What is purpura?

Spontaneous bleeding into the skin usually appears as a rash known as purpura

Petechiae is the term given to the individual small red or red-blue spots about 1 to 5mm in diameter which make up the rash. They are caused by a small local amount of bleeding within the skin. Deeper bleeding beneath the skin may be seen as larger spots (ecchymoses).

The difference between petechiae and abnormally prominent blood vessels can be shown by applying pressure to a red spot. If it is caused by an abnormal blood vessel the redness disappears temporarily. By contrast when pressure is applied to purpura the spots do not pale.

Petechia

Ecchymosis

www.netdoctor.co.uk/diseases/facts/purpura.htm

Trendelenburg's sign

A sign of gluteus medius weakness or relative inhibition. The sign is elicited by asking the patient to stand on the involved leg. If the sign is positive, the pelvis will drop on the uninvolved side.




The film clip depicts the same patient as described before, here he exhibits weak hip abductors. When standing on one leg with the aid of a walking frame the patient is stable because the upper body is supported by the arms. However, when asked to repeat the movement without holding the frame, the patients' pelvis drops on the unsupported side - a positive Trendelenburg sign. He tries to correct this by inclining his upper body over his supporting leg but he is unstable in this position and falls.

In poliomyelitis the virus may attack peripheral nerves such as the superior gluteal nerve which supplies gluteus medius and minimus, leading to a Trendelenburg gait.

Raynaud's Disease vs. Raynaud's Phenomenon (or Secondary Raynaud's)

Raynaud's phenomenon (RP) is a vasospastic disorder characterized by episodic color changes of blanching, cyanosis, and hyperemia in response to cold and/or emotional stress. Secondary RP is characterized by an age of onset of more than 30 years, painful and asymmetric attacks, ischemic skin lesions, positive autoantibodies, capillaroscopic abnormalities and/or clinical features suggestive of connective tissue diseases (CTDs). Among the CTDs, systemic sclerosis has the highest frequency of RP.

When Raynaud's appears by itself, without any other medical condition, it is called Raynaud's Disease. About 1 in 20 adults have primary Raynaud's, whereas only one in 4,000 have Scleroderma. When it appears along with autoimmune diseases such as Scleroderma, Systemic Lupus Erythematosus, and Rheumatoid Arthritis, it is called Raynaud's Phenomenon (or, Secondary Raynaud's.)

In primary Raynaud's, the blood vessels return to normal afterwards. However, in Raynaud's with Scleroderma there may be blood vessel scarring which can make medication ineffective. Digital (Finger) Ulcers are caused by the lack of oxygen to skin cells.

http://www.sclero.org/medical/symptoms/raynauds/a-to-z.html#disease

Osteokinematics VS. Arthrokinematics

We use OSTEOKINEMATIC terms, such as abduction or adduction, flexion or extension, to name the movements that occur between bones at synovial joints. These terms describe the movements that occur around a center of rotation, namely the joint axis.

We speak as if this joint axis is a fixed point, as if the center of rotation is stationary like an automobile axle. Joint axes' locations are fairly stable, but only because the joint surfaces move in a very specific way.

ARTHROKINEMATICS is the general term for the specific movements of joint surfaces. Normal joint surface movement is necessary to ensure long-term joint integrity. (Joint surface movements are sometimes called joint play motions or component motions).

Joint surfaces move with respect to one another by simultaneously (1) rolling, (2) gliding, and (3) spinning. This discussion focuses on how joint surfaces roll and glide with respect to one another, and largely ignores the spin component.





http://moon.ouhsc.edu/dthompso/namics/arthkin.htm

Differentiate between 'locking' and 'pseudo-locking'

A locked knee gets totally stuck in a position from which it cannot be unlocked without help, while pseudolocking can be 'unlocked' just with a simple manoevre. Locking may be due to a number of things, but very often it is due to a bucket-handle tear of the meniscus ('cartilages'), where a bit of torn meniscus flicks itself over and gets stuck between the bones of the femur (thighbone) and tibia (shinbone). Giving way may also be due to a meniscal tear (and other things), but is a common complaint when the ACL is torn.

The combination of an ACL and a meniscal tear is very common - they may both occur at the same injury, or the meniscal tear may be a consequence of the disordered mechanics of the knee after an ACL tear.

Pseudo-locking and giving way can also be features of mal-tracking and plicae, but the symptoms in this case of of a lesser nature.

You really need a really competent clinical history taken (your story) and a thorough examination to assess what is happening, but it seems pretty certain that there is some internal derangement.

http://www.kneeguru.co.uk/kneegeeks/2343666201.html

Pseudoclaudication vs. claudication: What's the difference?

Pseudoclaudication and claudication cause similar symptoms — such as leg pain — but for different reasons. Pseudoclaudication is due to narrowing of the lumbar spinal canal (spinal stenosis). This puts pressure on (compresses) the spinal root nerves, which control movement and sensation in the legs. Claudication, on the other hand, is a circulation problem that results in decreased blood flow to the arteries that supply blood to muscles in the legs.

Pseudoclaudication typically causes pain and discomfort in the buttocks, legs and feet with walking or prolonged standing. You may also experience numbness and weakness in your legs. Leg pain typically is relieved by sitting or bending forward at the waist, which reduces nerve pressure from lumbar spinal stenosis. Treatment of pseudoclaudication is directed at the underlying cause of spinal stenosis. Symptoms of claudication from insufficient blood supply are relieved soon after you stop walking.

http://www.mayoclinic.com/health/pseudoclaudication/HQ01278