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MSK > Arthiritis and lower limb conditions > Flashcards

Arthiritis and lower limb conditions Flashcards

1
Q

What is arthiritis?

A

Inflammation and stiffness in a joint

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2
Q

what is oesteoarthiritis?

A

Wearing away of cartilage due to old age, resulting in bone on bone grinding

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3
Q

What are the xray features of osteoarthiritis?

A

Joint space narrowing
Osteophytes (boney spurs)
Subchondral sclerosis (thin layer of increased bone density beneath the articular cartilage (appears more white)
Subchrondral cysts (fluid filled legions in bone- appear darker)
LOSS

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4
Q

What is rheumatoid arthiritis?

A

An auto immune condition where antibodies attack the synovial membranes leading to joint erosion and deformity

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5
Q

How are symptoms and signs of rheumatoid arthiritis different to osteoarthiritis?

A

RA: rheumatic nodules, age 40-50 (osteo generally 50+), also comes with systemic effects in eyes, skin, lungs, heart, kidneys ect)

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6
Q

What are the x ray features of Rheumatoid arthirits?

A
  • Less joint space
  • Erosion in non cartilage protected bone
  • Periarticular osteopnea (loss of bone substances near joints)
  • Gross deformity and sublaxation
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7
Q

What movement is difficult with a patella fracture?

A

extension of the knee

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8
Q

Where does the patella normally lie?

A

patellofemoral groove

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9
Q

Which muscle normally helps stabilise the patella and how?

A

vastus medius

attaches to pattella on its medial side pulling it inwards

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10
Q

In what group of people are patella dislocations more common due to the way that the muscles develop?

A

young girls

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11
Q

What is common mechanism of patella dislocations and which direction does it normally go in??

A

Pivoting femur internally on planted foot while knee is bent
direct blows or falls onto knee
normally dislocates laterally

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12
Q

What are signs and symptoms of patella dislocations?

A 
pain
feeling a shift & hearing popping sound
knee buckling
swelling and deformity
fear of changing direction when running
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13
Q

Which menisci is more commonly injured and why?

A

medial

it is more firmly adhered to the medial collateral ligament and joint capsule

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14
Q

What is sign of medial and lateral menisci tears?

A

lateral- pain on lateral rotation of tibia

medial- pain on internal rotation of tibia

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15
Q

Why do peripheral menisci tears often repair on their own?

A

They have a good enough blood supply

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16
Q

Which collateral ligament of the knee will be injured for varus and valgus stress’?

A

varus- extended and locked knee pushed laterally as ankle fixed will injure lateral collateral ligament
Valgus- extended and locked knee pushed medially can cause medial collateral ligament

17
Q

What movements can tear an ACL?

A
  • Lateral blows to a extended leg with fixed foot (causes unhappy triad)
  • Excessive lateral twisting of a flexed knee with fixed foot (also unhappy tirad)
  • Hyperextension and severe force to front of femur with knee semi flexed
18
Q

What is an unhappy tirad?

A
  • medial collateral ligament tear
  • Medial menisci tear
  • ACL tear
19
Q

When can a PCL tear occur?

A
  • When femur moves forward over tibia
  • falling onto tibial tuberosity with flexed knees
  • Tibia hitting dashboard in car crash
20
Q

what is supraplatella bursitis and how does it occur?

A

Swelling and inflammation of the bursa infront of the knee cap
Housemaids knee
Due to one off direct injury or repeatative friction from working on knees

21
Q

What is a superficial/ subcutaneous infrapatella bursitis how does it occur

A

clergymans knee

occurs due to friction between skin and tibial tuberosity causing oedema over proximal end of the tibia

22
Q

What is a locked knee?

A

When the leg is stuck in one position and it is unable to bend or straighten
Usually caused by a mechanical block where something is stuck inside the joint, such as a meniscal tear or loose body

23
Q

Why does the knee normally lock out on full knee extention- standing

A

Gives stability and means quads not needed to flex to stand up

24
Q

What happens when the knee locks on full extension? What muscle unlocks the knee?

A

biceps femoris flexs and tibia rotates laterally and femur rotates medially
popiteal muscle unlocks it

25
Q

What causes an antalgic gait?

A

a painful leg

- also called a limb

26
Q

Describe an antalgic gait

A
  • short stance phase in affected leg
  • lack bodyweight shift onto affected leg
  • short swing phase in unaffected leg
  • uneven gait cycle lengths on each leg
27
Q

On what side should someone place the walking stick?

A

On the opposite side to the painful leg

28
Q

When does a hempiplagic gait occur?

A
  • after brain injury affecting one side of the body (stroke, cerebral palsy, trauma ect)
29
Q

describe a hemiplagic gait

A
  • flexed arm with wrist hanging down on affected side
  • exteneded lower limb on affected leg
  • circumduction of affected leg- joint flexion on this side is hard so foot wont clear floor otherwise
30
Q

When does a diplegic gait occur?

A

in neuromuscular disorders affecting both sides

31
Q

describe a diplegic gait

A
  • scissoring of legs (knees in front of the other)
  • adductors and calf muscles tight
  • ankle is always planterflexed so hard to clear foot off ground and place it
32
Q

What is a high steppage gait?

A
  • the foot drops due to inability to dorsiflex the foot
  • toe hanging down meaning the often fall over their own feet
  • need excessive hip flexion on affected side to compensate
33
Q

What can cause a high steppage gait?

A
  • sciatica

- common peroneal nerve palsy or neuromuscular disorders

34
Q

What is a parkinsonian gait?

A
  • the shuffling/ short step gait where they lean forwards with no arm swinging
  • often must lean forward and start to fall in order to start walking and have difficulty stopping (fenistant)
  • seen in parkinsons
35
Q

What is a trendlenburg gait?

A
  • dropping of pelvis when lifting leg opposite to the one affected
  • caused by weakness of abductor muscles, which can be due to legions of the superior gluteal nerve

MSK (9 decks)

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