Degenerative conditions

Question 1

What is osteoarthritis

Answer 1

A disease of synovial joints in which the articular cartilage becomes split, fissured and softened and gradually resorbs tsometimes down to underlying bone

Question 2

What is the name given to the spurs of bone that are formed in osteoarthritis

Answer 2

Osteophytes

Question 3

Describe the changes seen in osteoarthritis

Answer 3

Softening and splitting of articular cartilage (fibrillation)

Question 4

What might be responsible for collagen break down

Answer 4

matrix metalloproteinases

Question 5

What are some secondary causes of osteoarthritis

Answer 5

Fractures 
joint infection 
inflammatroy joint disease
congenital abnormalities
joint instability 
cartilage damage
obesity

Question 6

What are the 3 main symptoms of osteoarthritis

Answer 6

stiffness - after rest, causes difficulty in every day tasks
swelling - overproduction of under-absorption of synovial fluid or from osteophyte formation
deformity - as a result of soft tissue changes such as muscular spasm
Pain - exacerbated by exercise

Question 7

Describe the changes seen when examining the movement of a joint with OA

Answer 7

restricted
muscle spasma and pain
crepitus

Question 8

What are the radiological signs of OA

Answer 8

narrowing of the joint space
osteophyte formation around the edges of the joint
sclerosis in the subchondral bone
cysts in the subchondral bone

Question 9

What are the mainstay of treatment in OA

Answer 9

analgesics

Question 10

How can the patient protect their joint

Answer 10

lose weight
use a stick
splint
change of lifestyle

Question 11

What are the surgical options for a patient with OA

Answer 11

osteotomy
arthrodesis - bones either side of the joint are jointed together permanently
arthroplasty - joint replacement
arthroscopic lavage - clearout debris, osteophytes, cartilage fragments - more a palliative procedure

Question 12

What groupp of conditions are characterised by deterioration i the structure and strength of those tissues that contain a high proportion of collagen

Answer 12

degenerative conditions of collagenous tissues

Question 13

What are tendinopathies

Answer 13

a group of conditions affecting the tendons themselves and are characterised by swelling, tenderness and gradual loss of function

Question 14

How does the collagen in tendinopathy become disorganised

Answer 14

constant splitting (tendinosis) and inflammation (tendonitis) and subsequent healing

Question 15

What eventually happens to the tendon

Answer 15

it loses its elasticity and original length

Question 16

What is the treatment for tendinopathy

Answer 16

nest
immbolisation
sometimes a splint
rarely injection of steroid or surgery

Question 17

What is tenosynovitis

Answer 17

a condition in which a tendon sheath becomes inflamed and often distended with fluid

Question 18

What does tenosynovitis usually affect

Answer 18

the flexor or extensor tendons in the thumb or fingers where they cross the wrist within a synovial sheath

Question 19

What are example of a tenosynovitis

Answer 19

De Quervain’s disease and trigger finger

Question 20

What is the treatment of Tenosynovitis

Answer 20

change in occupation

immobilisation for 2-3 weeks in a plaster cast to prevent thumb or finger movements

Question 21

What does the young intervertebral disc consist of

Answer 21

a ell demarcated nucleus pulposus and annulus fibrosus

Question 22

What happens to the disc in intervertebral disc degeneration

Answer 22

it loses its elasticity and ability to act as a shock absorber and the disc space becomes narrowed and distorted

Question 23

What is a disc prolapse

Answer 23

The nuclear material bursts through the annulus particularly during lifting or straining

Question 24

what happens in capsulitis

Answer 24

The collagen of the joint capsule may give way and become inflamed

Question 25

If capsulitis is chronic in the shoulder, what is it known as

Answer 25

Frozen shoulder

Question 26

What does a ganglion present as

Answer 26

a cystic swelling occurring in relation to a joint or tendon sheath

Question 27

Where are ganglia particularly common

Answer 27

on the dorm of the hand and wrist and around the ankle

Question 28

Describe the appearance of a ganglion

Answer 28

non tender
fluctuant
tranilluminable

Question 29

Why do ganglions arise

Answer 29

by a protrusion of synovium or synovial fluid through a microscopic split i the capsule or fibrous sheath

Question 30

What is the treatment for a ganglion

Answer 30

may disperse by a blow or pressure but may also be aspirated

Question 31

What must be excised if recurrence is to be avoided with ganglions

Answer 31

the neck of the ganglion