Bone And Joint Disorders Flashcards
what is avascular necrosis
Failure of the blood supply to the end of a bone, resulting in ischaemic necrosis of bone and marrow
where is most commonly affected by avascular necrosis
head of the femur
who usually presents with avascular necrosis
males 35-50
clinical presentation of femoral head AVN
commonly bilateral
insidious onset of groin pain exacerbated by stairs or impact
hanging rope sign
femoral head AVN
how is osteoarthritis often described
wear and tear
x-ray changes seen in osteoarthritis
Loss of joint space
Osteophytes
Subarticular sclerosis
Subchondral cysts
clinical presentation of osteoarthritis
joint pain and stiffness, worse on activity
clinical signs of osteoarthritis in the hands
heberdens nodes
bouchards nodes
squaring at the base of the thumb
weak grip, reduced ROM
clinical marker of generalised OA
heberdens nodes
clinical signs in osteoarthritis
joint line tenderness
crepitus
joint effusion
management of osteoarthritis
physio, weight loss, NSAIDs, activity modification
surgical management of osteoarthritis
joint replacements
arthroscopic surgery to remove loose bodies
who is more likely to have joint hypermobility syndrome
females
name some genetic syndromes associated with joint hypermobility syndrome
marfans, ehlers danlos
when does joint hypermobility syndrome usually present
childhood or 3rd decade
clinical presentation of joint hypermobility syndrome
pain
thin stretchy skin
what is used to classify joint hypermobility syndrome
modified beighton score
what is septic arthritis
inflammation of joint space caused by infection
most common cause of septic arthritis in adults
staph aureus
most common cause of septic arthritis in the elderly
e.coli
what predisposes to salmonella arthritis
sickle cell
clinical presentation of septic arthtitis
acute monoarthropathy, knee most commonly affected
clinical signs of septic arthritis
reduced ROM and swelling
systemic fever
name some risk factors for a prosthetic joint infection
corticosteroids
prior infection/surgery
prolonged duration of surgery
most common organisms in prosthetic joint infection
staph aureus, staph epi
management of early prosthetic joint infection
debridement, antibiotics, implant retention
what is osteomyelitis
infection of the bone/bone marrow
who usually presents with osteomyelitis
children
risk factors of osteomyelitis
immunocompromised, chronic disease
most common cause of osteomyelitis
staph aureus
clinical presentation of osteomyelitis
fever, pain/tenderness, erythema, swelling
best diagnostic tool for osteomyelitis
MRI
what is osteoporosis
a significant reduction in bone density
what is a less severe version of osteoporosis
osteopenia
when does physiological loss of bone density start
30 yrs
who is more likely to have osteoporosis
females
what is type 1 osteoporosis
exacerbated loss of bone in the post‐menopausal period
what is type 2 osteoporosis
osteoporosis of old age with a greater decline in bone mineral density than expected
name a drug that can exacerbate osteoporosis
corticosteroids
what can be used to measure bone mineral density
DEXA scan
lifestyle advice for osteoporosis
increase calcium intake
high intensity strength training
avoid smoking and excess alcohol
pharmacological management of osteoporosis
calcium + vit d supplements
oral bisphosphonates
zoledronic acid
what is osteomalacia
a condition where defective bone mineralisation causes “soft” bones
what is the most common cause of osteomalacia
vitamin D deficiency
symptoms of osteomalacia
bone pain
pathological fractures
symptoms of hypocalcaemia
symptoms of hypocalcaemia
paraesthesia, muscle cramps, irritability, fatigue
bloods in osteomalacia
↓ calcium and serum phosphate, ↑ serum ALP
x-ray of osteomalacia
pseudofractures
management of osteomalacia
vit D + calcium and phosphate supplementation
what is pagets disease
excessive bone turnover due to increased osteoclast and osteoblast activity
where does paget’s particularly affect
axial skeleton
presentation of pagets
can be asymptomatic
Bone pain
Bone deformity
Fractures
Hearing loss
what are the 3 main stages of pagets
osteolytic
mixed
osteosclerotic
bloods in pagets
↑ alkaline phosphatase with otherwise normal LFTs
x-ray appearance of pagets
cotton wool appearance
bone enlargement and deformity
management of pagets
bisphosphonates
complications of pagets
osteosarcoma, fibrosarcoma
