Degenerative conditions Flashcards
What is osteoarthritis
A disease of synovial joints in which the articular cartilage becomes split, fissured and softened and gradually resorbs tsometimes down to underlying bone
What is the name given to the spurs of bone that are formed in osteoarthritis
Osteophytes
Describe the changes seen in osteoarthritis
Softening and splitting of articular cartilage (fibrillation)
What might be responsible for collagen break down
matrix metalloproteinases
What are some secondary causes of osteoarthritis
Fractures joint infection inflammatroy joint disease congenital abnormalities joint instability cartilage damage obesity
What are the 3 main symptoms of osteoarthritis
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
Describe the changes seen when examining the movement of a joint with OA
restricted
muscle spasma and pain
crepitus
What are the radiological signs of OA
narrowing of the joint space
osteophyte formation around the edges of the joint
sclerosis in the subchondral bone
cysts in the subchondral bone
What are the mainstay of treatment in OA
analgesics
How can the patient protect their joint
lose weight
use a stick
splint
change of lifestyle
What are the surgical options for a patient with OA
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
What groupp of conditions are characterised by deterioration i the structure and strength of those tissues that contain a high proportion of collagen
degenerative conditions of collagenous tissues
What are tendinopathies
a group of conditions affecting the tendons themselves and are characterised by swelling, tenderness and gradual loss of function
How does the collagen in tendinopathy become disorganised
constant splitting (tendinosis) and inflammation (tendonitis) and subsequent healing
What eventually happens to the tendon
it loses its elasticity and original length
What is the treatment for tendinopathy
nest
immbolisation
sometimes a splint
rarely injection of steroid or surgery
What is tenosynovitis
a condition in which a tendon sheath becomes inflamed and often distended with fluid
What does tenosynovitis usually affect
the flexor or extensor tendons in the thumb or fingers where they cross the wrist within a synovial sheath
What are example of a tenosynovitis
De Quervain’s disease and trigger finger
What is the treatment of Tenosynovitis
change in occupation
immobilisation for 2-3 weeks in a plaster cast to prevent thumb or finger movements
What does the young intervertebral disc consist of
a ell demarcated nucleus pulposus and annulus fibrosus
What happens to the disc in intervertebral disc degeneration
it loses its elasticity and ability to act as a shock absorber and the disc space becomes narrowed and distorted
What is a disc prolapse
The nuclear material bursts through the annulus particularly during lifting or straining
what happens in capsulitis
The collagen of the joint capsule may give way and become inflamed
If capsulitis is chronic in the shoulder, what is it known as
Frozen shoulder
What does a ganglion present as
a cystic swelling occurring in relation to a joint or tendon sheath
Where are ganglia particularly common
on the dorm of the hand and wrist and around the ankle
Describe the appearance of a ganglion
non tender
fluctuant
tranilluminable
Why do ganglions arise
by a protrusion of synovium or synovial fluid through a microscopic split i the capsule or fibrous sheath
What is the treatment for a ganglion
may disperse by a blow or pressure but may also be aspirated
What must be excised if recurrence is to be avoided with ganglions
the neck of the ganglion
