Diagnosis and Treatment of Leg Musculoskeletal System Problems

Hip Problems

What are the symptoms of trochanteric bursitis?

Pain and burning are observed on the outer side of the hip and thigh. Complaints worsen with walking, squatting, and climbing stairs, and decrease with rest. Lying on the affected side at night makes the symptoms worse. There is tenderness when pressure is applied to the bony prominence on the outer side of the hip and thigh. Symptoms increase when the hip is opened outward. Trauma, overexertion during sports, muscle imbalances around the hip, prolonged walking, back strain, and obesity can contribute to this problem. It is important to differentiate this condition from herniated discs and hip joint problems.

How is trochanteric bursitis treated?

Treatment for trochanteric bursitis includes rest, reducing activity levels, particularly during walking, avoiding stressing the area, non-corticosteroid pain relievers, local injections, and physical therapy. Tight muscles around the hip should be addressed with stretching exercises, and weak muscles should be strengthened.

What is osteoarthritis (osteoarthritis)?

Osteoarthritis (osteoarthritis) is the most common rheumatic disease. Hip osteoarthritis is the most frequent cause of hip joint pain in adults. It is a chronic degenerative disease characterized by softening and structural damage to the articular cartilage, bone edema, and the formation of new bone.

What are the symptoms of osteoarthritis?

Symptoms include hip pain on the front of the hip that worsens with movement, squatting, and climbing stairs but decreases with rest; pain radiating from the groin to the knee; stiffness, especially after sitting or in the morning; and difficulty with activities such as climbing stairs and standing up from a sitting position. As the osteoarthritis progresses, patients may have difficulty with daily activities such as walking and putting on socks.

The diagnosis is made based on the patient's symptoms, history, and examination findings. Hip X-rays, MRIs, and blood tests are conducted to support the examination findings. The goal of hip osteoarthritis treatment is to control the patient's pain, increase joint mobility, address functional impairments, and improve the quality of life.

What are the treatment methods for osteoarthritis?

The foundation of osteoarthritis treatment includes non-pharmacological treatments, such as rehabilitation methods. The patient should be educated about the disease, treatment options, medication side effects, and precautions, as well as how to care for themselves. Activities such as climbing stairs, sitting on the knees, squatting, and sitting on low chairs should be avoided.

Physical therapy plays a significant role in patients with functional limitations. The strength of the muscles around the hip, the joint's stability, and its mobility are aimed to be improved. A cane or walker may be recommended to assist with walking. The patient's functional status can be improved by making environmental adjustments in their living space (e.g., eliminating the need to use stairs).

Obesity is a significant risk factor in the development and progression of osteoarthritis. Weight loss reduces the load on the joint, prevents disease progression, and alleviates symptoms. Therefore, the patient should be guided toward weight loss. Both pharmacological and non-pharmacological treatments should be applied together in osteoarthritis treatment.

The goal of hip osteoarthritis treatment is to control the patient's pain, increase joint movement, address functional impairments, and improve the patient's quality of life.

When is joint replacement surgery recommended for hip osteoarthritis?

2. Knee Problems

What is patellar chondromalacia?
It is pain that occurs on the front of the knee due to softening of the cartilage behind the kneecap.

What are the symptoms of patellar chondromalacia?
The symptoms worsen when the knee is kept in a bent position for a long time (cinema sign). Patients have difficulty when climbing or descending stairs.

How is patellar chondromalacia treated?
Treatment involves a strengthening exercise program for the quadriceps (front thigh muscles).

What is bursitis?

Bursitis is swelling in the bursae (fluid-filled sacs) around the knee due to inflammation and strain. The most important cause of this condition is prolonged pressure on the knee and repeated microtraumas.

How is bursitis treated?
Treatment involves rest, bandaging, cold application, non-corticosteroid pain relievers, and local injections.

What are the symptoms of knee osteoarthritis?

Knee osteoarthritis presents with complaints such as pain that increases with movement and decreases with rest, stiffness, difficulty walking, swelling, and deformity. Symptoms include pain that worsens with movement and improves with rest, stiffness that is often worse after sitting or in the morning, and crepitus (a crackling sound or sensation during movement). There may also be restriction of joint movement.

How is knee osteoarthritis treated?
The goal of knee osteoarthritis treatment is to control the patient’s pain, maintain or improve joint movement, address functional impairments, and improve the patient’s quality of life. While achieving these goals, it is important to protect the patient from the side effects of treatments as much as possible.

Patient education plays a critical role in the treatment of knee osteoarthritis. Other treatment methods include the following:

3. Ankle and Foot Problems

What is plantar fasciitis?
It is the most common cause of heel pain. It occurs due to repetitive trauma to the connective tissue layer on the bottom of the foot, where it attaches to the bone.

What are the symptoms of plantar fasciitis?
Pain increases with standing and walking, and there is tenderness on the inside-middle part of the heel when touched.

How is plantar fasciitis treated?
Treatment includes the use of heel supports, physical therapy, foot stretching exercises, and local injection treatments.

How is a heel spur treated?
Treatment includes the use of heel supports, physical therapy, foot stretching exercises, and local injection treatments.

What is Achilles tendinitis?
It is pain, swelling, and tenderness at the attachment site of the Achilles tendon at the heel.

What are the symptoms of Achilles tendinitis?
It develops due to repetitive trauma, long periods of walking, or running. The patient has difficulty standing on their toes.

How is Achilles tendinitis treated?
Treatment includes a physical therapy program, non-corticosteroid pain relievers, splint use, local injections, and surgical treatment options.