Bone and Joint Disorders Flashcards

1
Q

What are the possible causes of groin pain

A
Groin strain 
Lumbar radiculopathy
Early arthritis 
Kidney stone
Hip arthritis
Inguinal hernia- can you see a lump
Hip labrum tear
Hip fracture - is there a deformity of the lower limb making it short and externally rotates 
Osteoarthritis 
Nerve impingement - any change in sensation
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2
Q

What factors increases risk of osteoporosis

A
Age 
Female
Previous low energy fracture
Smoking
Diet
Excessive alcohol use
Emotional stress
Medications
Genetics
Environmental toxins
Inflammation oxidation
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3
Q

Life style factors affecting risk of OP

A

Excess alcohol
Smoking
Physical inactivity
Low body weight

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4
Q

Drugs increasing risk of OP

A

Glucocorticoids
Antiepileptic
Anticoagulant ( heparin)

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5
Q

Endocrine diseases

A
Hypogonadism 
Hyperthyroidism
Cushings disease
Growth hormone deficiency
Hyperparathyroidism
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6
Q

Medical disorders ;

A
Malnutrition of malabsorption 
Anorexia nervosa
Inflammatory intestinal disease
Intestinal resection 
Chronic inflammatory disease ( RA) 
Transplant patients ( solid organs and bone marrow) 
Systemic mastocytosis
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7
Q

Osteoporosis cause

A

Weakening of bones which means that it is more likely to fracture and break

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8
Q

Why do women have an increased risk of osteoporosis

A

Particularly after menopause as oestrogen slows bone loss and improves bodies absorption and retention of calcium

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9
Q

Main way of diagnosing osteoporosis

A

DEXA Scan - score of > -1 = normal
Score of -1 to -2.5 = osteopenia
Score of

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10
Q

Treat,ent of osteoporosis

A

Biphosphates - increase production of bones and act as anti bone resorption agents
Calcium and vitamin D supplements
PTH - re
Oestrogen receptor modulators - similar effects to oestrogen
HRT - replaces loss of oestrogen after menopause and helps to managing bone density

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11
Q

Osteomalacia

A

Inadequate mineralisation of the bone - more like cheesy bone
Phosphate deficiency caused by increased renal losses

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12
Q

Causes of osteomalacia

A

Insufficient dietary intake
Faulty vitamin D metabolism coeliac disease
Malnutrition during pregnancy

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13
Q

Diagnosis of osteomalacia

A

Very low vitamin D come

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14
Q

Treatment of vitamin D

A

Increase in dietary intake
Increase in outdoor time
Supplementation of vitamin D
Measure 24-hydroxy vitamin D

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15
Q

Possible causes of leg pain

A

Inflammation due to common colds/ bacterial infection
Infection - osteomyelitis / chicken pox
Others like tumours
Trauma
Abuse ?
Growing pains ? Unlikely as usually symmetrical

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16
Q

Tests

A

FBC
Esr
CRP
Renal function

Autoantibodies? - autoimmunity
? MRI - suspecting bone infection but to do an 3/4 yo you need general anaesthetic so this decision is not taken likely

17
Q

What does pus indicate

A

Usually indicative of bacterial infection

18
Q

Transient synovitis - usually due to infection or inflammation in joint

A
Treatment ; rest and NSAIDs- anti inflammatory drugs
Follow fever cure
Close observation for ; 
-  persistent/ worsening limping
- fever
- signs of systemic illness
19
Q

Septic arthritis treatment

A

Drainage in all cases - drain plus joint and the pus is usually indicative of bacterial infection
Multiple aspirations and irrigation - unstable patient , maybe gonococcal infection
Arthroscopic drainage
Open surgical drainage
IV antibiotics

20
Q

Multi focal endocarditis

A

Infection causing problems in other parts of the body

21
Q

How will bacteria change the joint fluid and blood

A

The clear straw coloured joint lubricating fluid would have changed its colour and consistency. In the presence of infection, it would look turbid or cloudy and maybe darker, presence of pus, increased viscosity and large volume of effusions from swellings

22
Q

How will bacterial infection be reflected in blood tests and joint fluid examination

A

Inflammatory markers within the blood tests include white cell count, ESR and CRP. Joint fluid should he aspirated and sent fro MC&S , gram staining and to rule out crystal arthropathy like gout/pseudo gout

23
Q

What increases the risk of gout in middle aged men

A

Increasesd red meat intake and drinking