Orthopedic and Musculoskeletal Impairments


Some of these files may require Adobe Reader for PDF files. These files are noted as PDF at the end of the site explanation. If you do not have Adobe Reader you can download it for free


Bone Diseases

  • Fibrous Dysplasia - Fibrous dysplasia is a chronic disorder of the skeleton that causes expansion of one or more bones due to abnormal development of the fibrous, or connective, tissue within the bone. The abnormality will cause uneven growth, brittleness and deformity in affected bones. Some patients have only one bone affected (monostotic), whereas other patients have numerous bones affected (polyostotic).
  • Osteoporosis - Osteoporosis, or porous bone, is a disease characterized by low bone mass and structural deterioration of bone tissue, leading to bone fragility and an increased susceptibility to fractures of the hip, spine, and wrist. Men as well as women suffer from osteoporosis, a disease that can be prevented and treated.
  • Paget's Disease of Bone - Paget's disease is a chronic disorder that typically results in enlarged and deformed bones. The excessive breakdown and formation of bone tissue that occurs with Paget's disease can cause bone to weaken, resulting in bone pain, arthritis, deformities, and fractures. Paget's disease may be caused by a "slow virus" infection, present for many years before symptoms appear. There is also a hereditary factor since the disease may appear in more than one family member.
  • Osteogenesis Imperfecta - Osteogenesis imperfecta (OI) is a genetic disorder characterized by bones that break easily, often from little or no apparent cause. There are at least four recognized forms of the disorder, representing extreme variation in severity from one individual to another. For example, a person may have just a few or as many as several hundred fractures in a lifetime.
  • Hearing Loss and Bone Disorders - For people with metabolic bone disorders such as Paget's disease of bone or osteogenesis imperfecta, hearing loss is an often overlooked yet serious handicap. To understand the nature of hearing loss in individuals with metabolic bone disorders, it is important to first understand the basic mechanism of hearing.
  • Hypophosphatasia - Hypophosphatasia is one of several disorders that resembles osteogenesis imperfecta. It is an inherited metabolic (chemical) bone disease that results from low levels of an enzyme called alkaline phosphatase (ALP). Enzymes are proteins that break down other chemicals in the body so the body can use them. ALP is normally present in large amounts in bones and the liver. In hypophosphatasia, abnormalities in the gene that makes ALP lead to the production of inactive ALP.
  • Myeloma Bone Disease - Myeloma means, literally, a "tumor composed of cells normally found in bone marrow." The majority of patients with myeloma develop destructive bone lesions, also known as osteolytic bone lesions. These lesions occur primarily in the vertebrae, the ribs, the pelvis, and the skull. They occur in the red bone marrow where nests of myeloma cells accumulate. Myeloma cells do not have a direct effect on the skeleton; rather, they cause bone destruction by producing signals that activate normal osteoclasts to resorb bone.
  • Osteopetrosis - Osteopetrosis is a congenital condition present at birth in which the bones are overly dense. This results from an imbalance between the formation of bone and the breakdown of bone, both of which are necessary in the development and maintenance of normal bone. In osteopetrosis, the cells that break down bone, or the osteoclasts, usually are either fewer in number or are ineffective in breaking down bone.
  • Primary Hyperparathyroidism - Primary hyperparathyroidism is a hormonal problem due to one or more parathyroid glands producing too much parathyroid hormone. Parathyroid glands, four small glands located in the neck near the thyroid gland, keep blood calcium from falling below normal. Rarely, there are more than four of these glands, and they may be in other parts of the neck or in the chest.
  • Bones, Muscles and Joints-The musculoskeletal system - Every time you walk your child to school, settle into a chair for a good-night story, or wrap your arms around your child in a hug, you're using your bones, muscles, and joints. Without these important body parts, you and your child wouldn't be able to stand, walk, run, or even sit.
  • Bone Markers - Throughout your lifetime, old bone is constantly being removed (resorption) and replaced by new bone (formation). During early childhood and in the teenage years, new bone is added faster than old bone is removed. As a result, bones become larger, heavier, and denser. Bone formation happens faster than bone resorption until you reach your peak bone mass (maximum bone density and strength), around age 24.
  • Glossary of Orthopedic Diagnostic Tests - Orthopaedic surgeons use a variety of diagnostic tests to help identify the specific nature of your musculoskeletal injury or condition. Orthopaedists also use results of these tests to plan an appropriate course of treatment. Here are some of the most frequently used diagnostic tests for musculoskeletal injuries and conditions.
  • Find an Orthopedist - This page allows you to search for an orthopedist by last name and optionally first name, city, state, zip code, and country. You can also search by a combination of fields.
  • Bone and joint infections - Your bones and joints, like nearly every part of your body, can fall prey to infection. Joint infections (septic or infectious arthritis) can damage cartilage and tissue within days. Bone infections, osteomyelitis (os-te-o-mi-uh-LI-tis), may fester for years and become debilitating if untreated.
  • Klippel-Feil Syndrome - Klippel-Feil Syndrome is a rare disorder characterized by the congenital fusion of any 2 of the 7 cervical (neck) vertebrae. It is caused by a failure in the normal segmentation or division of the cervical vertebrae during the early weeks of fetal development. The most common signs of the disorder are short neck, low hairline at the back of the head, and restricted mobility of the upper spine.
  • McCune-Albright Syndrome - The McCune-Albright syndrome is named for the two physicians who described it over 50 years ago. They reported a group of children, most of them girls, with an unusual pattern of associated abnormalities: bone disease, with fractures, asymmetry and deformity of the legs, arms, and skull; endocrine disease, including early puberty with menstrual bleeding, development of breasts and pubic hair and an increased rate of growth; and skin changes, with areas of increased pigment distributed in an asymmetric and irregular pattern.

To top

Brachial Plexus/Erb's Palsy

  • Overview of Brachial Plexus Palsy - A Brachial Plexus Injury is a nerve injury. The nerves that are damaged control muscles in the shoulders, arm or hand. Any or all of these muscles may be paralyzed.
  • Information - If your newborn's arm is notably weak or completely paralyzed, your child may have Brachial Plexus Palsy (BPP), also known as Erb's Palsy or Brachial Plexus Injury (BPI). The cause of this injury is usually the stretching of one (or both) sides of the neck during a difficult delivery.
  • United Brachial Plexus Network - The United Brachial Plexus Network strives to inform, support, and unite families and those concerned with brachial plexus injuries and their prevention worldwide.
  • Brachial Plexus Injury Assessment - Clinical Localizing Signs of Brachial Plexus Injuries
  • Can Shoulder Dystocia Be Prevented? - While shoulder dystocia (SD) is unanimously regarded as the “Nightmare of the Accoucheur”, it simply denotes difficult delivery of the shoulders following the delivery of the head. Fetal morbidity, in particular brachial plexus injury (BPI), was considered avoidable if SD could be prevented. Important lines of evidence that suggest that BPI is not associated with SD lead to a plausible antenatal etiology for this morbidity. Thus, avoiding SD will not avoid BPI.

To top

Cerebral Palsy

  • Overview - Cerebral palsy is an umbrella-like term used to describe a group of chronic disorders impairing control of movement that appear in the first few years of life and generally do not worsen over time. The disorders are caused by faulty development of or damage to motor areas in the brain that disrupts the brain's ability to control movement and posture.
  • Hopes through Research - In the 1860s, an English surgeon named William Little wrote the first medical descriptions of a puzzling disorder that struck children in the first years of life, causing stiff, spastic muscles in their legs and, to a lesser degree, their arms. These children had difficulty grasping objects, crawling, and walking. They did not get better as they grew up nor did they become worse. Their condition, which was called Little's disease for many years, is now known as spastic diplegia. It is just one of several disorders that affect control of movement and are grouped together under the term cerebral palsy.
  • Spasticity - Spasticity is a condition in which certain muscles are continuously contracted. This contraction causes stiffness or tightness of the muscles and may interfere with movement, speech, and manner of walking. Spasticity is usually caused by damage to the portion of the brain or spinal cord that controls voluntary movement.
  • Types - All children with cerebral palsy have damage to the area of the brain that controls muscle tone.  As a result, they may have increased muscle tone, reduced muscle tone, or a combination of the two (fluctuating tone).  Which parts of their bodies are affected by the abnormal muscle tone depends upon where the brain damage occurs. There are three main types of cerebral palsy...
  • Statistics - Because cerebral palsy influences the way children develop, it is known as a developmental disability.  In the United States today, more people have cerebral palsy than any other developmental disability, including Down syndrome, epilepsy, and autism.
  • Definition - Cerebral palsy is a term used to describe a group of chronic conditions affecting body movements and muscle coordination.  It is caused by damage to one or more specific areas of the brain, usually occurring during fetal development, or during infancy.
  • Diagnosis -Physicians use a variety of diagnostic tests to determine if a child has cerebral palsy.
  • Frequently Asked Questions and Answers -From BarinandSpinalCord.org.
  • Causes - Why does your child have cerebral palsy?  The simplest answer to this question is because your child has brain damage.  This leads naturally into the second question: Why does your child have brain damage?  There are many possible answers to this second question, because there are many reasons children can sustain brain damage.
  • History - Cerebral palsy is not a new disorder.  There have probably been children with cerebral palsy as long as there have been children.  But the medical profession did not begin to study cerebral palsy as a distinct medical condition until 1861.  In that year, an English orthopedic surgeon, Dr. William John Little, published the first paper describing the neurological problems of children with spastic diplegia.

To top

Muscular Dystrophy

  • Types, Symptoms, and Progression - Muscular dystrophy is a group of inherited diseases that are characterized by weakness and wasting away of muscle tissue, with or without the breakdown of nerve tissue. There are nine types of muscular dystrophy, but in each type there is an eventual loss of strength, increasing disability, and possible deformity.
  • Muscular Dystrophy Association - The Muscular Dystrophy Association is a voluntary health agency — a dedicated partnership between scientists and concerned citizens aimed at conquering neuromuscular diseases that affect more than a million Americans.
  • Muscular Dystrophy Information Page - From the National Institute of Neurological Disorders and Stroke: The muscular dystrophies (MD) are a group of genetic diseases characterized by progressive weakness and degeneration of the skeletal muscles that control movement. There are many forms of muscular dystrophy, some noticeable at birth (congenital muscular dystrophy), others in adolescence (Becker MD), but the 3 most common types are Duchenne, facioscapulohumeral, and myotonic.
  • Creatine Kinase Test: Almost everyone with a neuromuscular disorder has had, or will have, a creatine kinase test. But what exactly is creatine kinase (CK), and why are its levels measured in neuromuscular diseases?

To top

Poliomyelitis

  • Poliomyelitis Definition: Poliomyelitis, often called polio or infantile paralysis, is an acute viral infectious disease spread from person to person, primarily via the fecal-oral route.
  • World Health Organization information pages on Poliomyelitis - Poliomyelitis (polio) is a highly infectious viral disease, which mainly affects young children. The virus is transmitted through contaminated food and water, and multiplies in the intestine, from where it can invade the nervous system. Many infected people have no symptoms, but do excrete the virus in their faeces, hence transmitting infection to others.
  • Poliomyelitis: Overview, Symtoms, Treatment, & Prevention - "The Global Polio Eradication Initiative is a public-private partnership led by national governments with five partners – the World Health Organization (WHO), Rotary International, the US Centers for Disease Control and Prevention (CDC), the United Nations Children’s Fund (UNICEF) and the Bill & Melinda Gates Foundation. Its goal is to eradicate polio worldwide."

To top

Spina Bifida

  • Spina Bifida Association: Voluntary health agency dedicated to education, advocacy, research and service. Has a presence in more than 125 communities nationwide.
  • Spina Bifida Fact Sheet: (NIH) - Spina bifida fact sheet compiled by the National Institute of Neurological Disorders and Stroke (NINDS).
  • Spina Bifida: Mayo Clinic - Comprehensive overview covers symptoms, causes and treatment of this serious birth defect.

To top

Spinal Cord Injury

  • Information & Resources - Any damage to the spinal cord is a very complex injury. People who are injured are often confused when trying to understand what it means to be a person with a spinal cord injury (SCI). Will I be able to move my hands? Will I walk again? What can I do? Each injury is different and can affect the body in many different ways.
  • Information on Assistive Technology - AT3 Center provides objective information on assistive technology and rehabilitation equipment available from domestic and international sources to consumers, organizations, professionals, and caregivers within the United States. We serve the nation's disability, rehabilitation, and senior communities.
  • What is Spinal Cord Injury - A spinal cord injury usually begins with a sudden, traumatic blow to the spine that fractures or dislocates vertebrae. The damage begins at the moment of injury when displaced bone fragments, disc material, or ligaments bruise or tear into spinal cord tissue. Most injuries to the spinal cord don't completely sever it. Instead, an injury is more likely to cause fractures and compression of the vertebrae, which then crush and destroy the axons, extensions of nerve cells that carry signals up and down the spinal cord between the brain and the rest of the body. An injury to the spinal cord can damage a few, many, or almost all of these axons. Some injuries will allow almost complete recovery. Others will result in complete paralysis.

To top

Spinal Muscular Atrophies

  • Spinal Muscular Atrophies - Spinal muscular atrophy (SMA) is a genetic, motor neuron disease caused by progressive degeneration of motor neurons in the spinal cord. The disorder causes weakness and wasting of the voluntary muscles. Weakness is often more severe in the legs than in the arms.
  • Kennedy’s Disease - Kennedy's disease is an inherited motor neuron disease that affects males. It is one of a group of disorders called spinal muscular atrophy (SMA). Onset of the disease is usually between the ages of 20 and 40, although it has been diagnosed in men from their teens to their 70s. Early symptoms include tremor of the outstretched hands, muscle cramps with exertion, and fasciculations (fleeting muscle twitches visible under the skin).

To top

Scoliosis

  • Scoliosis Overview: From the American Association of Neurological Surgeons
  • Setting  Scoliosis Straight: settingscoliosisstraight.org is a non-profit 501(c)(3) organization "devoted to empowering families impacted by scoliosis through education, connection, and research. Our mission is to support discoveries and advance techniques in the treatment of spinal deformities in children and adolescents worldwide."
  • National Scoliosis Foundation:"The National Scoliosis Foundation (NSF) is a patient-led nonprofit organization dedicated since 1976 to helping children, parents, adults, and health-care providers to understand the complexities of spinal deformities such as scoliosis. Severe scoliosis impacts the quality of life, putting pressure on the heart, diminishing lung capacity, and limiting physical activity. Thankfully, through early detection and treatment advances, the worst effects of scoliosis may be prevented.We are involved in all aspects of scoliosis support, whether the issue is early detection through screening programs, treatment methods, pain management, or patient care. Our focus is on promoting public awareness, providing reliable information, fostering ongoing research in the field, and educating and nurturing the community of those affected by scoliosis."

To top