,
swelling and a feeling of "fullness" in the knee,
limitation of flexion and extension of the knee joint,
depending on the size of the cyst, there may be numbness in the calf area (also when the cyst ruptures), pain and swelling of the lower leg,
limb function limitation.

The arthroscopic procedure consists in removing the cyst, closing its connection with the joint and suturing the damaged joint capsule tightly. In the case of concomitant intra-articular diseases (or causes of secondary occurrence of the cyst), repair activities are also performed. Arthroscopy allows for the least invasive removal of all known and described causes of popliteal cyst formation, which significantly improves the effects of treatment and reduces the number of recurrences. It is performed when conservative treatment does not bring satisfactory results.

Hip arthroscopy is a minimally invasive procedure, which allows you to reduce the time spent in hospital up to one day after surgery. This is an advantage of arthroscopy compared to open surgery, after which the patient spends several days in the hospital. Please note that only selected hip treatments can be performed during arthroscopy. The decision on qualification for a given type of surgery is made by the operator surgeon.

Hip arthroscopy is a technically very difficult procedure, so it is worth choosing an operator who has experience in performing this type of procedure. In addition, physiotherapists should be present in the hospital, who teach to get up and walk after the procedure, show exercises after the surgery and provide important tips on the further rehabilitation process.

Exercises are selected individually by a qualified physiotherapist in consultation with the surgeon performing the operation. The aim of the exercises is to restore the possible hip function, painless walking and resumption of activity. The exercises consist mainly in improving neuromuscular coordination and gradual strengthening of the muscles of the pelvic girdle.

The required rehabilitation time is an individual matter - it may be from 8 weeks to several months. If the patient participated in preoperative rehabilitation, i.e. strengthened his muscles, and the physiotherapist prepared the soft tissues for the procedure, the recovery period will be faster. Convalescence will be slower if you have chronic conditions that affect wound healing or bone properties. Surgical access is also of great importance, i.e. what muscles were cut during the procedure. In addition, the type of endoprosthesis itself affects the length of rehabilitation - patients after less invasive capoplasty recover faster, while the procedure of implanting a prosthesis with a long stem will require more work to restore normal gait.

Full, free weight bearing of the operated limb is usually possible in the third month after the operation. This time is needed for the implant to stably fuse with the bone. In the earlier period, the limb can be partially loaded - the degree of load depends on the type of endoprosthesis, the fixing method (with or without cement) and the individual conditions related to the procedure performed. Follow your doctor's instructions carefully at each stage of recovery.

The length of the primary arthroplasty procedure takes about 1-1.5 hours and depends on the type of implanted endoprosthesis and the surgical access. The operation time may be longer when treating accompanying bone lesions or revision arthroplasty.

When choosing a hospital, we should be guided by the operator's experience, specifically in the field of hip arthroplasty. The conditions in the operating room are also important - care for the sterile procedure. In addition, it is worth choosing a hospital in which the patient is surrounded by the daily individual care of a physiotherapist immediately after the procedure, in order to be able to learn how to move with an implanted endoprosthesis in a safe way.

If the endoprosthesis is damaged, the range of motion and audible crackles that have not been present may be limited. As a result of dislocation of the prosthesis, the limb may become incorrectly positioned and the leg cannot be loaded due to pain and blockage of the prosthesis.

Among the factors predisposing to the occurrence of a hip fracture, the following are distinguished:

- osteoporosis and osteopenia,
- age and sex of the patient (hip fractures are the domain of older people and more often affect women than men, which results from hormonal disorders during menopause, which adversely - - affect the condition of the skeleton),
- neoplastic diseases (bone tumors),
- congenital fragility / fragility of bones,
- endocrine disorders,
- taking anti-inflammatory steroid drugs,
- malnutrition,
- lack of regular physical activity.

The choice of the method of surgical treatment depends on the type of fracture, the extent of the injury, age and activity of the patient. Depending on these factors, the following are performed:

- anastomosis of broken bone fragments with the use of screws or nails,
- reposition and internal stabilization with the use of dynamic hip screw (DHS),
- arthroplasty, i.e. replacement of a damaged fragment of the femur with an artificial element. The endoprosthesis may be partial (replacement of one joint member) or complete (replacement of both joint members).

Rehabilitation should last until the patient reaches the normative values ​​in clinical trials and locomotion tests. The patient's full load on the lower limb takes place approximately 12 weeks after the procedure.

Ankle arthroscopy is a one-day surgery procedure. Its purpose is to diagnose and treat damaged structures of the joint. The whole thing is to insert the arthroscope and small tools into the joint, which are manipulated while viewing the image of the joint on the monitor screen.

The procedure is usually performed under spinal anesthesia, which means that the patient is conscious all the time and has one or both lower limbs temporarily incapacitated.

The length of the procedure depends on the type of arthroscopy performed and the degree of damage to the ankle joint as well as the treatment method used. Usually, the entire procedure takes no more than 60 minutes.

Arthrodesis is a surgical procedure to stiffen the ankle joint. For this purpose, the articular surfaces are removed and the tibia is joined with the talus bone so that they become permanent fusing. Movement in the place of the operated joint is impossible, which is the intended effect - thanks to the stiffening of the ankle joint, pain relief, correction of incorrect positioning and restoration of the limb support function are achieved.

The arthrodesis procedure is most often performed in patients who suffer from pain associated with advanced degenerative changes of the ankle joint. The condition for qualification is the lack of effects of conservative treatment or the lack of purposefulness of undertaking other methods of surgical treatment. Stiffening of the ankle joint is also performed in extensive post-traumatic conditions involving the ankle joint. In addition, arthrodesis can be used as a method of correcting foot deformities, such as fixed flatfoot or clubfoot in adults.

Most patients are given epidural anesthesia to eliminate feeling from the waist down or the nerves supplying the operated limb are blocked. The ankle brace procedure is most often performed by the open method - the surgeon makes an incision of several centimeters on the side or in front of the ankle joint. Thanks to this, it has maximum access to the pond and can precisely correct its incorrect position. Arthrodesis can also be performed using the arthroscopic method, which leaves minimal scars (up to 4mm), but this method is reserved for smaller degrees of deformation.

During the operation, the surgeon removes the debris of the damaged cartilage, and then prepares the end of the tibia and the talus to allow them to heal later in the corrected position. The connection is stabilized with special screws or plates. The wounds are closed and a plaster splint is placed over the foot and ankle.

To prevent the development of bunions, it is recommended to regularly strengthen the foot muscles, stretch the calves, wear comfortable footwear with wide toe boxes, maintain a healthy body weight, and avoid prolonged periods of standing. It's important to keep in mind that factors such as genetic conditions, rheumatoid arthritis, and diabetes can contribute to the development of hallux valgus, so it's not always possible to completely prevent bunions. However, we can take steps to slow down the progression of the deformity. People who are more susceptible to bunions should undergo regular foot examinations to detect the condition in its early stages.

Bunion surgery is the only effective way to permanently correct deformation. It makes it possible to reduce the width of the foot and straighten the big toe, thanks to which the desired cosmetic effect and reduction of pain are obtained after the treatment. Conservative treatment, i.e. wearing haluksy braces or orthopedic insoles, may alleviate symptoms, but does not reduce deformities.

Orthopaedists advise undergoing a surgical procedure for hallux valgus when it becomes difficult to wear normal shoes comfortably due to the size of the painful bunion, and when the pain is severe enough to significantly affect the quality of life. The physician should have a comprehensive conversation with the patient regarding the expected outcomes of the surgery, taking into account the patient's expectations.

The length of convalescence after the bunion treatment depends on the initial degree of deformation and the extent of the treatment. Full recovery in most cases is possible in the third month after the procedure. An important role is played by the patient's involvement in rehabilitation, which significantly speeds up the recovery process after surgery.

After your surgery, you will need to wear a specialized orthosis called a Barouk shoe to help relieve pressure on your operated forefoot. It will take approximately 6 weeks for the bones to fuse properly before you can begin walking in normal shoes again. 

A well-planned and carefully performed bunion surgery brings lasting results. If the patient follows the specific recommendations of the orthopedist and physical therapist, there is no possibility of the hallux recurrence. Wearing high-heeled shoes or shoes with narrow toes is contraindicated as, regardless of the result of the operation, it may cause the big toe to curvature again.

The indications for surgical treatment of ankle instability include:

complete rupture of ligaments with acute instability of the ankle joint, which seriously disrupts biomechanics and prevents the patient from returning to normal activity,
another habitual ankle sprain, which could not be brought about by conservative treatment to a state in which the patient could function freely without pain symptoms,
chronic mechanical instability, when conservative treatment does not bring the results expected by the patient, e.g. alleviating pain,

The Internal Bracing method is based on the use of strong sutures or a non-absorbable polystyrene tape, which additionally strengthens the repair performed on the patient's own tissues - in the case of the ankle joint of the articular bag with a ligament. The advantage of the Internal Bracing method is the preservation of your own ligament without the need to collect the graft and faster return to normal activity after the procedure due to the high primary strength of the implants.

Untreated chronic ankle instability increases the risk of habitual ankle sprains, subsequent cartilage and / or sagittal injuries, and leads to the acceleration of degenerative changes manifested by gradual limitation of the range of motion and ankle pain that makes walking difficult.

In children up to 7 years of age, there is physiological flat feet, which means that children's flat valgus foot is a natural stage in the development of the lower limbs. In order to stimulate the outgrowth of physiological valgus, give the child plenty of exercise, and especially allow the child to walk barefoot on a variety of surfaces - this stimulates the foot muscles to work. Flat feet should always be monitored, especially in cases where there are aggravating factors: excessive joint laxity, overweight, muscle tone disorders or abnormalities in the hips. The final decision as to treatment is made by the orthopedic surgeon after thorough diagnostics. Conservative treatment includes exercises to strengthen the feet, exercises to stimulate the correct positioning of the lower limb and the possible wearing of orthopedic insoles. The indication for surgery is painful flat feet, rapidly progressing and not amenable to conservative treatment.

The type of treatment depends on whether the flat feet are still flexible (can be actively corrected) or the defect has already been fixed. If we are dealing with flexible flatfoot, one of the methods used is to place a small implant in the tarsal sinus. The tarsal sinus is the space between the ankle bone and the calcaneus, felt through the skin as a depression in the foot in front of the lateral ankle. The procedure is a minimally invasive one, therefore the return to walking is much faster compared to classic correction methods. The implant placement procedure can be performed in children over 3 years of age and in adults with corrective flat feet. Fixed flat feet with degenerative changes in the foot and ankle are operated using other methods, the choice of which is up to the surgeon.

Relief in ailments caused by transverse flat feet is provided by the use of individually made orthopedic insoles. The inserts on the transverse platform relieve the forefoot and normalize the pressure distribution under the feet, thanks to which the foot is less painful. The insoles work when worn in shoes. Permanent improvement in ailments and correction of accompanying deformities of the fingers can be achieved through surgery. The surgical procedure allows you to straighten the bunion, hammer or claw toes and change the shape of the foot to improve comfort while walking.

The length of convalescence depends on the extent of the procedure and the surgical technique used. For the first 6 weeks, the patient should wear a special shoe that relieves the operated part of the foot. Return to full activity is usually possible in the third month after the procedure, but it may be shortened if the procedure was performed using a minimally invasive technique.

In the case of Achilles tendon pain, an orthopedist should be consulted, who will accurately diagnose the cause of the ailments and establish a treatment plan. The management consists mainly of a temporary limitation of sports activity, performing eccentric calf muscle exercises and procedures in the field of physical therapy. In the treatment of chronic Achilles tendinopathy, modern methods are used to stimulate the processes of proper healing and tissue repair, e.g. the Topaz electrode coblation procedure.

Strengthening the Achilles tendon by stimulating the reconstruction of the fiber structure can be achieved by performing eccentric training according to the Alfredson protocol. This training involves the controlled lowering of the heel down below the level of the step on which the forefoot rests. The exercise is performed with the knee extended and then bent. The training includes 15 repetitions in 3 series in the morning and evening for a minimum period of 3-6 months. To be sure that the exercise is being performed correctly, it's best to check with your physical therapist.

The rigid big toe is manifested by pain in the metatarsophalangeal joint of the big toe while walking, when the heel rises above the ground and the foot prepares to take off. Pain often makes it impossible to fully climb on toes or wear high-heeled shoes. The bone conflict results from the presence of degenerative changes that limit the passive dorsiflexion of the big toe. X-ray images show a narrowing of the joint space and the presence of bone spurs (osteophytes).

The metatarsophalangeal arthrodesis of the big toe is an effective form of surgical treatment of the rigid big toe. The procedure consists in cutting out the articular surfaces and then permanent stiffening of the big toe joint in a slight dorsiflexion. The treatment relieves pain and allows the patient to freely take up everyday activities, and even play sports.

After the procedure, the patient should move in a special shoe that relieves the front of the foot. This is necessary for a period of about 6 weeks or until the toe joint is firmly in place.

The cheilectomy procedure, i.e. the removal of degenerative changes inhibiting the dorsiflexion of the big toe, is performed in young active people who complain of pain in the big toe joint with the accompanying limited mobility. The condition for the success of the operation is the initial stage of degenerative changes in the big toe joint - the head of the metatarsal bone should have more than half of the undamaged articular cartilage. Only then is it possible to restore the painless range of motion of the big toe.

During subluxation of the tendons of the peroneal muscles, they abnormally shift forward to the lateral ankle. It is accompanied by damage to the upper cord of the fibula muscles, which should keep the tendons in their correct position. Symptoms of subluxation are pain and a feeling of jumping the tendon on the side of the ankle joint, which is most easily observed when placing your foot on the outer edge of the foot or when trying to deform the ankle joint.

The risk of subluxation or dislocation of the fibula tendons is increased in people who have an anatomically too shallow groove of the fibula in which the tendons of these muscles lie. Additional varus position of the heel predisposes to overloading the strap and weakening its structure. A history of inversion ankle sprain and chronic lateral instability of the ankle joint are also a risk factor for this type of injury.

Sagittal muscle dislocations are most often treated surgically. The procedure involves the repair or reconstruction of the upper reticulum of the fibula muscles, which holds the tendons behind the lateral ankle. Additionally, it is possible to deepen the too shallow groove of the fibula or build up the posterior edge of the fibula with bone blocks to better stabilize the tendons in their anatomical position. After surgery, you should participate in regular rehabilitation, the main goal of which will be to restore the muscular stabilization of the ankle joint and safely return to normal activity.

The accessory triangular bone is found in 7-25% of people and is located at the back of the talus. In most cases, its presence does not cause any discomfort. In athletes who perform repeated plantar flexion movements (such as ballerinas who climb toes), the triangular ankle may be irritated as manifested by overload pain at the back of the ankle.

An additional navicular bone lies on the medial side of the tarsus. The pain is exacerbated by the conflict between the protruding ankle and the upper of the shoes. In the case of a flat valgus foot, the discomforts can be alleviated by using an insole correcting the incorrect position of the foot. Failure to achieve the desired effect may be an indication for the surgical removal of the additional navicular bone.

Surgical excision of the accessory ankle is performed in the event of an acute injury that resulted in a fracture of the accessory ankle. Surgical treatment also includes conditions where medical treatment has not been successful.

There are many ways to treat hammer fingers, such as finger exercises, manual therapy by a physical therapist, and wearing special finger straightening orthoses. There are strategies that allow you to relieve ailments, slow down the progression of deformity or improve the position of the fingers for a short time. In order to obtain the desired shape of the fingers permanently, it is recommended to undergo surgery.

An indication for surgery is any degree of deformation of the hammer toes, which causes pain and makes it difficult to use everyday shoes.

Thanks to the stiffening of the finger with wire, very good results are obtained, but in some cases internal implants are also used. The decision on the type of anastomosis is made by the surgeon - depending on the type of deformity and the patient's expectations. Internal implants cost a treatment several hundred zlotys and provide worse stability than the classic so-called Kirschner rod.

A broken ankle should not be weighed down for at least 6-8 weeks, and in some cases even for 10 weeks. During this period, the patient uses crutches, initially wearing a plaster shoe and then wearing a special Walker brace. Gradual load on the limbs can only be started after receiving information from the orthopaedist regarding the occurrence of bone union.

The rehabilitation time after an ankle fracture varies - depending on the severity of the injury, it may last from 3 to 8 months. The patient's involvement in the rehabilitation process is of great importance for the duration of the recovery. Rehabilitation should always be carried out in cooperation with the physiotherapist and the orthopedist who performs the surgery or conducts conservative treatment.

Minor pain in the first 2-3 months after an ankle fracture may result from active bone remodeling processes. The active participation of the patient in rehabilitation allows to prevent pains resulting from the presence of postoperative scars or tissue adaptation to re-burdening with body weight. It should be borne in mind that some complex types of fractures may prevent the perfect reconstruction of the articular surfaces, which is related to a certain limitation of the ankle joint function. Some patients with massive ankle injuries may develop degenerative changes within 2-10 years despite maximum care.

Achilles tendon suturing should be performed as soon as possible - no later than 6 weeks after the injury. The longer the procedure is delayed, the greater the risk of shortening and atrophy of the calf triceps muscle. An early procedure allows the Achilles tendon to be fully restored using classical methods, without the need to extend the tendon or harvest grafts.

Shoulder arthroscopy is a method of performing a surgical procedure involving the endoscopy of the shoulder joint area. The operator makes minimal incisions through which he introduces a camera (arthroscope) and surgical instruments. Arthroscopy enables effective treatment of many diseases and injuries of the shoulder, e.g. sub-shoulder tightness, rotator cuff injuries or instability of the shoulder and shoulder-clavicular joints. Arthroscopy is a minimally invasive procedure, thanks to which the patient leaves the hospital the very next day after the surgery.

Before qualifying for surgery, shoulder pain should be thoroughly diagnosed by an orthopedist. Clinical tests and imaging tests allow to determine the severity of degenerative changes and / or the extent of shoulder injuries. Surgery is performed if the identified changes hinder sports or professional activity, do not undergo rehabilitation treatment, or a shoulder injury can only be treated surgically. When planning treatment, the doctor also takes into account the patient's expectations regarding the level of shoulder fitness and readiness to undertake rehabilitation after the procedure.

The time of rehabilitation after shoulder arthroscopy depends on the extent of shoulder injuries, the type of procedures performed during arthroscopy and the patient's level of activity. Minor repairs of the shoulder structures are associated with several weeks of rehabilitation, other more extensive treatments require regular participation in rehabilitation for up to several months. It is worth noting that the recovery period is always shorter compared to open shoulder surgery.

The rotator cuff, also known as the hood or the rotator cuff, is a group of muscles that surround the head of the humerus. They are responsible for the stabilization of the humerus in the acetabulum of the scapula and for movements in the shoulder joint (mainly abduction movements and rotations).

Tendon damage is often caused by falling on a straightened limb or when lifting a heavy object while rotating the arm. People who actively practice sports (especially those disciplines that require frequent lifting of hands, e.g. retina) and people who perform physical work that require frequent repetition of the same movements, causing microtrauma and overload in the tendons of the rotator cuff, are also exposed to damage to the rotator cuff tendon.

Patients experience a decline in muscle strength and pain, often described as stabbing, appearing around the top of the shoulder and sometimes radiating down to the forearm. Pain can also appear when you are resting - for example, while you are sleeping. Patients may find it difficult to move the limb, especially raising the arm to the side.

Patients who are usually qualified for the surgery are those who have not been successful in conservative treatment, as well as those who are active in sports, in whom damage to the rotator cuff is the result of acute trauma. The surgical procedure is also indicated when the damage is so extensive that it prevents normal functioning and may contribute to the formation of secondary overload changes in the shoulder.

The operation of the rotator cuff usually consists in suturing - with the use of special anchors and sutures - the tendons in their anatomical position.
The treatment may include the following methods:

classical (open) reconstruction of the rotator cuff
minimally invasive rotator cuff surgery - mini-open procedure
arthroscopic removal of calcification of the rotator cuff
arthroscopic reconstruction of the rotator cuff

Shoulder instability is a condition in which the head of the humerus is displaced relative to the acetabulum. Recurrent slipping of the humerus head out of the acetabulum is called chronic shoulder instability.

The symptom of a dislocation in the shoulder joint is stinging and sharp pain in the shoulder area. People with a dislocated shoulder joint have problems with moving the arm, and distortion of the outline around the shoulder can often be observed. Accurate diagnosis of the injury should be performed by an orthopedic surgeon.

After a shoulder dislocation, conservative treatment is undertaken in most cases. When the dislocation is accompanied by severe damage to the labrum and / or the acetabulum of the scapula, surgical treatment is required. The orthopedic doctor makes the final decision regarding the choice of treatment.

In the case of damage to the labrum of the acetabulum, it is necessary to undergo surgical treatment. Surgery is also necessary if the damage is extensive or the dislocation is habitual.

The aim of the operation is to reattach the acetabular labrum in its anatomical place. Depending on the type of injury, anatomical conditions and the degree of labral damage, the operation can be performed arthroscopically or with the classic opening of the joint.

The return to full fitness takes place within 6 to 9 months after the surgery.

Symptoms, including pain, the feeling of skipping the shoulder blade, and the presence of an audible click when moving the shoulder may be a sign of the so-called snapping scapula syndrome. The cause of the disease is structural changes leading to a mechanical conflict of the bone or soft tissues lying under the scapula. Pain under the scapula without the feeling of skipping may be related to the inflammation of the subscapular bursa. In order to determine the cause of the ailments, you should go to an orthopedist who will perform a detailed clinical examination and order additional imaging tests. Early diagnosis and treatment of "popping scapulae syndrome" is very important - ignoring the symptoms can lead to a progression of structural changes that can only be treated with surgery.

The main goal of rehabilitation is to restore the correct movement patterns of the scapula, which will not overload the tissues lying in the subscapular area. The first stage of physiotherapy includes methods to normalize muscle tension and to extend the shortened muscles to restore the normal mobility (mobility) of the shoulder blade. The crackling scapula exercises involve activating the appropriate muscles to achieve the required scapula stabilization. Gradually, the patterns of the entire upper limb are included, while maintaining the correct biomechanics of the scapula and the shoulder joint. The last stage of rehabilitation is strength and endurance exercises of the upper limb and elements of the sports discipline. The therapy process should be carried out under the supervision of an experienced physiotherapist.

The indication for surgical treatment is the presence of degenerative-productive bone changes, free bodies in the scapulo-costal space and other pathologies that cannot be rehabilitated. The most common procedure is the excision of the bone growths of the upper or lower edge of the scapula and the release of connective tissue adhesions that cause jumping and pain under the scapula. If necessary, the pathologically thickened synovial bursa are also removed.

Performing the surgery is recommended when:

the pain persists despite the implementation of rehabilitation treatment, the use of anti-inflammatory and analgesic drugs and injecting the spine with a steroid,
there is muscle paresis or urinary incontinence - these are conditions indicating advanced compression of the nerve roots, requiring urgent surgical intervention.

The aim of the surgery is to decompress the compressed nerve structures by removing the nucleus pulposus that has slipped out of the degenerated intervertebral disc. The choice of surgical access and the procedure technique is up to the neurosurgeon who qualifies the patient for surgery.

One method of widening a narrowed spinal canal is through laminectomy. This procedure consists in cutting out the vertebral arch plates together with the spinous process limiting the canal space from the back side. In a hemilaminectomy, the surgeon cuts the arch lamina on one side of the spinous process (right or left). If necessary, bone growths are removed and the intervertebral holes are deepened. The treatment allows you to decompress the pressed nerve roots or the spinal cord and relieve pain.

After a laminectomy (excision of the vertebral arches), getting up and walking is possible within a few days of the operation. The doctor makes the decision about the possibility of standing upright. Sometimes it is necessary to use a corset that stabilizes the operated section of the spine. Getting up and walking is done under the supervision of a physiotherapist.

Vertebroplasty is performed to strengthen the vertebral bodies that have been fractured by compression, most often as a result of osteoporosis. The procedure consists in the percutaneous injection of a special cement into the vertebral body, which hardens after about 20-30 minutes. The effect is to strengthen the weakened shaft and alleviate or completely eliminate the pain of a broken vertebra. Vertebroplasty is also performed in people with neoplastic processes in the spine and other pathological changes that weaken the bone structure.

When injected into the vertebral body, the liquid cement hardens after about 20-30 minutes. It is recommended that patients remain lying down for a minimum of 2 hours after the procedure. Standing up and walking is possible with the express consent of the doctor.

Microdiscectomy is one of the minimally invasive methods of treating intervertebral disc herniation. The surgeon makes a small incision of the body integuments (3-4 cm). Then he folds back the paraspinal soft tissues to the side so as to gain convenient access to the nerve root pressed by the nucleus pulposus. Thanks to the use of miniature tools and apparatus enlarging the area of ​​the operating field, the nucleus pulposus can be precisely removed from the place where it puts pressure on the nerve structures. At the same time, intraoperative tissue trauma is much less extensive compared to traditional surgical access. The advantage of microdiscectomy is that it does not interfere with the structures of the spine, which gives a better cosmetic effect, enables early upright standing and shortens the recovery period.

Standing up and walking is only possible with the consent of the surgeon. Uprighting usually takes place on the same day or on the second day after the surgery. The patient receives a discharge from the hospital after an examination confirming good general and neurological condition.

Discectomy is the removal of the nucleus pulposus that slipped out of the degenerated intervertebral disc and led to irreversible pressure on the nerve root. Nerve root decompression enables the restoration of muscle functions supplied by the compressed nervous structure (lifting of paresis). The endoscopic procedure is characterized by low invasiveness - it requires making one or two small holes (approx. 5 mm) on the back through which surgical instruments and a camera are inserted. There is no need to cut the muscles or bone elements of the spine. As a result, the patient's convalescence period is shorter compared to an open surgery.

The indications for surgical treatment are irreversible pressure of the nucleus pulposus on the nerve root. An urgent indication is the occurrence of complications in the form of limb paresis or dysfunction of the sphincters (urinary incontinence). Surgical treatment is also undertaken in the case of no effects of rehabilitation, anti-inflammatory and analgesic treatment, when pain and / or sensory disturbances persist and negatively affect the patient's quality of life.

The discectomy procedure is most often performed under local anesthesia, i.e. local deprivation of sensory stimuli. In most cases, general anesthesia is not necessary.

Laminophoraminotomy is one of the methods of surgical treatment of herniated intervertebral discs. This procedure is often performed within the cervical spine. The operation consists in cutting the laminae of the arches of two adjacent vertebrae, widening the intervertebral foramen, and then removing the nucleus pulposus compressing the nerve root or the meningeal sac.

In the early postoperative period, it may be necessary to wear an orthopedic collar to stabilize the cervical spine (if recommended by your doctor). On the seventh day after the procedure, the operated area and the patient's neurological condition are checked, and the stitches are removed. Then the patient should strictly follow the doctor's instructions and participate in rehabilitation. Convalescence after surgery is a very individual process, depending on the type of surgery performed, its course, the presence of possible complications and the patient's involvement in rehabilitation.

If rehabilitation and painkillers do not alleviate the pain, it may be necessary to insert an implant between the spinous processes. The implant increases the distance between the spinous processes, reducing pain resulting from mechanical tissue irritation. Qualification for surgery is performed by a surgeon on the basis of a clinical examination and assessment of X-rays and other imaging tests. Sometimes the pain may result from multiple pathologies present in the course of degenerative disease of the spine, therefore it is very important to carefully diagnose and plan the appropriate treatment.

After the procedure, the mobility of the lumbar spine is limited. It is contraindicated to perform bends, sudden rotations and lifting heavy objects. The recommended form of activity is swimming and exercises to strengthen the muscles in a lying or supported kneeling position. Following the doctor's recommendations after the procedure reduces discomfort in the spine and extends the life of the implants. Individual activity limitations are discussed with the patient during a medical visit.

Treatment of Dupuytren's contracture should be selected by a specialist physician to suit the individual needs of the patient. After the correct diagnosis has been made, the patient is usually referred to surgery, which is minimally invasive, well-tolerated by patients and gives long-term, satisfying results that improve the patient's quality of life. After the surgery, rehabilitation procedures should be implemented, aimed at maintaining the range of motion in the joints, loosening the postoperative scar and accelerating the recovery. I use orthopedic equipment in the form of a splint that keeps the fingers in extension to consolidate the effect.

The course of the disease is usually unnoticeable in the early stages. Only later do thickened bands of connective tissue and palpable nodules appear under the skin. The bending contracture of the fourth and fifth fingers is characteristic, i.e. the ring and the small fingers. There are problems with straightening the fingers during various activities, and with time straightening is no longer possible. The earlier we see a doctor, the better the prognosis and the possible full recovery.

Each surgical procedure interferes with our body and carries a certain risk. It is worth choosing a proven facility where the patient is qualified for the procedure and operated by an experienced surgeon. The availability of a physiotherapist who, in consultation with a doctor, will conduct manual therapy and teach you appropriate exercises is also important.

The first symptoms of rheumatoid arthritis develop slowly. Periodic low-grade fever appears, accompanied by pain in joints and muscles. There are morning stiffness, tactile pain and symmetrical swelling of the joints. Rheumatoid arthritis most often affects the small joints of the hands and feet, less often the elbow, knee and hip joints. The diagnostic process of RA should be carried out by a rheumatologist or orthopedist.

Due to the inflammatory nature of RA, drugs to suppress arthritis and immunosuppressants are the main methods of fighting the disease. A form of non-pharmacological treatment in patients who have been taking medications for a minimum period of 3-6 months is a surgical procedure consisting in the removal of the synovial membrane of joint capsules and tendon sheaths. The synovial membrane is the primary focus of inflammation, and its resection prevents the spread of lesions to adjacent tissues and reduces the degree of deformation. Other methods of treatment include rehabilitation, the use of orthoses to stabilize the joints and psychotherapy of the patient (due to the progressive nature of RA).

Corrective boutonniere and swan neck finger deformities can be treated surgically using a tendon transfer procedure. This procedure influences the direction of the tendon forces on the finger joints and reduces the degree of deformation. Persistent deformities require arthrodesis (stiffening the joint) or implantation of an artificial finger joint prosthesis. The surgical method is selected by the surgeon who qualifies for the procedure.

Symptoms of a dislocated finger are pain and swelling in the joint area, an abnormal deformity of the finger and an inability to move. A dislocated toe is a dislocation of the finger joint, but it can also be accompanied by a fracture in the area of ​​the joint. To find out if a fracture has occurred, an X-ray should be taken.

The pain and swelling of the finger associated with contusions is due to damage and secondary inflammation of the soft tissues. Pain symptoms may last up to 2-3 weeks and during this period they decrease.

A "skier's thumb" injury usually results from a fall on the arm with the thumb exposed and the thumb resting on the handle of the ski pole. The essence of the injury is damage to the ligament, which stabilizes the metacarpophalangeal joint of the thumb from the side of the index finger. The result of the injury is pain, swelling, and possible instability in the thumb joint, making it difficult to grasp larger objects.

Finger numbness is usually a symptom of neuropathy, i.e. dysfunction of the peripheral nerves. Numbness of individual fingers in one hand is most often the result of pressure on the nerve by other tissues, e.g. inflammatory edema, connective tissue scars or degenerative changes. Within the upper limb, places of frequent nerve compression are the wrist and the elbow joint area. The cause of sensory disturbances may also be compression of the nerve root due to degenerative changes in the cervical spine. Symmetrical numbness of the fingers, on the other hand, may indicate a systemic cause of neuropathy, e.g. diabetes, which leads to the weakening of nerve conduction in all the smallest nerves of the human body. In the event of the appearance of the above-mentioned symptoms, it is necessary to consult a doctor who will conduct a detailed diagnosis and establish a treatment plan.

The surgical procedure in the course of the ulnar nerve groove consists in removing the cause of the nerve compression. It is usually a resection of degenerative bone lesions or connective tissue scars limiting the displacement of the ulnar nerve. The procedure requires a few centimeters incision along the nerve path in order to carefully work out the area of ​​the medial area of ​​the elbow. After the surgery, rehabilitation is necessary, which helps to restore the proper slide of the nerve and allows the weakened muscles of the upper limb to be strengthened.

When local inflammation is the cause of nerve compression, therapy is aimed at reducing the inflammation and rapidly evacuating the edema. It is advisable to take anti-inflammatory drugs and to temporarily relieve the limb. However, when post-inflammatory tissue adhesions have occurred or the cause is a bone change or a growing tumor, surgical removal of the lesion is necessary. In the case of overload neuropathies, it is recommended to rest and give up the activity that aggravates the symptoms. In patients who have relapsed neuropathy, surgery is the only effective method of permanent cure.

The essence of de Quervain's disease is mechanical irritation and inflammation of the tendon sheaths of the thumb extending and abducting muscles. The symptom of the disease is pain on the dorsal part of the thumb and the wrist area under the thumb, which increases with grasping and manipulative movements of the hand, and softens when resting. There may be slight swelling and tenderness of the dorsal part of the thumb. The occurrence of the above symptoms should prompt you to visit an orthopedist who will assess the condition of the tendon sheaths, exclude the presence of other pathologies and propose appropriate treatment.

Conservative treatment of de Quervain's disease consists of:

- wearing an orthosis that stabilizes the wrist and the metacarpophalangeal joint of the thumb,
- avoiding movements that exacerbate pain in the thumb and wrist,
- myofascial therapy,
- treatments in the field of physical therapy,
- the use of anti-inflammatory drugs.

In case of severe ailments, a blockade is performed, i.e. a corticosteroid is administered to the inflamed tendon sheath. If the conservative treatment is unsuccessful, a surgical procedure is performed to remove adhesions that prevent the free sliding of the thumb tendons. After the surgery, it is necessary to participate in rehabilitation, which includes scar mobilization, restoration of full thumb mobility and gradual strengthening of the grip strength.

De Quervain's disease is a term used to refer to two different conditions - thumb muscle tenosynovitis and thyroiditis.

Symptoms of carpal tunnel syndrome include numbness in the fingers, tingling in the hand, pain in the hand and forearm, which often occurs at night, weaker grip strength, difficulty in performing precise tasks or holding small objects.

The most vulnerable to carpal tunnel syndrome are people who work for a long time at the computer, on the production line, musicians, cyclists, seamstresses - people who often repeat the same movements of the wrist.
The doctor decides whether surgery is necessary - in the early stages of the disease, surgery may not be necessary. However, it should be emphasized that surgical decompression of the median nerve gives the best treatment results.

The doctor decides whether surgery is necessary - in the early stages of the disease, surgery may not be necessary. However, it should be emphasized that surgical decompression of the median nerve gives the best treatment results.

The procedure is short-lived - the operation itself takes 10-15 minutes. Patients usually return home on the same day after surgery.

Depending on the patient's condition and the type of work performed, return to overseas activity is possible in the period between 2 and 8 weeks after the surgery. Usually, patients return to work 3 weeks after the surgery.

The term "tennis elbow" is used to describe a pain in the area of ​​the lateral epicondyle of the humerus, which increases when the fingers and wrist are straightened. Pain is often accompanied by decreased strength and dysfunction of the upper limb. The symptoms of tennis elbow are not the result of inflammation but of degenerative changes involving the attachments closer to the tendons of the wrist extending muscles.

Pain from a tennis elbow appears on the lateral side of the elbow and may radiate to the dorsal part of the forearm and hand. Patients complain of increasing pain when straightening the fingers, wrist and elbow. Most often, severe pain occurs when lifting heavy objects, twisting or unscrewing (jars, screws, etc.), shaking hands when greeting. The pain may be so severe that some patients are unable to even lift a glass of water. Additionally, there may be weakening of the wrist strength and weakening of the functions of the upper limb.

The disease is common among tennis players (hence the name). However, it is primarily people who use their hands in their work, especially if they constantly make the same wrist and elbow movements, repeated many times - builders, plumbers, mechanics, painters, carpenters, people working in production plants, seamstresses, musicians. A large group of patients are also people whose work is related to the constant use of a computer - programmers, computer graphic designers, office workers and even writers. Tennis elbow is also common among people actively involved in sports - exercising a lot in the gym, especially if they put an intense strain on the muscles of the forearms. This disease usually occurs in people over 40 years of age.

To reduce pain, you can apply temporary cold compresses as well as painkillers and anti-inflammatory agents. However, it should be remembered that they only bring short-term relief, without eliminating the cause of the pain. A very important element of treatment is rehabilitation, which consists in manual therapy of soft tissues and physical therapy (e.g. shock wave treatments). Surgery is performed in the case of persistent, severe pain in the elbow and failure of conservative treatment.

Conservative treatment is mainly used. Avoid movements that overload the extensor muscles of the wrist and cause pain. The range of treatment methods includes: manual therapy, massage, wrist extensor stretching exercises, cryotherapy, needle therapy, shock wave treatments, plasma injections with concentrated platelets (biological treatment).

Tennis elbow is not caused by inflammation, so drug treatment misses the point. In exceptional cases, steroid drugs are administered - when pain prevents the patient from functioning or acute swelling has occurred. However, it is an emergency treatment and cannot be used for a long time

When, after one year of conservative treatment, severe pain in the elbow does not disappear - the patient is qualified for surgery.

A ganglion is a small fluid-filled cyst that can be found under the skin or in deeper tissues. Ganglions are most common in the wrist, foot, and ankle joint. Common symptoms of ganglion are:

presence of a soft lump under the skin,
possible soreness in the joint with the lump in it,
possible palpation of the muscle tendons near the ganglion

Treatment of a ganglion includes types of procedures: aspiration of the contents of the nodule, administration of a steroid block to the nodule, or complete removal of the ganglion.

Most ganglions are painless and do not require treatment - observation of the lesion is sufficient management. When ganglion causes local pain or causes compression of a nerve or blood vessel, the ganglion should be removed.

A blockage of the spine involves injecting the spine with a strong anti-inflammatory drug - a steroid, thanks to which the pain in the spine is reduced or eliminated. The procedure is performed under the control of fluoroscopy (X-ray view) in an outpatient setting.

The first analgesic effect that appears a few hours after the injection is due to the anesthetic drug given together with the steroid. The proper analgesic effect of Diprophos begins on the 3-7th day after the injection and lasts for several weeks (usually 4 weeks). If necessary, the blockade can be repeated, but there should be no more than 3-5 spine injections a year. Some patients, after blockage, function without back pain for a longer period of time and do not even need additional injections.

The spine injection procedure called a steroid blockade is an effective method of treating sciatica pain. The ingredient in the injectable drug is a steroid that works by inhibiting the inflammatory response responsible for pain. There are many preparations available on the market that are used for spine injections, such as Diprophos or Depo-Medrol.

Back pain can be treated both by an orthopedist specializing in the treatment of the spine and by a neurosurgeon. After collecting a detailed history, examination of the spine and analysis of imaging tests, the doctor should suggest the optimal methods of conservative or surgical treatment. The choice of treatment depends on the severity of the disease, the level of severity of back pain, the attempts to treat the spine so far and the presence of comorbidities in the patient. Conservative treatment can be carried out by an orthopedist with the active participation of a physiotherapist. If an invasive procedure (e.g. spine blockade) or surgery is required, treatment should be carried out by an experienced neurosurgeon.

The knee block is the injection of a steroid with strong anti-inflammatory and analgesic properties into the knee joint. The procedure is justified in the case of inflammation of the knee bursa or the joint itself. The blockade can be given in the case of advanced knee degeneration - the steroid does not heal degenerative changes, but it significantly alleviates pain. The steroid is injected into the knee under ultrasound guidance.

A steroid blockade is the topical administration of a steroid-containing drug (e.g., Diprophos) that has strong anti-inflammatory and analgesic properties. The steroid is given as an injection under ultrasound or fluoroscopy guidance. Injection sites may include a joint, bursa, tendon sheath, nerve area, or subcutaneous tissue. A steroid blockade does not cure the cause of the disease, but inhibits inflammation and thus can effectively reduce the level of pain. It is recommended that blockages be performed only in case of severe pain that does not go away despite the use of other conservative treatments.

Due to the possible side effects in the form of weakening of the tissue structure, it is recommended not to administer the steroid to the same place more than 3-5 times during the year. The attending physician decides whether to repeat the injection.

A typical symptom of an umbilical hernia is a palpable bulge around the navel. It may contain the peritoneum and / or displaced organs of the abdominal cavity (most often the intestines). Gradually, the hernia grows - from a few millimeters lesion to a hernia the size of a reticulated ball. A hernia may be accompanied by abdominal pain around the navel, which is aggravated by coughing, sneezing or passing stools. Ailments can also be caused by applying pressure to the hernia with the hand in order to discharge its contents into the abdominal cavity.

In adults, umbilical hernia is an indication for surgery. The operation consists in draining the peritoneum and internal organs into the abdominal cavity and closing the hernia's gates. In some cases, it is necessary to strengthen the abdominal wall with a special mesh that prevents recurrence of the hernia.

The duration of the operation depends on the size of the hernia and on the procedures necessary during the procedure (e.g. additional mesh implantation). The operation usually takes 30 minutes to 1.5 hours.

The length of the sick leave depends on the type of work performed. After hernia surgery, the activities of lifting heavy objects and a sharp increase in pressure in the abdominal cavity should be avoided. The period of release is usually around 2 months.

Symptoms of an abscess are pain in the buttock, a feeling of distension in the muscle, increased warmth and possible reddening of the skin. Local symptoms may be accompanied by general malaise and fever. An abscess should not be underestimated - its rupture may lead to spread of infection and serious complications, including sepsis. You should see a surgeon who will assess the size of the abscess and decide on drainage and antibiotics.

Superficial abscesses are removed under local anesthesia. The surgeon cuts the abscess and evacuates its contents, which are then subjected to culture tests. If necessary, the surgeon will insert a filter that allows the continuous removal of pus from the wound. Filters are replaced within 1-3 days. The wound after the procedure is sutured and covered with a dressing. If local anesthesia is used, there is no need for hospitalization - the patient may leave the hospital on the day of the procedure. Follow-up visits with assessment of wound healing follow a schedule determined by the physician.

Ingrown nails can be treated conservatively with a special clamp placed by a podiatrist. Surgical excision of the ingrown nail is performed in the case of very advanced lesions and in the event of failure of podological treatment. It is a safe and completely painless procedure, but it involves a temporary loss of part or all of the nail plate. After the treatment, the nail gradually grows back.

The toenail grows to its full length, usually 12-16 months after its removal.

You can walk right away after the nail removal procedure. Due to the fact that a dressing is put on the toe, it is necessary to have open shoes or boots with very wide tips. However, long-term walking should be avoided until the stitches are removed (10-14 days). The foot should be kept above thigh level as often as possible and cold compresses should be applied.

The presence of stones in the gallbladder (gallbladder) may initially be asymptomatic. Only when the accumulated deposits impede the outflow of bile from the gallbladder, symptoms typical of the so-called biliary colic. The pain is localized in the right upper abdomen and usually begins up to 2 hours after eating a fat-rich meal. Pain relief is achieved by taking painkillers and relaxants. Due to the location of the gallbladder, the symptoms associated with urolithiasis are often interpreted as a symptom of liver dysfunction. In order to diagnose the problem, visit a gastroenterologist or perform an ultrasound examination of the abdominal cavity.

The only effective method of removing stones is surgery, which involves the complete excision of the gallbladder (cholecystectomy). The absence of a gallbladder does not disturb the digestive functions and does not significantly reduce the quality of life after surgery.

A laparoscopy of the gallbladder takes about an hour. The duration of the procedure depends on the patient's individual anatomical conditions and the surgeon's proficiency in performing this type of surgery.

The removal of the gallbladder by laparoscopy allows you to get up and walk quickly and reduce pain after the procedure. The discharge usually takes place on the second day after surgery.

Pain ailments result from the healing of disturbed tissues within the abdominal cavity and are a natural phenomenon. Mild abdominal pain may persist for up to a week after the procedure, but should be of a decreasing nature. If pain worsens, flatulence or vomiting occurs, consult a doctor.

In the period of 4-6 weeks after the procedure, it is advisable to follow a low-fat diet. An easily digestible diet based on natural ingredients is recommended. Purees of boiled vegetables and fruits without peel, lean meat, fish, light bread, natural yoghurts are allowed. Highly bloating vegetables such as beans and cabbage should be avoided. Foods fried in fat, carbonated drinks, spicy spices and alcohol are forbidden. A few months after the surgery, you can gradually return to your normal diet, maintaining the general principles of healthy eating.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

W okresie 4-6 tygodni po zabiegu wskazane jest stosowanie diety ubogotłuszczowej. Zalecana jest lekkostrawna dieta oparta na naturalnych składnikach. Dozwolone są przeciery z gotowanych warzyw i owoców bez skórki, chude mięso, ryby, jasne pieczywo, jogurty naturalne. Należy unikać warzyw wzdymających takich jak fasola czy kapusta. Zakazane są potrawy smażone na tłuszczu, napoje gazowane, ostre przyprawy oraz alkohol. Po kilku miesiącach od zabiegu można stopniowo powrócić do normalnej diety z zachowaniem ogólnych zasad zdrowego odżywiania.

 

 

 

 

 

 

 

 

 

 

Varicose veins are treated by a vascular surgeon and / or an angiologist. It is worth going to a doctor who will perform an ultrasound of the veins. Thanks to the ultrasound examination, it is possible to accurately assess the venous system - it facilitates the selection of the appropriate treatment method.

There are many methods of treating varicose veins in the lower extremities. Treatment should be directed by an angiologist or vascular surgeon. Compression products (knee socks, tights, anti-varicose stockings) are available in medical stores, which reduce leg swelling and facilitate the return of venous blood towards the heart. This prevents to some extent the build-up of varicose veins and the appearance of new foci of "spider veins" on the legs. Small and medium-sized varicose veins can be treated with sclerotherapy or by local varicose excision (miniphlebectomy). Varicose veins of larger diameter are eliminated by performing the so-called stripping of the saphenous or small saphenous vein. The surgery to remove insufficient superficial veins and varicose veins in their basin shows the greatest effectiveness in the treatment of varicose veins.

Operations of varicose veins are low-risk procedures. As with any surgery, complications are possible, but they are very rare. When deciding on the operation of varicose veins, it is worth choosing an experienced vascular surgeon who will select the most appropriate surgical techniques for the patient's condition.

You are discharged from the hospital on the day of surgery or on the next day after surgery.

Light leg pain after surgery may persist for 2-3 weeks. During this period, you should strictly follow the doctor's instructions, perform the exercises recommended by the physiotherapist and avoid excessive overloading of the operated limb. If necessary, your doctor may prescribe painkillers.

For cosmetic reasons, moles can be removed with a laser. However, when the mole has atypical features that threaten the development of skin cancer (melanoma), surgical excision of the lesion is indicated. The mole is removed entirely within the boundaries of healthy skin tissues, and the collected material is sent for histopathological examination.

The features of dysplastic lesions include enlargement and change in shape of the mole, discoloration, and pain or bleeding from the mole. If disturbing symptoms occur, the change should be consulted with a dermatologist. Do not delay the visit to the doctor - melanoma is a very aggressive cancer and too late diagnosis significantly reduces the chances of a successful cure.

Surgical removal of the mole is a minimally invasive procedure usually performed under local anesthesia. The risk of any complications is small due to the excision of superficial tissues. The procedure takes about 20-30 minutes. The patient can go home 2-3 hours after the procedure.

Rectoscopy is also known as an endoscopy of the rectum. During the examination, the patient is in the knee-elbow position or lying on his side. The doctor inserts a camera with a light source (rectoscope) through the anus. Thanks to covering the speculum with an anesthetic, the examination is very well tolerated by the patient. The diagnostic procedure of rectoscopy enables the detection of pathological changes in the intestinal wall, such as polyps, diverticula, ulcers and colorectal cancer. Rectoscopy also allows you to remove the detected lesions and stop any bleeding.

The rectoscopy procedure is painless, although it is possible to feel a slight discomfort related to the presence of a rectoscope in the intestine.

3 days before the procedure, you should start using an easily digestible diet, preferably in a liquid form. In the evening before the examination, an enema should be performed. On the day of the examination, do not eat anything, only drink water. A second enema should be performed 1-2 hours before rectoscopy. Proper preparation makes it easier for the doctor to perform the examination.

Removal of atheromas or lipomas is a minimally invasive procedure. Small-sized cysts or lipomas may be excised under local anesthesia on an outpatient basis. After the small wound has been secured with stitches and a dressing, the patient can go home. In very rare cases, it is necessary to use general anesthesia (large dimensions and difficult localization of the lesion, multiple lesions). After waking up from general anesthesia, the patient must remain in the hospital for at least one day for observation.

Surgical removal of the fibroma is associated with the disruption of the skin, so after the procedure, scar formation should be taken into account. However, it is very small and will remain less visible if it undergoes regular massage after removing the stitches.

For small, several-millimeter atoms, you can use an astringent compress made of horsetail leaf infusion. This will reduce the secretion of sebum and facilitate the absorption of the atheroma. However, if this does not help or the atheroma is more than 5 mm, a dermatologist or surgeon should be consulted. The doctor will evaluate the change - whether it is a benign nodule. When the atheroma is an aesthetic problem, it is surgically excised. The atheroma removal procedure is painless and safe, so you shouldn't be afraid of it.

Ultrasound is an imaging method that allows you to visualize bone contours and superficial soft tissues. The knee ultrasound allows the assessment of tendons, collateral ligaments, bursae and the vessels of the popliteal fossa. Ultrasound examination of the knee joint shows some limitations in the diagnosis of meniscus and cruciate ligament injuries. Knee magnetic resonance imaging is a test that enables a precise assessment of intra-articular structures.

Ultrasound does not require special preparation. It is a non-invasive and completely safe test, so pregnant women and young children can use it. It is worth bringing the results of other imaging tests (eg knee X-ray) and laboratory tests (blood, urine) with you for the ultrasound examination.

The doctor authorized to perform the knee ultrasound is an orthopedist or a radiologist after completing training in the ultrasound of the knee joint.

Ultrasound is used to assess superficial tissues. It is an easily available examination method and much cheaper compared to magnetic resonance imaging (MRI), but it does not allow for a complete assessment of intra-articular structures. MRI of the knee is performed when it is necessary to precisely assess damage to the articular cartilage, menisci and cruciate ligaments. MRI is the gold standard in diagnostics before a planned surgery.

In order to exclude an ankle fracture, an X-ray of the ankle joint is recommended. This is especially recommended in the case of severe pain and massive swelling and the inability to load the limb in the three-step test. Ankle ultrasound should be performed in every case of ankle sprain to assess the efficiency of the damaged ligaments and to exclude the presence of complications in the pathology of other soft tissues.

Ankle ultrasound examination is a non-invasive imaging examination using ultrasound waves. During the ultrasound examination, the radiologist or orthopedist applies a special head to the ankle, first applying a coupling gel to the skin of the examined area. All soft tissues surrounding the ankle (ligaments, muscle tendons, straps, nerves, blood vessels) are assessed. Ultrasound images also show the synovium and the contours of the anterior part of the Talus. During the so-called dynamic ultrasound examination, the doctor performs special tests to assess selected structures (e.g. the efficiency of ligaments). It may also ask you to tighten a muscle or make a specific movement with your foot.

Ultrasound of the hip shows inflammation, exudate and free bodies inside the hip joint. Ultrasound can detect damage to the tendons in the muscles surrounding the hip joint or in the groin area. Moreover, it is possible to evaluate the course of nerves supplying the lower limb in order to exclude neuropathy from compression.

In order to properly diagnose the cause of hip pain, it is often necessary to perform both tests - X-ray and ultrasound. X-ray pictures show degenerative and productive changes in the bony parts of the hip. Ultrasound makes it possible to evaluate the soft structures surrounding the joint (ligaments, tendons, muscles, bursae) and allows for their evaluation in relation to the bone contours of the joint during hip movement (the so-called dynamic ultrasound examination). In some cases, it is necessary to perform magnetic resonance imaging, which is the only one to accurately assess the damage to the cartilage of the hip joint, labrum and other structures that are poorly accessible by ultrasound.

Ultrasound of the hip joint enables imaging of hip structures thanks to the use of ultrasound waves emitted by the ultrasound head. It is a non-invasive and completely safe test - it can be repeated many times in children and pregnant women. Hip ultrasound does not require special preparation, but if you have previously taken X-rays of the hip joint, bring them to your appointment. The examination requires uncovering the groin and the side of the buttock. Depending on the range of assessed structures, the ultrasound examination of the hip lasts from 15 to 30 minutes.

Shoulder ultrasound is mainly used to assess the pathology and damage within the tendons of the muscles - most often the tendons of the supraspinatus, which is part of the so-called the rotator cuff. Thanks to the ultrasound examination of the shoulder, it is also possible to diagnose pathologies related to the remaining tendons of the shoulder muscles, features of degenerative changes, inflammation of the synovial bursa and general joint inflammation, e.g. in the course of systemic diseases such as RA.

A dynamic ultrasound examination of the shoulder allows the assessment of the mutual relationship between soft tissues (tendons, muscles, bursae) and bone elements during arm movements. The dynamic examination is most often used to determine the cause of the damage to the supraspinatus tendon. Thanks to the ultrasound, it is possible to locate the conflicting structures and to visually determine the disturbances in the biomechanics of the shoulder joint. Dynamic ultrasound helps the doctor choose the appropriate treatment method for most soft tissue pathologies.

Shoulder sonosurgery is a term used to describe percutaneous procedures performed under ultrasound guidance. Within the shoulder, ultrasound is used to monitor the position of the needle as the drug is administered to specific joint structures. Most often it is the administration of a steroid block to the changed subacial bursitis and the injection of overloaded rotator cuff tendons with plasma. Under ultrasound guidance, a percutaneous procedure is also performed to remove calcification within the tendons of the rotator cuff muscles and joint puncture, i.e. collection of synovial fluid for diagnostic or therapeutic purposes.

A dynamic ultrasound examination of the shoulder allows the assessment of the mutual relationship between soft tissues (tendons, bursae) and bone elements during arm movements. The dynamic examination is most often used to determine the cause of damage to the tendon of the supraspinatus muscle running in the subacromial space. Thanks to the ultrasound, it is possible to locate the conflicting structures and to visually define the disorders of the biomechanics of the shoulder joint. Dynamic ultrasound helps the doctor choose the appropriate treatment method for most soft tissue pathologies.

The ultrasound of the elbow joint allows, first of all, to assess the bone contours and the condition of the soft tissues surrounding the elbow joint (tendons, muscles, bursae, nerves). The indication for performing a magnetic resonance imaging of the elbow (MRI) is an ambiguous ultrasound examination result or the need for a precise evaluation of cartilage and bone injuries of the elbow joint, which can only be seen on MRI scans.

Ultrasound of the elbow does not require special preparation from the patient. Ultrasound is a non-invasive and completely safe examination - pregnant women and young children can use it without restrictions. For the ultrasound examination, it is worth bringing with you previously taken X-rays of the elbow joint, which will help the doctor interpret the bone outlines visible in the ultrasound examination.

During the ultrasound examination, the doctor places a special probe dedicated to the examination of small joints and smaller anatomical structures of the body to the dorsal or palmar surface of the wrist, hand or fingers. The scope of the examination depends on the indications resulting from the clinical picture. Ultrasound examination of the hand allows for the identification of damage to muscle tendons, inflammation of the tendon sheaths and joints, as well as degenerative and productive changes. Thanks to the ultrasound examination, it is possible to assess the course of the median and radial nerves and the possible cause of compression of these nerves.

The ultrasound examination may be performed by a radiologist, orthopedist or rheumatologist with a certificate of training in ultrasound of the wrist and hand structures.

Hand ultrasound does not require any special preparation. It is worth bringing the results of other tests, e.g. X-rays of the hand, laboratory results for rheumatoid diseases or the results of nerve conduction test in case of suspected compression neuropathy.

The duration of hand ultrasound depends on the range of structures assessed. In the case of rheumatological changes, the wrist and each finger are assessed separately, which may extend the duration of one hand examination to 50 minutes. When clinical examination indicates the need for an ultrasound examination of a single structure, e.g. the median nerve in the carpal tunnel, the ultrasound usually takes about 10-15 minutes.

During the ultrasound examination, the doctor moves a head emitting ultrasound waves over the examined area. The test does not emit ionizing radiation harmful to the body, therefore it is completely safe and can be repeated freely. During the ultrasound scan, your doctor may ask you to move your limb or tighten a muscle. This enables the functional assessment of the muscle and the mutual displacement of the surrounding soft tissues.

Ultrasound examination enables the diagnosis of overload conditions, acute sports injuries and chronic diseases affecting the skeletal muscles of the body. Ultrasound also allows detecting tissue conflicts, e.g. compression of a nerve by a hematoma or inflammatory edema. In addition, thanks to ultrasound, it is possible to detect tumors of the muscle tissue, which allows for quick commissioning of additional tests differentiating benign lesions from malignant neoplastic lesions.

Breast ultrasound examination can be performed on any day of the cycle - at the Dworska Hospital in Krakow, we have equipment that enables precise assessment of changes, regardless of the day of the cycle.

Ultrasound is performed by a radiologist or gynecologist trained in breast ultrasound diagnostics.

Every woman can come to a breast ultrasound without the need for a referral. Ultrasound is an easily accessible, fast and completely safe method of imaging. Breast ultrasound can be repeated without restrictions, therefore it is the most frequently performed examination at the beginning of the diagnosis of suspicious changes. During the ultrasound examination, the doctor may order a mammogram if he deems it necessary. Mammography is more often ordered in women over 50 because it is better suited for imaging breasts with less glandular tissue.

Ultrasound examination of the thyroid gland is a non-invasive and completely safe method of imaging. For an ultrasound examination of the thyroid gland, you should bring your previous ultrasound results and the results of laboratory tests indicating disorders of the thyroid gland (measurements of thyroid hormone levels) - if previously prescribed by a doctor. Besides, ultrasound examination of the thyroid gland does not require special preparation.

During an ultrasound examination of the thyroid gland, the radiologist places a special head emitting ultrasound waves on the front part of the neck. This test is non-invasive and may be repeated many times in children and pregnant women. Thyroid ultrasound is based on the imaging of the thyroid gland and adjacent tissues along with the lymph nodes in the neck. Ultrasound of the thyroid gland allows for an objective measurement of the volume of the thyroid gland and the identification of enlarged thyroid gland (the so-called goiter). Ultrasound also allows you to determine the location and size of any nodules on the thyroid gland. The morphological features of the nodules visualized on ultrasound along with the clinical picture may determine the need for a thyroid biopsy.

Most thyroid nodules are benign and have no negative effects on the body. However, each nodule requires careful examination to exclude the source of hormonal disorders or thyroid cancer. To do this, you should visit the thyroid gland ultrasound.

The content of the digestive tract may obscure the picture of organs, so it is advisable to refrain from eating for about 6 hours before the examination. In addition, in the period of 2 days before the examination, heavy and flatulent meals should be avoided. The day before the abdominal ultrasound examination, it is recommended to take an intestinal gas reducing agent (eg Espumisan), because their excess may also make diagnostics difficult.

1-2 hours before the abdominal ultrasound examination, drink one liter of still water (4 glasses). You should come for an ultrasound scan with a full bladder - it makes it easier for the doctor to assess the urinary system and the organs in the pelvis. It is forbidden to drink tea or coffee, so as not to stimulate the intestinal peristalsis.

Abdominal ultrasound is a non-invasive and completely safe method of imaging. If necessary, the ultrasound examination can be repeated any number of times. It is worth remembering that ultrasound does not detect all pathologies responsible for abdominal pain. When ultrasound is not sufficient to make a diagnosis, the doctor orders additional tests (gastroscopy, colonoscopy, magnetic resonance imaging, computed tomography).

During the ultrasound examination of the abdomen, it is not possible to assess the lumen and mucosa of the gastrointestinal tract. Under certain conditions, ultrasound may reveal appendicitis and the presence of large tumor masses indicating advanced stage colorectal cancer. The doctor will order a colonoscopy to evaluate the changes in the intestines more accurately.

Lymph nodes are small, oval-shaped lumps that are found in various parts of the body. around the neck, over the collarbones, in the armpits, in the groin and in the abdomen. Lymph nodes are part of the immune system - the lymph flowing through the lymph nodes from the body tissues is filtered for the presence of microbes. When an infection occurs, the lymph nodes produce cells related to immune processes. Thanks to this, bacteria, viruses and fungi are rendered harmless. In the course of an infection, the lymph nodes become temporarily enlarged, which is completely normal. It is worth noting that lymphadenopathy may also be a symptom of many serious diseases, and even cancer. To assess whether the observed condition is physiological or pathological, ultrasound of the lymph nodes is performed.

Enlarged lymph nodes appear as oval lumps that can be felt by palpating the subcutaneous tissue around the neck, groin or armpits. Lymphadenopathy is observed during infection. Less frequently, it may be a symptom of a systemic disease, cancer of the lymphatic system or neoplastic metastases. The image of the structure of the lymph nodes can be visualized during ultrasound examination (USG).

Painful to the touch, soft and sliding enlarged lymph nodes are most often an expression of an infection in the body. As the inflammation is calmed down, the lymph nodes, as a rule, cease to be tender to touch and gradually shrink. The most dangerous, however, are painless, hard and compact enlarged lymph nodes, because their presence may indicate an active neoplastic process (e.g. lymphoma, leukemia or neoplastic metastasis). In the event of such changes, an urgent ultrasound examination of the lymph nodes should be made.

Superficial lymph nodes are located on the sides of the neck. When the body remains healthy, the lymph nodes are usually not felt. Enlargement of the lymph nodes in the neck is observed, among others, in in the course of pharyngitis (angina) or tooth decay. Palpation is used to assess the consistency of an enlarged lymph node. A physiologically enlarged lymph node (in the course of an infection) is soft, easy to move, but can be painful. The abnormal pathological enlargement of the lymph node (cancer) may be indicated by a compact, hard structure fused with the substrate, and the lymph node itself is painless. Ultrasound examination (USG) and lymph node biopsy enable a more precise assessment of the lymph nodes.

 Lymphadenopathy is not a separate disease entity. Lymphadenopathy may be a symptom of infection, systemic disease, or cancer. Treatment is always directed to the cause of lymphadenopathy.

An indication for ultrasound of the salivary glands is painful swelling of the cheek area in front of the ears or discomfort felt backwards from the chin. The complaints usually worsen when eating and talking. A common symptom indicating pathologies of the salivary glands is also an unpleasant smell from the mouth and a chronic feeling of dry mouth. In the event of the above symptoms, you should see a doctor who will determine whether an ultrasound of the salivary glands and / or an ultrasound of the neck lymph nodes is necessary.

The most frequently diagnosed disease during ultrasound examination is salivary gland inflammation. Other pathologies include: congenital defects (e.g. incomplete development of the salivary gland), changes in the salivary glands associated with systemic and metabolic diseases, and benign and malignant neoplasms of the salivary glands. Ultrasound can also be used to detect the presence of a cyst, abscess or traumatic hematoma of the salivary gland.

The doctor puts a special head on the cheek in front of the ear, which emits ultrasound waves. On the monitor screen, the doctor observes the image of the salivary glands and adjacent structures of the neck obtained thanks to the reflection of ultrasound waves from the tissues. The test is non-invasive and completely safe for the patient. During ultrasound examination, the salivary glands are assessed on both sides of the face.

The enlarged prostate puts pressure on the urethra, which drains urine out of the bladder. Typical symptoms of prostate enlargement are: delayed and weakened stream of urine, feeling urgent to urinate, feeling of incomplete emptying of the bladder after urinating, pollakiuria. If these ailments occur, a urologist should be consulted who will perform an ultrasound of the prostate and assess the degree of possible prostatic hyperplasia.

A TRUS test is a type of ultrasound scan performed transrectally. The TRUS examination allows very accurate visualization of changes in the prostate, because the ultrasound head located in the rectum is very close to the prostate. During the examination, the patient lies on his side. The examination takes approximately 20 minutes.

A few hours before the examination, it is advisable to do an enema. This will improve the patient's own comfort and make it easier for the doctor to perform the examination.

 

The ultrasound examination of the testicles is performed by a doctor qualified in the field of ultrasound diagnostics of the genital organs (urologist, radiologist, surgeon).

The ultrasound does not require any special preparation. Before the ultrasound examination, the doctor palpates the scrotum. During the ultrasound examination, the doctor moves the ultrasound head over the scrotum. The monitor screen shows the image of the nuclei and adjacent structures obtained thanks to the reflection of ultrasonic waves. The examination lasts several minutes, is painless and has no negative effect on the function of the testicles.

A common symptom of testicular cancer is a painless lump on the testicle. Initial diagnosis is possible during the ultrasound examination of the testicles. In order to confirm the diagnosis, the level of tumor markers is determined. Abdominal ultrasound, lymph nodes ultrasound and chest tomography are also performed to visualize any metastases.

The most common indications for ultrasound examination of the kidneys and urinary tract are abdominal pain, pains radiating along the lumbar spine, abnormal urine test results, pain during urination, haematuria, blood pressure disorders.

Within two days before the date of the ultrasound, do not consume heavy or bloating products. On the day before the examination, you should take an agent that reduces gas accumulation in the digestive tract, eg Espumisan. The ultrasound should be performed on an empty stomach or not eaten for 6 hours before the examination. It is advisable that the bladder is full during the examination, therefore one liter of still water (4 glasses) should be drunk 1-2 hours before the ultrasound examination.

During the examination, the patient lies on his back; in cases of difficulties with visualizing the kidneys in other positions (on the side, back, standing). The doctor puts an ultrasound head emitting ultrasound waves to the body shells. The head is moved from the hypochondrium to the posterior region of the lower chest, to the side of the spine and along the lower abdomen. The image from inside the abdominal cavity appears on the monitor screen in real time. During the examination, the doctor may ask the patient to use the toilet and then re-evaluate the urinary tract. The ultrasound examination takes about 15-20 minutes and is completely painless and safe.

Disturbing symptoms that should be checked in ultrasound of the lungs include: chronic cough, chest pain, shortness of breath, breathing problems, traumatic conditions of the chest and hemoptysis. Ultrasound is an easily accessible and safe examination that does not expose the patient to X-rays. Ultrasound examination can be performed in young children and in pregnant women.

Ultrasound enables the assessment of the pleura and peripheral parts of the lungs. In the range available in the examination, the doctor can detect: pleurisy and pneumonia, interstitial lung diseases, pulmonary edema, pneumothorax, presence of pleural adhesions, pleural empyema, lung abscess. In order to extend the diagnostics with changes located in the deeper regions of the lungs, it is recommended to take an X-ray of the lungs or computed tomography.

The patient is asked to lie down and expose the chest. The doctor covers the surface of the patient's skin with a special gel and then applies the ultrasound head. The image of the pleura and lungs in the range available in the examination is displayed on the monitor screen. The ultrasound is painless and takes about 15-20 minutes.

Ultrasound of hip joints in children is a screening test that allows you to assess whether a child's hips are developing properly. An ultrasound scan is performed on a baby between 4 and 6 weeks of age. The second control date of the study is the period of 12-14 weeks of age.

Ultrasound of hip joints in children can detect abnormalities in the structure of pathological changes in the course of diseases such as: hip dysplasia, desquamation of the femoral head, Perthes disease (sterile femoral head necrosis).

Ultrasound of hip joints does not require special preparation. The examination is completely painless and safe for the child. The doctor places the transducer around the child's hip after applying a small amount of coupling gel to obtain the best image quality. The examination takes approximately 20 minutes.

Ultrasound examination is performed in children:
prematurely born (premature babies)
with a burden in the history of the pathology of the course of pregnancy,
with perinatal hypoxia,
with recognized developmental defects,
with impaired functions of the circulatory or respiratory system,
with meningitis,
with the presence of nonspecific neurological symptoms.
Ultrasound examination is possible in newborns and infants up to about 6 months of age or until the front fontanel is atrophied.

Ultrasound examination does not require special preparation. There is also no need to put the baby to sleep. The ultrasound examination is painless and completely safe for the baby. The doctor covers the top of the baby's head with a small amount of gel. Then, he places a special ultrasound head to the area of ​​the anterior fontanel, through which the ultrasound waves have a chance to reach intracranial structures. The echo image waves are observed on the ultrasound monitor. The test usually takes about 15 minutes.

An ultrasound of the thyroid gland can detect congenital abnormalities in the position of the thyroid gland, poor development of the thyroid gland, signs of inflammation of the thyroid gland or the presence of nodules. The thyroid ultrasound complements the diagnosis of hormonal disorders in children, e.g. hypothyroidism.

The ultrasound examination is based on the emission of ultrasound waves, the operation of which is safe for the child's body. Ultrasound examination can be performed even in newborns and infants. The thyroid ultrasound can be repeated at will, which makes it possible to regularly check the condition of the child's thyroid gland.

Abdominal ultrasound examination should be performed in each case of abdominal pain symptoms reported by the child, especially if the pain is accompanied by chronic constipation, diarrhea and fever. Frequent attacks of colic occurring in newborns and infants, regardless of the type of food consumed, are a disturbing symptom. It is worth noting that some diseases, and even tumors of the abdominal cavity initially do not have to show clear symptoms. Ultrasound screening allows the early detection of these abnormalities in children, greatly increasing the chances of a successful cure.

Fasting enables a more accurate assessment of the abdominal organs (food masses do not obscure the image of internal organs). If possible, your baby should not eat for 3 hours before the ultrasound scan. A filled bladder facilitates the assessment of the pelvic organs, therefore it is recommended that the child drink 2-3 glasses of still water an hour before the examination.

The ultrasound examination of the abdominal cavity of children can be performed by a radiologist or pediatrician.

Parents should not underestimate the chronic enlarged lymph nodes associated with weight loss, the presence of hard and painful lumps in the neck, or the constant enlargement of the observed lesion. In addition, frequent abdominal pain and excessive fatigue in a child may be disturbing. If you notice the above symptoms, you should immediately consult a pediatrician who will perform an examination and order an ultrasound of the lymph nodes.

An ultrasound scan can detect even minor changes in your lymph nodes, which may or may not be a serious disease. In most children, enlarged lymph nodes are associated with an infection that the child's body is fighting against. Ultrasound examination distinguishes physiological lymphadenopathy from the presence of a chronic systemic disease or neoplastic infiltration.

Ultrasound examination of lymph nodes is completely painless and safe for the child. Ultrasound is often a form of screening test that allows for early detection of pathological changes. The ultrasound examination recommended by the pediatrician should not be delayed, as this may delay the diagnosis of the disease and the implementation of appropriate treatment.

A typical symptom of salivary gland inflammation is facial swelling and pain in the area where the salivary gland is located:

on the side of the cheeks in front of the ears (parotitis)
under the mandible (submandibular salivary gland inflammation),
on the floor of the mouth (sublingual salivary gland inflammation).
Your baby may have trouble chewing and swallowing food. In order to confirm the diagnosis, an ultrasound examination of the salivary glands is performed. It is a form of diagnostic imaging that is completely safe for a child.

Ultrasound of a child's salivary glands does not require any special preparation. If you have other test results (laboratory blood or urine tests, or other imaging tests of the neck area), bring them to your appointment.

The testicular hydrocele in a newborn is most often a developmental defect, which consists in incomplete sealing of the canal through which the testicles moved from the abdominal cavity to the scrotum. As a result, fluid from the peritoneal cavity accumulates in the scrotum. In the first year of life, the testicular hydrocele should be spontaneously absorbed, otherwise surgery is performed. To be sure that the cause of the scrotal deformity is a hydrocele, see your baby's doctor for an ultrasound scan and make a diagnosis.

Under normal conditions, the testicles should descend into the scrotum around 7 months of gestation, and at the latest in the first year of life. Lack of descent of the testicles (cryptorchidism) in the 2-3 years of age is an indication for surgical treatment.

Carotid ultrasound examination is recommended in patients with an increased risk of ischemic stroke. People suffering from frequent headaches, dizziness, fainting, and especially patients with hypertension, diabetes and / or atherosclerosis should undergo it. Periodic control of the condition of the carotid arteries is indicated in people who have suffered an ischemic stroke or in the case of the so-called transient ischemic attacks (TIA). Doppler ultrasound is also used to assess the effects of treatment after surgical plaque removal.

An ultrasound scan detects abnormal blood flow in the arteries that supply blood to the brain. Ultrasound shows atherosclerotic plaques that are a potential source of embolic material. Thanks to this, it is possible to diagnose an increased risk of ischemic stroke early. Ultrasound examination enables regular monitoring of the patient's condition and modification of the treatment method depending on the advancement of changes in the arteries.

Ultrasound examination of the cerebral (cervical and vertebral) arteries does not require special preparation. It is necessary to expose the neck and the area above the collarbones, so it is worth taking care of a comfortable outfit (e.g. a buttoned blouse). If the ultrasound is performed again, bring your previous test results with you.

The most common indications for venous ultrasound are persistent swelling of the lower limbs, a feeling of heaviness in the legs, pain in the calves, varicose veins. Vein ultrasound can confirm or rule out venous thrombosis. The ultrasound of the venous system is also a standard test performed before the planned surgery to remove varicose veins.

During the ultrasound examination, the patient is lying down, standing or sitting with legs lowered. The doctor covers the skin of the examined person's legs with a special gel and then places the ultrasound head on it. The image obtained thanks to the reflection of ultrasonic waves from the tissues is observed on the monitor screen. The doctor moves the probe along the course of the following veins, assessing them in very small sections (every 1 cm). Ultrasound examination includes the assessment of deep and superficial veins along the entire length of the lower limb up to the groin. Sometimes it is also necessary to examine the veins in the pelvis and abdominal cavity.

In the case of another USG examination, the results of the previously performed examinations should be brought with you - this will enable the doctor to compare the observed changes. Vein ultrasound requires exposing the lower limbs from the feet to the groin area.

The ultrasound of the arteries of the lower extremities is performed in the case of:

leg pain that increases with walking and decreases with rest (so-called intermittent claudication),
poor skin condition of the feet and calves, impaired wound healing,
frequent feeling of cold feet,
high blood pressure, diabetes mellitus, poor blood test results (e.g. dyslipidaemia),
diagnosed atherosclerosis in a previous ultrasound examination,
post-operative checks on arteries.

The doctor covers the limb at the level of the examined section of the artery with a special gel and then applies an ultrasound head emitting ultrasound waves. The ultrasound reflects off the tissues and blood flowing in the artery, and then returns to the ultrasound head. The resulting image of the vessels is observed by the doctor on the monitor screen. The ultrasound of the arteries is completely painless and non-invasive. The duration of the examination depends on the length of the artery segment being assessed and may take up to 40-60 minutes.

Ultrasound examination detects places of narrowing and obstruction of the arteries. Accurate blood flows above the stenosis, blood flow rates at and below the stenosis are documented. It is also possible to determine the severity of atherosclerotic lesions along with an assessment of the risk of atherosclerotic plaque detachment and embolism formation. This makes it easier for the doctor to make the right decision about choosing the right treatment method.

Rezonans magnetyczny odcinka szyjnego kręgosłupa wykonuje się w przypadku, gdy konieczna jest ocena krążków międzykręgowych, rdzenia kręgowego, korzeni nerwowych oraz innych tkanek miękkich otaczających kręgosłup. Badanie MRI jest przydatne w diagnostyce rwy barkowej, wykrywania chorób obejmujących rdzeń kręgowy oraz w stanach pourazowych kręgosłupa. Aby wykonać rezonans kręgosłupa szyjnego należy posiadać skierowanie uzyskane od ortopedy, neurologa, neurochirurga lub lekarza radiologa.

Czas trwania badania MRI zależy od wskazań i rozległości ocenianych struktur. Badanie metodą rezonansu przeważnie trwa około 30-60 minut. 

Dożylne podanie środka kontrastowego jest konieczne, gdy wymagana jest szczegółowa ocena struktur bogato ukrwionych lub gdy celem diagnostyki jest dokładna lokalizacja stanów zapalnych i guzów nowotworowych.

W przypadku rezonansu z kontrastem należy posiadać wynik poziomu kreatyniny we krwi oraz nic nie jeść w ciągu 6 godzin przed badaniem. Osoba badana powinna także zabrać ze sobą zaświadczenia o posiadanych elementach obcych w ciele oraz być przygotowana do udzielenia informacji na temat obecnego stanu zdrowia oraz chorób i zabiegów operacyjnych przeprowadzanych w przeszłości. Ponadto, ubiór powinien być pozbawiony metalowych elementów takich jak sprzączki, guziki, spinki.

Pacjent kładzie się na specjalnym stole, który następnie jest przysuwany do urządzenia rezonansu (jest to typ otwarty urządzenia). Wokół kolana zakładana jest specjalna cewka.  Badanie trwa około 20-60 min w zależności od celu diagnostycznego. Podczas badania należy przyjąć nieruchomą pozycję ciała, aby uzyskany obraz był pozbawiony zakłóceń. Pacjent przez cały czas pozostaje w kontakcie słownym z radiologiem wykonującym badanie. Analizowane obrazy rezonansu stanowią przekroje struktur kolana w dowolnie wybranej płaszczyźnie. Wyniki wydawane są w postaci opisu tekstowego oraz zdjęć zapisanych na nośniku elektronicznym.

Najczęstszymi wskazaniami są urazy kolana, które wymagają dokładnej diagnostyki uszkodzeń tkanek miękkich i wewnętrznych struktur stawu. Rezonans stanowi złoty standard nieinwazyjnych metod diagnostyki w procesie kwalifikacji pacjenta do zabiegu operacyjnego rekonstrukcji więzadeł krzyżowych czy leczenia pęknięć łąkotek. Badanie MRI znajduje także zastosowanie w każdym przypadku, w którym zdjęcia RTG, tomografia komputerowa oraz USG są niewystarczające do określenia rodzaju i rozległości patologii w obrębie kolana.

Cena rezonansu kolana bez kontrastu wynosi najczęściej około 400-600zł, choć może być także niższa lub wyższa – zależy to od celu diagnostycznego badania. Jeśli rezonans magnetyczny kolana przeprowadzany jest z wykorzystaniem środka kontrastującego, cena z reguły wzrasta średnio o 200zł.

Pacjent kładziony jest na specjalnym ruchomym stole. Kończyna górna może zostać ułożona w określony sposób i zabezpieczona przed zmianą pozycji. Dookoła barku zostają umieszczone małe cewki, które biorą udział w uzyskiwaniu wysokiej jakości obrazu. Jeśli zaplanowano badanie z podaniem kontrastu, wcześniej pielęgniarka zakłada wenflon w okolicy dłoni lub przedramienia, przez który dożylnie podawany jest środek kontrastowy. Jeśli zaplanowano artrografię, środek kontrastowy wstrzykiwany jest przez lekarza do stawu. Pacjent otrzymuje stopery lub słuchawki do uszu, ponieważ w trakcie badania będzie słyszalny hałas towarzyszący pracy urządzenia, co jest zjawiskiem normalnym. Następnie stół wsuwany jest w głąb aparatu do rezonansu.

Badanie trwa około 15-45 minut w zależności od rozległości ocenianych struktur oraz opcji rezonansu z kontrastem czy bez. Podczas badania nie wolno się poruszać, ponieważ mogłoby to spowodować zaburzenia obniżające jakość pozyskiwanego obrazu.

Osobą wykonującą badanie i interpretującą jego wynik jest lekarz radiolog, który specjalizuje się diagnostyce obrazowej narządu ruchu. Radiolog sporządza opis, który razem ze zdjęciami rezonansu jest wydawany pacjentowi.

MRI barku z podaniem kontrastu jest bardzo dokładną i jednocześnie bezpieczną metodą diagnostyczną. Jeśli planuje się wykonanie rezonansu z podaniem kontrastu, przeprowadzany jest dokładny wywiad z pacjentem dotyczący jego stanu zdrowia. Wykonuje się także badanie poziomu kreatyniny we krwi, aby wykluczyć zaburzenia funkcjonowania nerek, które są przeciwwskazaniem do dożylnego podania kontrastu. Uczulenia na środek kontrastowy zdarzają się bardzo rzadko, a ewentualne objawy reakcji alergicznej są łagodne i przemijające.

Rezonans magnetyczny biodra wykonuje się na podstawie skierowania wydanego przez lekarza. Badanie MRI pozwala na najbardziej dokładną nieinwazyjną ocenę zmian zwyrodnieniowych stawu biodrowego, a także rozległości uszkodzeń tkanek miękkich w stanach pourazowych, np. po zwichnięciu biodra. Analiza wyników rezonansu magnetycznego jest jednym z czynników, na podstawie których lekarz kwalifikuje do zabiegu operacyjnego oraz dokonuje wyboru techniki operacyjnej.

Artrografia MRI polega na podaniu do wnętrza stawu biodrowego środka cieniującego o właściwościach ferromagnetycznych, a następnie poddaniu biodra badaniu rezonansem magnetycznym. Artrografia jest metodą diagnostyczną, która pozwala na bardziej szczegółową ocenę uszkodzeń chrząstki i obrąbka stawowego oraz obecności wolnych ciał w stawie niż w przypadku klasycznego badania MRI bez podania kontrastu.

Rezonans magnetyczny stawu biodrowego trwa około 15-60 minut. Ostateczny czas trwania badania zależy od wskazań, rozległości ocenianych struktur oraz tego, czy rezonans biodra przeprowadzany jest z podaniem kontrastu. W przypadku MRI z kontrastem proces przygotowania pacjenta polegający na założeniu wenflonu lub wstrzyknięciu kontrastu do stawu wydłuża czas przebywania pacjenta w pracowni radiologii. Zaleca się także, aby po zakończeniu badania MRI z podaniem kontrastu pacjent pozostał pod obserwacją personelu przez około 15 minut.

Rezonans magnetyczny wykorzystuje zjawisko rezonansu cząsteczek, które tworzą ciało człowieka oraz ocenę czasu ich relaksacji. Badanie MRI pozwala na uzyskanie obrazów będących przekrojami stawu skokowego i stopy w dowolnej płaszczyźnie. Pozwala to na niezwykle precyzyjną diagnostykę urazów i schorzeń w obrębie stawu skokowego. Badanie trwa około 30-60 minut, w trakcie którego pacjent leży na stole przysunietym do urządzenia rezonansu magnetycznego. Podczas badania nie wolno poruszać kończyną, ponieważ mogłoby to prowadzić do zaburzeń w odbiorze obrazu i obniżenia jakości badania. W niektórych przypadkach konieczne jest wykonanie rezonansu z podaniem środka kontrastowego, który wzmacnia sygnał odbierany z tkanek i zwiększa wyrazistość obrazu. Uczulenie na kontrast występuje rzadko, ale jeśli w trakcie badania pojawiłyby się jakiekolwiek niepokojące objawy, należy je natychmiast zgłosić personelowi pracowni.

Koszt rezonansu wynosi kilkaset złotych - z reguły jest to przedział około 300-600zł. Jeśli wykonywane jest badanie z podaniem kontrastu, cena może zwiększyć się o dodatkową kwotę około 200zł.

Rezonans łokcia wykonuje się najczęściej w stanach pourazowych, które przebiegają z uszkodzeniem chrząstki stawu i/lub tkanek miękkich (więzadeł, mięśni). Obrazowanie rezonansu pozwala na dokładne określenie rozległości uszkodzeń i zaplanowanie leczenia operacyjnego. Struktury łokcia ukazywane są w przekrojach wykonanych w dowolnie wybranej płaszczyźnie, co umożliwia niezwykle precyzyjną diagnostykę. W przypadku patologii nieurazowych, na obrazach rezonansu można dokładnie ocenić strukturę tkanek, co jest ważne w przypadku podejrzenia zmian zapalnych, degeneracyjnych czy nowotworowych.

Rezonans magnetyczny jest przydatnym badaniem umożliwiającym określenie miejsca oraz przyczyny ucisku nerwu. Gdy wynik badania USG jest niejednoznaczny, warto wykonać rezonans, by móc ocenić tkanki niespecyficzne, które mogą stanowić przyczynę danej neuropatii.

Mielografia MR jest to nieinwazyjna metoda uwidocznienia przestrzeni podpajęczynówkowej kanału kręgowego oparta jest na sekwencjach silnie T2 zależnych, uzyskiwanych metodą dwu- (2D) lub trójwymiarową (3D), która służy ocenie zaawansowania zmian chorobowych w obrębie kanału kręgowego, rdzenia kręgowego i płynu mózgowo- rdzeniowego. Badanie w sposób bezpieczny dla pacjenta pozwala na uwidocznienie przestrzeni płynowych kręgosłupa, zwiększa w sposób istotny czułość konwencjonalnego badania MR, zwłaszcza w aspekcie oceny ucisku korzeni nerwowych, co jest szczególnie ważne przy podejmowaniu decyzji dotyczących sposobu postępowania terapeutycznego. Mielografia MR w większości przypadków diagnostycznych pozwala na zastąpienie konwencjonalnej mielografii.

• podobna czułość w wizualizacji w porównaniu z konwencjonalną mielografią,
• metoda całkowicie nieinwazyjna i przyjazna dla pacjenta,
• nie ma skutków ubocznych związanych z niepożądaną reakcją na kontrast dooponowy, takich jak zapalenie pajęczynówki,
• krótki czas obrazowania,
• brak ekspozycji pacjenta na promieniowanie jonizujące.

Głównymi patologiami ośrodkowego układu nerwowego i kanału kręgowego diagnozowanymi przy wykorzystaniu mielografii MR są:

• wady wrodzone kręgosłupa,
• wady rozwojowe ośrodkowego układu nerwowego,
• przepukliny krążków międzykręgowych,
• adhezyjne zapalenie pajęczynówki,
• choroby nowotworowe i guzy rdzenia kręgowego i kanału kregowego oraz ocena stopnia złośliwości procesów nowotworowych,
• schorzenia zapalne ośrodkowego układu nerwowego: wirusowe, bakteryjne, grzybicze i pasożytnicze,
• zwężenie zwyrodnieniowe kręgosłupa (stenozy kanału kręgowego);
• anomalie i wady naczyń ośrodkowego układu nerwowego – tętniaki, kręgowe malformacje naczyniowe,
• diagnostyka zmian niedokrwiennych mózgu i rdzenia kręgowego,
• choroby demielinizacyjne, zmiany zwyrodnieniowe i degeneracyjne ośrodkowego układu nerwowego.

Obrazowanie metodą rezonansu magnetycznego jest najbardziej przydatne w diagnostyce uszkodzeń stawów stopy, neuropatii uciskowych w obrębie stopy (zespół kanału stępu, nerwiaka Mortona), urazów tkanek miękkich oraz innych patologii, które nie mogą być dostatecznie ocenione na zdjęciach RTG, podczas badania USG czy tomografii komputerowej.

In the course of a shoulder, the nerve root is compressed by a hernia of the nucleus pulposus or a bone growth (osteophyte). Moreover, the nerve root may become jammed in the narrowed intervertebral opening. The most common cause of the described structural changes is the degenerative disease of the spine resulting from bad habits (the position of the head tilted forward and forward). Less commonly, pressure can be caused by the mass of the cancerous tumor.

A typical symptom of shoulder pain is unilateral pain radiating from the nape of the neck to the upper limb (shoulder, elbow, forearm or fingers). Pain may be accompanied by sensory disturbances, numbness and weakness in the muscles of the shoulder girdle and / or upper limb. The severity of the pain usually depends on the current position of the cervical spine.

In most patients, adequate management is oral painkillers and anti-inflammatory drugs, physical therapy and specialist spine rehabilitation. If necessary, the doctor performs a local injection of the spine with a steroid (cervical spine blockade). In the event of unsuccessful conservative treatment or aggravation of neurological deficits, a surgical procedure to decompress the compressed nerve structures is considered.

Sciatica manifests itself as severe pain in the back and one of the legs. Pain occurs in the lumbosacral spine and buttock, or it can radiate through the back of the thigh and calf to the foot.

One of the most common causes of sciatica is the prolapse of the nucleus pulposus outside the area of ​​the intervertebral disc (disc). The prolapse of the pulmonary nucleus occurs most often when lifting heavy objects or other activities that overload the lumbar spine. Sciatica is usually the result of many years of progression of degenerative changes in the spine.

The diagnosis of sciatica includes: an interview, neurological examination, examination of the range of spine mobility, functional examination, examination of the variability of pain symptoms depending on the body position and analysis of imaging tests (MRI, X-ray or computed tomography).

In the first place, rehabilitation and pharmacological treatment are used as an auxiliary. If conservative treatment is unsuccessful, surgical treatment is undertaken, e.g. microdiscectomy, i.e. excision of the nucleus pulposus that compresses the nerve root.

The essence of the jumper's knee is the degeneration of the fibers of the patellar ligament that connects the kneecap to the tibia. The patella ligament tightens along with the quadriceps when the knee is extended and when landing on a bent leg. As a result of excessive overload accompanying jumping or running, microtrauma in his patellar ligaments and the release of pain ailments occur. Healing processes do not keep up with the formation of further microdamages, as a result of which the structure of the patellar ligament is gradually degenerating.

Jumper's knee is showing pain as well as possible swelling and palpation at the front of the knee under the kneecap. The ailments worsen during activities with a large component of running or jumping.

The main cause of the jumper's knee is excessive overloading of the joint and neglecting periods of recovery and rest. The risk of the disease is increased in people with weakened quadriceps muscle, imbalance of tension in the thigh muscles, disturbance of the knee axis (valgus, varus) or abnormal anatomical structure of the patellar femoral joint.

Minor injuries are subject to conservative treatment aimed at facilitating the healing process and then increasing the strength of the patellar ligament to loads. Rehabilitation includes transverse massage of the patellar ligament, shock wave therapy, and exercises to stretch and strengthen the quadriceps. Particular emphasis should be placed on exercises that improve the eccentric work of the quadriceps - that is, those that consist in inhibiting the knee deflection by the muscle (e.g. when going down into a squat or deepening a lunge).

When the patellar ligament damage is extensive, repair procedures are performed or ligament reconstruction procedures are performed.

Due to the complex multilayer structure of the articular cartilage, it is not possible to fully rebuild the hyaline articular cartilage. By using treatment methods in the field of regenerative medicine (plasma with concentrated platelets), it is possible to accelerate the healing and repair processes of damaged cartilage. Biological treatment is effective provided that the patient is appropriately qualified for the therapy. If you want to read more about how we treat it in our hospital, click here.