Definitions and random cases Flashcards by Marysia Thomson

adhesive capsulitis

frozen shoulder

connective tissue becomes inflamed, thick and stiff

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differentials for orthopaedic problems of the hand:

dupuytren’s disease

trigger finger

de Quervian’s tenovaginitis

carpal tunnel

cubital tunnel syndrome

ganglion

OA at the base of the thumb

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dupruytren’s disease risk factors:

diabetes

alcohol

tobacco .

HIV

epilepsy

(it is also autosomal dominant)

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what is paget’s disease of the bone?

increased bone turnover!

increased bone resorption and increased bone formation

(leads to disorganised bone- more fractures, less compact, more vascular)

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RFs for paget’s disease of the bone:

strong genetic component

chronic viral infection

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symptoms of paget’s disease of the bone:

bone pain

excessive heat

hearing loss

bone deformity or fracture

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patient has synovitis - what do you think of?

Rheumatoid arthritis

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what condition gives thin bones with an increased risk of low trauma fracture?

osteoporosis

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what is FRAX? what is it used for?

Fracture risk assessment tool (by WHO)

used for assessing fracture risk in osteoporosis

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DXA scan
what is it?
when is it used?

dual energy X-ray absorptiometry

scan that measures the density of your bones

osteoporosis

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What is gout?

hyperuricaemia

a form of inflammatory arthritis

high levels of uric acid in the blood

acid creates deposits of mineralised/ crystal material

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how do you treat an acute flare of gout?

NSAIDs

colchicine

steroids (IM, Oral)

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JIA

group of inflammatory disorders affecting children under 16

most common rheumatic disease in children

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important disease in disability and blindness in children:

JIA

juvenile idiopathic arthritis

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what are the 3 main criteria for JIA?

children under 16

lasts for under 6 weeks

has joint swelling (arthritis), decreased range of motion, swelling etc

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what are the 3 types of JIA?

pauciarticular (4 or less joints)

periarticular (5 or more joints)

systemic onset

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how do you treat JIA?

1st line: simple pain killers (NSAIDs, steroid injections into the joint)

2nd line: methotrexate, anti TNF, IL-1 inhibitors

what is osteogenesis imperfecta?

deficiency in type 1 collagen

genetic disorder of connective tissue characterised by fragile bones (from mild trauma or even just day to day life)

what is osteoporosis?

micro architectural deterioration of bone resulting in and increased risk of fracture

what tool do you use to assess fracture risk?

FRAX

fracture risk assessment tool (WHO)

causes of osteoporosis:

rheumatoid arthritis

ankylosing spondylitis

polymylagia rheumatica

cushings

thyrotoxicosis

steroids

PPI

menopause

how do you investigate osteoporosis?

DXA scanning

dual energy x-ray absorptiometry

how do you treat osteoporosis?

biphosphonates (main treatment)

HRT

SERM (selective oestrogen receptor modulator)

how do you reduce you fracture risk in osteoporosis?

reduce the risk factors

ensure good calcium and vitamin D

medication adherence

what is ankylosing spondylitis?

long term inflammation of the joints of the spine

hallux valgus

bunions lateral angulation of the big toe

how do you test for achilles tendinopathy?

calf squeeze test (simmonds test) squeeze calf and if the foot moves then the achilles is NOT fully ruptured

what are some uses for methotrexate?

RA ectopic pregnancy/ abortion psoriasis Crohn's Chemo

most common malignant bone tumour in children

osteosarcoma

most common malignant bone tumour in older patient

myeloma

Bone tumours give what symptoms?

mass pain (mostly activity related)

what do you look for in a bone tumour?

shape texture tenderness location consistency mobility temperature

7 most common cancers that metastasise to the bone

lung breast prostate kidney thyroid GI tract melanoma

classic signs of mortons neuroma?

maulders click loss of sensation between 3rd and 4th webspace

Mensical tear causes

twisting of knee hyper-flexing of the knee joint

signs of carpal tunnel syndrome

burning/tingling/itch in thumb and palm weakness pain at night waster thenar eminences and lack of sensation over lateral 3 and a half digits

what tests can you do for carpal tunnel syndrome?

tinnels - hit wrist (tap) median nerve - feels tingling phalens - reverse prayer sign - tingling in lateral hand (thumb, index, middle fingers)

how do you treat carpal tunnel?

wrist brace surgery

capsaicin is used to treat what?

osteoarthritis

colchicine is used to treat what?

gout

SALTR harris fracture scale is what?

fractures in children that involve the growth plate

what are the stages of the SALTR harris scale?

s - straight across the growth plate a - away from the joint (into metaphysis) L - lower than joint (into epiphysis) t - through the joint (extends into epiphysis and metaphysis) R - rammed (crush injury without displacement)