COMPARTMENT SYNDROME|a painful

condition that occurs when pressure within the muscles builds WHAT Develops when swelling or bleeding within a compartment. The fascia does not stretch pressure on the capillaries, nerves, and muscles in the compartment Blood flow to muscle and nerve cells is disrupted Classified into: o Acute - develops after a severe injury o Chronic - athletic e ertion ! e ertional CAUSES ACUTE o "racture o Badly bruised muscle o Crush injuries o Constricting bandage o #nabolic steroids use CHRONIC o $epetitive e ercise eg running, cycling, bi%ing etc

SYMPTOMPS Acute o o o o Pain Paraesthesia Pallor Paralysis Pulselesness

&ain &aresthesias The muscle may feel tight or full 'umbness or paralysis

5 Ps ALI

Chronic o &ain or cramping during e ercise o 'umbness o Difficulty moving the foot o (isible muscle bulging

INVESTIGATION $enal function Blood urea nitrogen )B*'+ Creatinine phospho%inase Compartment pressure meter Doppler ultrasound

TREATMENT Acute o ,urgical emergency - fasciotomy Chronic o Conservatives - &hysical therapy, orthotics )inserts for shoes+, and anti-inflammatory medicines o Surgical - elective procedure fasciotomy

CHONDROSARCOMA| malignant cartilaginous tumor of

bone ).rd most common malignant bone tumor+ WHAT / common 0 / aggressive than osteosarcoma # tumor of mesenchymal origin that predominantly is made of cartilage 1ld age, pea% 2 34 yo EATURES Deep, dull, achy pain &ain at night 2 joint - $17 disturbed Divided into: o &rimary arises de novo 45 - 65 yo 78" o ,econdary pree isting lesion of cartilage. transformation from enchondroma or osteochondroma INVESTIGATION &lain radiography o ,ubtle, radiolucent, permeative lesion o >ytic lesions that often erode the corte with or without cortical thic%ening o 7ay have ha?y or s"ec#$e% c&$ci'ic&tions w! either a diffuse @salt 0 pepper@ pattern or a more discrete @pop corn@ pattern o &attern of calcification is usually diagnostic of cartilaginous tumor; 7$: Bone ,can Biopsy

GRA!ING 9rade : )low grade+ 5 ,imilar to enchondroma ; cellularity is higher, with occasional plump nuclei with open chromatin structure < 9rade :: )intermediate grade+ 5 :ncreased cellularity; distinct nucleoli are present in most cells, and foci of my oid change may be seen < 9rade ::: )high grade+ =igh cellularity, prominent nuclear atypia, and the presence of mitosis TREATMENT $adiotherapy Chemotherapy ,urgical therapy