Bone And Joint Disorders Flashcards

1
Q

what is avascular necrosis

A

Failure of the blood supply to the end of a bone, resulting in ischaemic necrosis of bone and marrow

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2
Q

where is most commonly affected by avascular necrosis

A

head of the femur

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3
Q

who usually presents with avascular necrosis

A

males 35-50

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4
Q

clinical presentation of femoral head AVN

A

commonly bilateral
insidious onset of groin pain exacerbated by stairs or impact

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5
Q

hanging rope sign

A

femoral head AVN

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6
Q

how is osteoarthritis often described

A

wear and tear

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7
Q

x-ray changes seen in osteoarthritis

A

Loss of joint space
Osteophytes
Subarticular sclerosis
Subchondral cysts

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8
Q

clinical presentation of osteoarthritis

A

joint pain and stiffness, worse on activity

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9
Q

clinical signs of osteoarthritis in the hands

A

heberdens nodes
bouchards nodes
squaring at the base of the thumb
weak grip, reduced ROM

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10
Q

clinical marker of generalised OA

A

heberdens nodes

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11
Q

clinical signs in osteoarthritis

A

joint line tenderness
crepitus
joint effusion

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12
Q

management of osteoarthritis

A

physio, weight loss, NSAIDs, activity modification

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13
Q

surgical management of osteoarthritis

A

joint replacements
arthroscopic surgery to remove loose bodies

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14
Q

who is more likely to have joint hypermobility syndrome

A

females

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15
Q

name some genetic syndromes associated with joint hypermobility syndrome

A

marfans, ehlers danlos

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16
Q

when does joint hypermobility syndrome usually present

A

childhood or 3rd decade

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17
Q

clinical presentation of joint hypermobility syndrome

A

pain
thin stretchy skin

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18
Q

what is used to classify joint hypermobility syndrome

A

modified beighton score

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19
Q

what is septic arthritis

A

inflammation of joint space caused by infection

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20
Q

most common cause of septic arthritis in adults

A

staph aureus

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21
Q

most common cause of septic arthritis in the elderly

A

e.coli

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22
Q

what predisposes to salmonella arthritis

A

sickle cell

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23
Q

clinical presentation of septic arthtitis

A

acute monoarthropathy, knee most commonly affected

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24
Q

clinical signs of septic arthritis

A

reduced ROM and swelling
systemic fever

25
name some risk factors for a prosthetic joint infection
corticosteroids prior infection/surgery prolonged duration of surgery
26
most common organisms in prosthetic joint infection
staph aureus, staph epi
27
management of early prosthetic joint infection
debridement, antibiotics, implant retention
28
what is osteomyelitis
infection of the bone/bone marrow
29
who usually presents with osteomyelitis
children
30
risk factors of osteomyelitis
immunocompromised, chronic disease
31
most common cause of osteomyelitis
staph aureus
32
clinical presentation of osteomyelitis
fever, pain/tenderness, erythema, swelling
33
best diagnostic tool for osteomyelitis
MRI
34
what is osteoporosis
a significant reduction in bone density
35
what is a less severe version of osteoporosis
osteopenia
36
when does physiological loss of bone density start
30 yrs
37
who is more likely to have osteoporosis
females
38
what is type 1 osteoporosis
exacerbated loss of bone in the post‐menopausal period
39
what is type 2 osteoporosis
osteoporosis of old age with a greater decline in bone mineral density than expected
40
name a drug that can exacerbate osteoporosis
corticosteroids
41
what can be used to measure bone mineral density
DEXA scan
42
lifestyle advice for osteoporosis
increase calcium intake high intensity strength training avoid smoking and excess alcohol
43
pharmacological management of osteoporosis
calcium + vit d supplements oral bisphosphonates zoledronic acid
44
what is osteomalacia
a condition where defective bone mineralisation causes “soft” bones
45
what is the most common cause of osteomalacia
vitamin D deficiency
46
symptoms of osteomalacia
bone pain pathological fractures symptoms of hypocalcaemia
47
symptoms of hypocalcaemia
paraesthesia, muscle cramps, irritability, fatigue
48
bloods in osteomalacia
↓ calcium and serum phosphate, ↑ serum ALP
49
x-ray of osteomalacia
pseudofractures
50
management of osteomalacia
vit D + calcium and phosphate supplementation
51
what is pagets disease
excessive bone turnover due to increased osteoclast and osteoblast activity
52
where does paget's particularly affect
axial skeleton
53
presentation of pagets
can be asymptomatic Bone pain Bone deformity Fractures Hearing loss
54
what are the 3 main stages of pagets
osteolytic mixed osteosclerotic
55
bloods in pagets
↑ alkaline phosphatase with otherwise normal LFTs
56
x-ray appearance of pagets
cotton wool appearance bone enlargement and deformity
57
management of pagets
bisphosphonates
58
complications of pagets
osteosarcoma, fibrosarcoma