Tendonitis or not

[Bnatural]

I recently was told I had tendonitis by my physician... but for some reason I just knew he was wrong so I went to an orthopedist whom took x-ray's of both wrist and told me I had Madelung Deformity (when the two bones in the wrist do not grow to the correct lengths there is suposed to be a 2mm difference I have a 7mm difference) Has any one had any experience with this specificly ? Thank you all in advance.

Bnatural
steeler901@hotmail.com (not sure if i set it to show my email by default so just in case)

[UOPJohnny]

I have tendonitis in both wrists from saxophone and (to a lesser degree) flute playing. It's pretty bad, but I keep it under control by icing my wrists daily. I ice them about 15 minutes a day, take extra-strength advil when I need to (which is occasional). I was on Bextra for awhile, which really helped out.

I'm a young guy, too, by the way. I guess these things can happen.

Sorry if you wanted information on the bone structure... I can't offer any of that.

[Bnatural]

Thanks you very much for your reply I'll try some of what you said but I was more so looking for any sax players with madelung deformity

Thank you again and hopefully the Advil will help me. You mentioned Bextra I am not sure I know what that is
Bnatural

[L1]

Bextra is one of the newest prescription anti-inflammatory medications called a COX-2 inhibitor (inhibits cyclooxygenase-2). Others in this class are Vioxx and Celebrex. It has less incidence of stomach and other gastrointestinal ulceration, but it is rather expensive and many insurance companies won't cover it without prior-authorization. (You would typically need to have a history of gastrointestinal problems or allergy to the older non-steroidal anti-inflammatories such as Advil or Aleve)

[Bnatural]

I figured i would keep u all informed with my situation... well I continue to keep playing as the mobility of my wrist decreases... they sent me in for a bone scan and am awaiting the 5th for the results to be shown to me.... fun fun fun..... I'll let you know..... hope this doesn't happen to anyone else

[doc]

BNat here's what the book says. In short if you're over 30 this is probably a post-traumatic lesion. It may require surgery but only after failure of conservative therapy. My advice is, as always, find an orthopod who's a musician. He/she will be best able to accomodate your needs effectively long term. Otherwise be sure to tell your orthopod what you need . He/she may actually need to see you hold your horn prior to surgery to assure that you get the desired outcome. the PT folks may also be able to help you with a brace to decrease strain/pain.

I didn/t stay at a holiday inn express last night but i am really a doctor.

keep honkin'

From:Campbell's Operative Orthopaedics, 9th ed
Madelung deformity is an abnormality of the palmar ulnar part of the distal radial epiphysis in which progressive ulnar and
volar tilt develops at the distal radial articular surface, with dorsal subluxation of the distal ulna. The deformity probably was
first described by Malgaigne in 1855 and later by Madelung in 1878. It is believed to be a congenital disorder, although it
seldom is obvious until late childhood or adolescence. It is a rare anomaly, accounting for only 1.7% of hand anomalies in
Flatt's series. The cause of Madelung deformity is uncertain; however, it has been shown to be transmitted in an autosomal
dominant pattern. Other Madelung-like deformities have occurred after trauma, as reported by Vender and Watson in a
gymnast, and after infection or neoplasm. There is no definitive method of distinguishing these from idiopathic Madelung
deformity. Vender and Watson classified Madelung and Madelung-like deformities into four groups: posttraumatic, dysplastic
(dyschondrosteosis or diaphyseal aclasis), genetic (for example, Turner syndrome), and idiopathic. They believe that acquired
deformities usually can be distinguished by a lack of appropriate physical findings, unilaterality, less severe carpal deformities,
and the appropriate history of repetitive injury or stress.

Madelung deformity typically consists of volar subluxation of the hand, with prominence of the distal ulna and volar and ulnar
angulation of the distal radius. It is more commonly bilateral and affects girls more frequently than boys. A family history of the deformity often is present. The
deformity usually manifests in late childhood or early adolescence, with decreased motion and minimal pain. As growth occurs,
the deformity worsens in appearance.

[sjonesjrmd]

probably do not have true Madelungs but some degenerative changes in the triagular fibrocartlage complex on the ulnar side of the wrist.......or more likely, plain old tendonitis of the ulnar side of the wrist. I agree with Ice and some nonsteroidal anti inflammatory drug such as ibuprofen or advil or aleve. A mri may be neccessary to make the diagnosis. Try to get an Occupational therapist to make you a splint for your right hand which when playing the sax is usually in some radial deviation.

Rust and mileage!!!! :P

[Cameron Wigmore]

It was neccessary for me to take over a year off from playing. I was busking prior to that - playing for over 5 hours a day for months in the cold weather agrivated my wrists to the point where my hands were asleep when I woke up every morning! Yet I did not take a break! I eventually did for a year. You might want to rest your wrists now while you may still be able to recover.
Nasty stuff really. :cry: :cry: :cry:

[tkushin]

.....

[Bnatural]

Figured it was about time I updated everyone. Well, eventually I got referred to a specialist (at the Philadelphia Hand Center) who basically laughed at the diagnosis... well actually his intern person did then he did the same. So he felt my wrist and looked at the various test. Sent me for an MRI that same night. Then when I go back he says that he still isn't positive but wants to go in to look around (he had narrowed it down to two things; neither of which i remember the technical term for but they amount to a loose ligament w/ a short bone, or a circulatory problem) so I had the surgery and now about a month later I'm feeling pretty good, still a bit sore but certainly much better. All he ended up doing was scraping away some cartilage and tightening a tendon. Doc says I could have a problem due to the cartilage but we can hope not. They just have me doing some movement exercises and then I can begin strength next month. So I'm just waiting around til I can get back to playing... thanks for all your advice and information

[Torachan]

Nice result. Good on you for having the courage to question the doctor's diagnosis. Doctors are smart and know a lot. However they don't know everything.

Had you taken the easy road you'd no longer be playing.

Thumbs up!!