001. Introduction to Rheumatology Flashcards
What rheumatological condition is Achilles tendonitis associated with?
Seronegative rheumatological conditions
Describe the typical x-ray appearance of an osteoarthritic joint?
Loss of joint space
Osteophytes
Subarticular sclerosis (abnormal hardening below the joint)
Subchondral cysts (fluid filled erosion within the joint)
How would an x-ray of a joint with rheumatoid arthritis present.
Juxta-articular osteopenia (obliteration of fat planes)
Soft tissue swelling
Joint deformity
Loss of joint space
What are the x-ray features of gout
Peri-articular erosions (punched out bone lesions)
Normal joint space
Soft tissue swellings
What are red flag causes of back pain?
refer all for urgent assessment
Age<20 or >50
Constant or progressive pain
Nocturnal pain
Systemic symptoms
Previous cancer
Thoracic back pain
leg claudication (spinal stenosis)
What are the causes of back pain aged 15-30
Prolapsed disc
Trauma
Fractures
AS
Between the ages of 30 and 50, what are the most common causes of back pain?
Degenerative spinal disease
Prolapsed disc
Malignancy
When an individual is over the age of 50 what are the most likely causes of back pain
Degenerative osteoperotic vertebral collapse
Paget’s
Malignancy
Myeloma
Spinal stenosis
Why is alkaline phosphatase levels a test for Paget’s?
Sign of bone turnover
What is acute cauda equina compression?
How does it present?
A neurosurgical emergency caused by sudden compression of the nerves of the back below the level of L1
Alternating or bilateral leg pain
Saddle anaesthesia
loss tone tone perianally
bladder and bowel incontinence
Acute cord compression is another neurosurgical emergency
What are its presenting signs?
Bilateral pain
lower motor signs at level of compression
upper motor sign signs and sesnsory loss below lesion
Sphincter disturbance
What are the causes for both cauda equina and cord compression?
Bony metastasis
Large disc protusion
Myeloma
Cord or paraspinal tumour
What are the signs of osteoarthritis?
Pain and crepitus
Worse with prolonged activity
Joints may feel unstable and lack power
joint tenderness and bony swellings
What are the various managements of osteoarthritis?
Lifestyle:exercise to improve local muscle strength and aerobic fitness
Analgesia- paracetemol and topical NSAIDS
Codeine/short term oral NSAID
Intra-articular steroids may relieve symptoms
Surgery- joint replacement if severe
What are the risk factors for septic arthritis?
Pre-exisiting joint disease DM Immunosurpression Chronic renal failure Recent joint surgery
