Treatment For Psoriatic Arthritis

by Administrator 19. September 2017 16:56

People who have psoriasis- development of red patches on the skin together with a silvery scaly appearance may also develop arthritis. The combination of these two conditions is referred to as Psoriatic Arthritis. Although the joint inflammation may develop before the skin is affected but the presence of Arthritis may be detected much later than Psoriasis.

Psoriatic Arthritis may affect any part of the body from the hands, fingertips, spine, legs etc. the condition tends to flare up at certain times and then subsides. It is a progressive disorder. Although there is no permanent cure for Psoriatic Arthritis, measures can be taken to curb and manage the symptoms. Lack of treatment may result in physical disability besides increasing the chances of cardiovascular diseases.


  • Attacking of the healthy cells by the body’s immune system
  • Faulty immune system results in excessive production of skin cells leading to inflammation
  • Genetic factors
  • Physical trauma to the joint or a skin injury
  • Joint infections
  • It generally affects adults in the age group of 30-50 years
  • Smoking, emotional stress, alcohol, hormonal imbalance may aggravate the Psoriasis and lead to Psoriatic Arthritis


The symptoms of Psoriatic Arthritis may vary from being mild to severe as the condition progresses. These may include the following.

  • Stiffness in the affected joint
  • Swelling and inflammation
  • One or both the sides of the body may be affected
  • The skin around the inflamed joint is warm to touch
  • Deformed hands or feet
  • Pain at the points where the tendons and ligaments are connected to the bones
  • Development of Spondylitis in the lower back
  • Visibly deformed fingers or toes
  • Inflammation and redness in the eyes


  • Detailed physical examination of the affected joint to check for swelling, pain and inflammation
  • Palpation to check for tenderness
  • X-ray imaging to assess changes in the joint structure
  • MRI and CT scan to check the condition of tendons and ligaments
  • A syringe may be inserted into the joint to draw out joint fluid. It is then tested for the presence of uric acid crystals
  • Rheumatoid factor (RF) test may be done to rule out the chances of Rheumatoid Arthritis


  • Prescription of anti inflammatory medicines and pain killers
  • Disease-modifying antirheumatic drugs (DMARDs) may be prescribed to arrest the progression of the disease
  • Tumor necrosis factor-alpha (TNF-alpha) inhibitors may be administered to reduce stiffness and pain
  • Prescription of immunosuppressant to slow down the immune system to prevent its attack of the healthy tissues
  • Injecting steroids into the joint gives a lot of relief
  • Surgical removal of severely damaged joints and these may be replaced by artificial joint parts or prostheses
  • Light exercise to keep the joint flexible
  • Application of hot and cold packs to reduce pain and swelling

Consult the doctors at OrthoTexas for diagnosis and treatment of various joint problems. For an appointment, call at (972) 727 – 9995 or visit 7300 Eldorado Parkway, Suites 165/165A, McKinney, TX 75070.

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Joint Replacement

by Administrator 26. June 2017 09:46

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Subscapularis Tendon Tears: Causes, Symptoms And Treatment

by Administrator 9. May 2017 06:29

A group of four muscles, known as the rotator cuff muscles, control the movement of the upper arm and shoulder. The subscapularis muscle is the strongest muscle of this group that is located on the front side of the upper arm. It keeps the muscle stable and helps in inward rotation of the arm. This muscle also prevents the head of the humerus from slipping out of the shoulder socket. About two- thirds of this muscle is made up of tendons which makes it prone to injuries, particularly in athletes who indulge in swimming, playing tennis or throwing actions. Damage to the tendon that supports this muscle is termed as Subscapularis Tendon Tears.


  • Repeated arm movement that involves lifting or throwing actions
  • Inefficient warm ups before playing a sport
  • Overuse injuries
  • Playing a sport or training when the muscles are strained or injured
  • Inherent mechanical problems in the shoulder joint
  • Tendinitis- prolonged use of the muscles leads to degeneration
  • Falling on the shoulder to break a fall
  • Forceful forward or backward movement of the arm
  • Slipping out of the biceps tendon from its grove and cutting across the subscapularis tendon


  • Pain in the front part of the shoulder, which may get aggravated with upper arm or body movement.
  • Decreased movement of the joint.
  • Lifting, twisting and rotation of the arm may be painful
  • Weakness of internal rotation
  • Anterior shoulder swelling
  • Tenderness in the affected part of the joint
  • The shoulder may hurt when touched


  • Bear-hug test
  • Gerber’s Lift Test
  • Belly-press Test
  • Ultrasound
  • MRI Scan


  • The preferred mode of treatment in elderly patients is physical therapy for this condition.
  • Arthroscopic surgery may be recommended in people who are physically active. During the procedure, the tendon is replaced or treated as per the severity of the condition
  • Pec Major Transfer- This surgical procedure is adopted in case of chronic tears. The Pectoralis major muscle is transferred in place of the subscapularis as it has the capability to perform the same function
  • Sufficient rest is required for the affected shoulder and all activities that cause stress to the joint need to be avoided
  • Injecting cortisones into the affected part may provide immediate relief
  • Post-surgery, physical therapy and gradual mobility training may be helpful in regaining movement and strength
  • The operated arm may be immobilized using a sling for a few days or weeks

To know more about the treatment options for Subscapularis Tendon Tears, consult the physicians at OrthoTexas. You can call at (972) 727-9995 or visit 7300 Eldorado Parkway, Suites 165/165A, McKinney, TX 75070.

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Distal Femur (Thighbone) Fractures Of The Knee

by Administrator 30. September 2016 08:47

Distal femur is the lower end of the thigh bone which lies just above the knee joint and resembles an inverted funnel. The end of the bone is lined by a thick slippery substance called cartilage which allows it to slide across other bones that constitute the joint. It also helps in movement of the distal femur when the knee is bent.

A crack or a break in this part of the bone is medically referred to as the Distal Femur Fracture of the Knee. In case the force causing the fracture is strong enough, it may also damage the kneecap. Such fractures are commonly observed in people aged above 50 years as their bones are relatively weaker. However, younger populace is at an equal risk although the causative factors may vary. The injury can be classified as follows:

  • Closed Fracture- The skin is not ruptured
  • Open Fracture- The skin is cut open during the injury and a part of the bone may stick out
  • Comminuted Fracture- The injury causes the bone to shatter into multiple pieces
  • Transverse Fracture- The crack or breakage occurs straight across the bone

These fractures may not only damage the femur but also affect the tendons and ligaments that surround it. The hamstring and the quadriceps muscles may tend to snap and shorten when the bone breaks.


  • A fall from a height
  • Vehicular accident
  • Loss of bone strength and density as age increases
  • Direct hit to the knee
  • Sports injuries


  • Severe pain
  • Inability to stand or bear body weight
  • Swelling
  • The injured area may be tender when touched
  • Visible deformity
  • Change in gait as the leg may become crooked or shorter


  • Clinical evaluation of the injured leg by an orthopedic doctor
  • Evaluation of the mode of injury, patient’s medical records and the symptoms
  • The blood supply to the nerves and their ability to feel sensations may be tested
  • X-ray imaging, CT scan or MRI may be performed


  • If the bone is in a relatively stable condition and does not involve multiple fracture, it may be treated by using a cast or plaster
  • The doctor may attach a traction pin to the bone and tie weights with a pulley. This may help to hold the bone in place.
  • Surgery may be required in case of an open fracture to avoid infection.
  • The broken bone may be put in place using external fixator devices (screws and pins) which are fixed on a frame attached to the leg. Internal fixation may also be done by making surgical incisions. A metal rod may be inserted to keep the femur in place
  • Severely damaged bone may need a bone graft which involves extraction of a piece of bone from the pelvis. Artificial bone fillers or allograft may be used in some cases
  • Knee replacements may be recommended for elderly patients
  • Physical therapy may be required in the post-operative phase to aid healing and restore flexibility as well as strength in the leg

For effective treatment of Distal Femur Fracture of the Knee and other injuries, visit OrthoTexas. To schedule an appointment with the orthopedic doctors in McKinney, TX, you can call at (972) 727 – 9995 or visit 7300 Eldorado Parkway, Suites 165/165A, McKinney, TX 75070.

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Frozen Shoulder: Orthopedic Treatment In McKinney, TX

by Administrator 23. January 2016 07:07

Frozen Shoulder, or Adhesive Capsulitis, is a condition causing severe pain and stiffness in the shoulder. An injury, Diabetes, overuse or some other factors may lead to stiffening of tissues around the shoulder joint accompanied by formation of scar tissues which may lead to pain and restrict its movement.

The shoulder is a ball and socket joint in which the proximal humerus (rounded top of the arm bone) fits into a socket shaped scapula. In case of a Frozen Shoulder, the joint capsule thickens or swells, leading to restriction of motion of the bones. The condition is commonly observed in the people aged 40-60 years of age. The patient may take a year to recover from the effects of a Frozen Shoulder. There are three main stages of a Frozen Shoulder:

  • Freezing Stage- The shoulder may feel stiff and pain increases with time. Movement is gradually restricted and the patient may experience maximum pain while sleeping
  • Frozen Stage- The patient may feel pain as well as stiffness and motion is limited. The pain does not increase beyond this stage.
  • Thawing Stage- Flexibility and range of motion may improve gradually as well as the pain may diminish.


  • Direct injury or trauma to the shoulder
  • Overuse of the upper arm or shoulder joint
  • Aging
  • An after effect of menopause in women
  • Health related issues such as Diabetes, Arthritis, Parkinson’s Disease, cardio-vascular problems or stroke
  • Surgery or immobilization of the shoulder joint for a long period
  • Fracture in the arm
  • Hypothyroidism or Hyperthyroidism
  • Injury to the rotator cuff


  • Pain that increases gradually
  • Stiffness
  • Loss of motion in the shoulder
  • Difficulty sleeping due to severe pain


  • A detailed examination of range of motion and symptoms by an orthopedic doctor
  • Evaluation of the patient’s medical history to assess the potential underlying cause
  • The doctor may press the affected joint to check for swelling and also move it in different directions to analyze range of motion
  • MRI and X-ray may be recommended to evaluate damage to the joint


  • Application of alternate hot and cold packs to reduce pain as well as swelling
  • Prescription of anti inflammatory drugs
  • Practicing gentle stretching exercises to restore flexibility and motion
  • Transcutaneous Electrical Nerve Stimulation, i.e. application of electric pads to numb the pain causing nerve endings in the spinal cord
  • Manipulation in which the patient’s arm is moved in various directions under the effect of general anesthesia to loosen the tight muscles
  • Arthroscopic surgery to remove scar tissue or release the tight tissues
  • Joint Distension, which involves injection of sterile water into the joint to stretch the tissues

OrthoTexas provides complete diagnosis and treatment for Frozen Shoulder. To schedule an appointment with our orthopedic surgeons in McKinney, TX, you can call at (972) 727-9995.

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Total Joint Replacement In McKinney, TX

by Administrator 4. March 2015 07:53

Total joint replacement is a common surgical procedure involving the removal of a damaged joint and substituting it with a prosthetic one. The most commonly replaced joints are hip, knee and shoulder, although the procedure can also be performed on elbow, foot, ankle and wrist. The artificial joints are designed carefully in order to enable the patient to move in the same manner as with the original joint.

Causes for undergoing Joint Replacement Surgery 

Total joint replacement is often recommended for patients having severely damaged joints due to one or more of the following conditions:

  • Genetic factors
  • Congenital joint deformities
  • Degenerative joint conditions such as Osteoarthritis or Rheumatoid Arthritis
  • Repetitive injuries
  • Intense trauma to the joint tendons or cartilage

The patient may feel intense pain, stiffness and immobility in the affected joint. The orthopedic doctor may suggest total joint replacement surgery if the non-surgical treatment approaches fail to provide relief from the distressing symptoms.

The Procedure

There are two main techniques of performing Total Joint Replacement Surgery, namely minimally invasive or the traditional open surgery. In the former one, the orthopedic surgeon makes a small incision so as to correctly insert the implant. However the latter technique requires an incision to be made that is as large as 11 to 12 inches. During the procedure, the surgeon may remove the damaged bone and cartilage from the joint and replace it with a prosthetic part that is made of plastic, metal or other material. The artificial joint is similar in shape and movement to the original one, so that it can fully replicate its functionality.


Patients can take anywhere between 6 to 12 weeks to recover from a Total Joint Replacement Surgery. Taking precautions as mentioned by the surgeon and indulging in exercises, as prescribed by the physical therapist, can help to restore strength and stability to the joint.

Benefits Of Total Joint Replacement

  • Relief from pain
  • Improved joint functioning
  • Increased mobility and movement
  • Deformity corrections
  • Increased joint strength
  • Improved quality of life
  • Ability to perform daily activities, such as walking, climbing, running, squatting etc.

For Total Joint Replacement Surgery in McKinney, TX, visit OrthoTexas. The orthopedic surgeons here provide treatment for various degenerative and deformity conditions of the hip, knee and shoulder.  They use advanced technology to make sure that your recovery period is as short and easy as possible. To schedule an appointment with the orthopedic surgeons, you can call at (972) 727 – 9995.

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