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Movement > Bone disease > Flashcards

Bone disease Flashcards

1
Q

Most common places for osteoporotic fractures?

A

Neck of femur (hip), wrist (Colles’), vertebral

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2
Q

Osteopororis definition?

A

Metabolic bone disease:

Low bone mass with micro architectural deterioration of bone tissue > fragility of skeleton > incr in fracture risk

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3
Q

What is the most important role of osteocytes?

A

Maintaining bone mass

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4
Q

What stimulates osteoclastic and osteoblastic activity aka bone turnover?

A

Movement

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5
Q

Why is osteoporosis more common in women than men?

A

Oestrogen deficiency (as occurs with menopause) > bone loss

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6
Q

Where does bone coupling occur?

A

Howship’s lacunae, never on flat bone

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7
Q

Why does oestrogen deficiency > incr osteoclastic activity?

A

Incr stimulation of RANKL pathway because decr oestrogen = decr OPG (natural inhibitor of RANKL pathway).

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8
Q

What is rate of bone loss in first 5 years in post menopausal women? When does osteoporosis start to present?

A

3% per year

20 years post menopause

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9
Q

How much bone mass can women lose post menopause

A

40%

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10
Q

What is the most significant factor when determining whether someone will be at risk of fracture after bone mass reduction?

A

Peak bone mass

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11
Q

How can you treat osteoarthritis?

A

Replacement of the joint

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12
Q

6 categories of joint disease?

A 
Degenerative (osteoarthritis)
Inflammatory/autoimmune (RA, spondiloarthropathies)
Metabolic (gout)
Trauma
Infection
Neoplastm
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13
Q

What is always important to consider when thinking about joint disease?

A

Systemic autoimmune?

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14
Q

What is osteoarthritis?

A

Degenrative changes in the articular cartilage

Followed by reactive change in the subchondral bone and the synovium

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15
Q

What is the gender split in osteoarthritis? How does age affect epidemiology?

A

Equal, exponential increase after age of 50.

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16
Q

How does osteoarthritis appear on X-rays? (4) mem aid. + 1 extra
What order do they appear in re. severity?

A

In order of severity

Loss of articular space
Osteophytes (don’t correspond to stage really)
Subchondral sclerosis
Subchondral cysts

Occasionally also get fragmentation of osteochondral compression (loose bodies) - quite rare

17
Q

How does RA differ from osteoarthritis.

A

Inflammation of the synovial capsule.

Inflammation covers the articular surface, suffocates it > degeneration

18
Q

Which joints tend to be affected in osteoarthritis?

Women are also more prone to get arthritis where?

A

Weight bearing joints: knee, hip, spinal

Small joints: hands and feet

19
Q

What is the percentage split between primary and secondary osteoarthritis?

A

90 : 10 %

20
Q

Obesity, congenital deformities and obesity can all increase risk of OA, when does each of the following also increase risk?

  • oestrogen status
  • bone mineral density
A

Low oestrogen

High bone density

21
Q

Which therapeutic interventions slow down the onset of OA?

A

None

22
Q

What hand deformities are seen in OA?

How do these differ from RA?

A

Bouchard’s nodes, Heberden’s nodes (PIP and DIP joints), squaring at the base of the thumb.

MCP joints are spared

23
Q

Where in the body is bony malalignment particularly common in OA? What does this cause?

A 
Knees.
Knock knees (genu valgum), bow  legs (genu varum)
24
Q

Other than the hand, where else can bony deformities develop in advance OA?

A

Knee (due to new bone formation)

25
Q

Which of the following is the most common presentation of OA in the knee joint?

  • crepitus
  • stiffness
  • effusion
A

Crepitus

26
Q

In OA, what would you expect the following test results to show?

  • CRP
  • ESR
  • RF
  • anti CCP antibody
A

Normal
Normal
Negative
Negative

27
Q

What is the cause of primary osteoarthritis?

A

Proteoglycan and collagen II changes

28
Q

List some causes of secondary arthritis (4)?

A

Deformity , RA, metabolic disease, crystal deposition disease?

29
Q

What is an osteophyte? What is their effect re. joint disease?

A

New bone formation at edge of joint

Can compress nerves –> pain

Movement (10 decks)

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