The effects of limb length discrepancy vary from patient to patient, depending on the cause and size of the difference. Differences of 3.5 percent to 4 percent of the total length of the leg (about 4 cm or 1 2/3 inches in an average adult) may cause noticeable abnormalities when walking. These differences may require the patient to exert more effort to walk.

Limb length discrepancy can be measured during a physical examination and through X-rays. A limb length discrepancy may also be detected on a screening examination for curvature of the spine (e.g., scoliosis). However, limb length discrepancy does not cause scoliosis.

Our experts are experienced in limb lengthening techniques, and they can explain the treatment options and decide what treatment, if any, is best for you. For minor limb length discrepancy in patients with no deformity, treatment may not be necessary. Because the risks may outweigh the benefits, surgical treatment to equalize leg lengths is usually not recommended if the difference is less than 1 inch. For these small differences, the physician may recommend a shoe lift, which can often improve walking and running, as well as relieve any back pain that may be caused by the limb length discrepancy. Shoe lifts are inexpensive and can be removed if they are not effective. In growing children, legs can be made equal or nearly equal in length with a relatively simple surgical procedure. This procedure slows down the growth of the longer leg at one or two growth sites. Your surgeon can tell you how much equalization can be gained by this procedure, which is performed under X-ray control through very small incisions in the knee area. This procedure will not cause an immediate correction in length. Instead, the limb length discrepancy will gradually decrease as the opposite extremity continues to grow and “catch up.”

You may experience dull, aching pain around the front of the kneecap, where it connects to the lower end of the thighbone (e.g., the femur). The pain may worsen when going up or downstairs, squatting or kneeling.

If you’re experiencing pain or a dull aching in one or both knees, Dr. Robert A. Kayal and his elite team of NJ orthopaedic surgeons will assess your injury and pinpoint the source of your symptoms.

Treatment of patellofemoral pain depends on the underlying cause. The most important way to improve your condition is rest, rehabilitation or knee bracing. It is important to modify activity. Keeping the knee as straight as possible can help relieve underlying irritation. Physical therapy can help to strengthen the quadriceps muscle and allow your kneecap to track properly. In some cases, surgery can correct the underlying condition and improve support to the knee. Arthroscopy, which involves the use of a small, pencil-sized camera, can be used to smooth fragments of kneecap cartilage. Realigning the kneecap is also an alternative, and this is done by opening the knee and reducing the abnormal pressures on the cartilage.

The main symptom is aching pain over the part of the outer hip. The pain worsens with movement or pressure, and it may travel down the outside of the thigh toward the knee. Pain caused by pressure at night can make sleeping very difficult.

Your doctor will be able to diagnose bursitis when he or she physically examines the specific area that’s causing pain and tenderness. However, an X-ray may be taken to rule out other causes, too.

Initial treatment of bursitis involves resting, immobilizing the area, and non-steroidal anti-inflammatory medications (NSAIDs) to reduce inflammation and relieve pain—a regimen that is often effective. Exercise and physical therapy, especially for the hip and lower back, can be helpful to strengthen the surrounding muscles and help prevent further episodes. If these measures don’t relieve your pain, a doctor may recommend an injection of corticosteroids around the bursa, which usually brings rapid pain relief. Surgery to remove the damaged bursa may be an option in severe cases.

In some cases, knee bursitis will cause no more than joint stiffness or a minor ache. However, severe cases may result in debilitating stiffness and immobility, aching, and shooting pain during joint movement. Swelling and redness of the affected area are also common.

After hearing a description of the pain, a qualified surgeon typically diagnoses bursitis by:● Conducting a thorough examination; and● Identifying localized swelling, tenderness, and pain of the affected joint.

Surgery is rarely needed for bursitis. The first step in treatment is to cease the repetitive motion or activity that’s causing the problem, and in some cases, to immobilize the affected joint. Icing the area and taking an anti-inflammatory medication for a few weeks are also initial treatment steps. If bursitis continues, our physicians may aspirate or inject cortisone into the area to reduce inflammation. Shoulder pain and/or a lack of mobility in the joint persist after these more conservative treatments, surgery would be considered to drain excess fluid and remove damaged tissue.

Although some people who have osteoarthritis say they feel no pain, most people who have OA experience pain, feel joint stiffness (especially in the morning), show signs of swelling and tenderness in one or more joints such as the hips, knees or spine, and may even hear a crunching sound in their joints. For some people, OA can become completely debilitating.

In order to diagnose you properly, your doctor will consider your symptoms and your medical history, examine your joint(s), and order one or more diagnostic tests. Further, your doctor may order blood work, X-rays, a CT scan, or an MRI, which can be scheduled at Kayal Medical Imaging in Bergen County, to get a clearer view of the alignment of your painful joint and its condition.

Your Bergen County doctor may recommend different treatment options, depending on the severity of your osteoarthritis and its impact on your joint(s). If you are still experiencing arthritis pain and joint damage that’s affecting your quality of life, even after all other conservative measures have been taken, your doctor may suggest orthopaedic surgery, which will be performed conveniently right here in Bergen County, to help relieve your pain and restore your mobility.
Your doctor will determine the proper surgical treatment based on the severity of your arthritis and its location. Today, a full range of surgical solutions exists that enable your doctor to customize surgical procedures to your particular needs and anatomy, whether you need arthroscopic debridement (removing inflamed and/or irritating debris from the joint), arthrodesis (fusing the joint for greater support) or arthroplasty (replacing the arthritic joint).

Rheumatoid arthritis symptoms often begin in small joints such as the knuckles of the hands and the toes of the feet. The most common symptoms are pain, swelling, and stiffness in the joints. Typically, these symptoms transpire in multiple joints throughout the body. Since this condition is a systemic disease, an affected individual may feel more diffuse symptoms including fever, loss of appetite, body tiring easily, and lumps developing near the joints.

Diagnosis of rheumatoid arthritis involves a thorough physical examination of the affected area and an evaluation of the patient’s medical history. The Kayal Orthopaedic Center physicians in Bergen County will look for specific physical characteristics that indicate the presence of RA. These include:
● Skin. The presence of callouses indicates areas where abnormal pressure is being applied.● Joint shape. RA weakens ligaments, which causes joint deformities, such as bunions, claw toes, finger angulation, and flat feet to arise.● Flexibility. A joint’s flexibility directly relates to the stage of the condition. If the joint still has a decent level of flexibility, then the condition is in its early stages. If flexibility is limited or barely present, it’s a good indication that there has been a significant loss of cartilage and the condition has progressed.● Tenderness. To determine which joints RA has affected and the severity of treatment required, our physicians will apply pressure to specific areas to see which joints react to the pressure and which remain unbothered.
There are other tests our physicians may request to further confirm the affected patient’s diagnosis, including an X-ray, a CT scan, and an MRI scan, which can be conveniently scheduled at Kayal Medical Imaging in Bergen County. A blood test is frequently utilized to test the patient’s blood for certain autoimmune markers.

Once a diagnosis has been made, Dr. Kayal and his team will assist patients, who can choose from several convenient offices in Bergen County, with deciding on treatment options. Although there is no existing cure for rheumatoid arthritis, there are progressive approaches that may alleviate symptoms and slow down the progression of the condition. Conservative, non-surgical treatment measures may involve steroid injections, orthotic devices, and viscosupplementation, in which lubrication fluid is injected into the joint. Medications can also help to slow down the progression of the disease. For more severe cases, surgical options may be recommended based on our physician’s discretion. Possible surgical treatment options include:
● Minimally invasive arthroscopy to remove diseased cartilage● Fusion for severely damaged joints or ligaments● Total ankle replacement to restore the ankle’s range of motion

The main symptom of shoulder bursitis is an aching pain with overhead activities, or with pressure on the upper or outer arm.

After hearing a description of the pain, a qualified surgeon typically diagnoses bursitis by:● Conducting a thorough examination● Identifying localized swelling, tenderness, and pain of the affected joint.

Surgery is rarely needed for shoulder bursitis. The first step in treatment is to cease the repetitive motion or activity that’s causing the problem, and in some cases, to immobilize the affected joint. Icing the area and taking an anti-inflammatory medication for a few weeks are also initial treatment steps. If shoulder bursitis continues, our physicians may inject cortisone into the area to reduce inflammation. Shoulder pain and/or a lack of mobility in the joint persist after these more conservative treatments, surgery would be considered to drain excess fluid and remove damaged tissue.