Diseases of Musculoskeletal System Flashcards
What is meant by the term Arthritides?
Pain and stiffness in the joint
Inflammation in joint
Lots of diseases come under this title
Is osteoarthritis acute or chronic? What structures are formed/destroyed?
Chronic and degenerative
Progressive erosion of articular cartilage
Formation of bony spurs/cysts at the margin of joints
What parts of the body are most commonly affected by osteoarthritis?
knees
hands
What are chondrocytes?
cells that produce cartilage
What 2 processes that affect chondrocytes in osteoporosis?
Chondrocytes produce IL-1 = initiate matric breakdown
Postaglandin derivatives cause release of lytic enzymes = prevents matrix synthesis
How does muscle strength affect osteoporosis?
Increase muscle strength delays onset due to less pressure on the joints
What are Herberdens and Bouchard nodes?
Bouchard’s nodes = hard, bony outgrowths/gelatinous cysts on the PIJ
Herberden’s nodes = hard, bony outgrowths/gelatinous cysts on the DIJ
What is Rheumatoid arthritis?
Chronic progressive disease causing inflammation in the joints and resulting in painful deformity and immobility
Ankylosis of joints - abnormal stiffness due to fusion of the bone
What parts of the body are affected in Rheumatoid arthritis?
joints skin muscles heart lungs blood vessels
What is the pathogenesis of Rheumatoid arthritis?
Thickening of the synovium - produces a pannus ( sticky substance filled with inflammatory cells)
Causes erosion of articular cartilage
Penetrates into bone = cysts
What are the clinical features of rheumatoid arthritis?
Malaise/fatigue
Generalised musculoskeletal pain initially
Joints swollen/warm/stiff - In morning/after activity
Deformed joints
Symmetrical
Rhematoid nodes - later stages
Rhematoid factor
Radiological changes - narrowing of joint space, loss of cartilage
How is rheumatoid arthritis diagnoised?
Rheumatoid factor - not very specific though
Analysis of synovial fluid for neutrophils
What is palisaded granuloma?
Subtype of necrotizing granuloma
Mononuclear phagocytes at the periphery have elongated or spindle-shaped nuclei
What is gout?
A type of arthritis in which small uric acid crystals form inside and around the joints
What are the clinical features of gout?
Acute arthritis - red, swollen, painful
Tophi - deposit of crystalline uric acid at the surface of joints or in skin or cartilage
Gouty Nephropathy - decreasing kidney function due to hyperuraemia
What is pyogenic osteomyelitis?
pathogen causing infection of the bone
What are the signs and symptoms of pyogenic osteomyelitis?
systemic illness - fever/malaise/chills
Pain over affected region
Bone destruction surrounded by sclerosis
Blood culture = positive
What microorganisms most commonly cause infective arthritis?
Staphylococcus
Streptococcus
What is osteoporosis and its characteristics?
Bones become brittle and fragile from loss of bone mass
Can be localised or the entire skeleton
What two factors contribute to primary osteoporosis?
Age
Post-menopause = oestrogen exposure
What 3 things can osteoporosis cause?
Verterbral fractures
Kyphosis
Scoliosis
What 3 conditions cause secondary osteoporosis?
Endocrine disorders - hyperparathyroidism, Type I diabetes
Neoplasias - multiple myeloma
Malnutrition
What 4 conditions are caused by osteoclast dysfunction?
Paget’s disease
Osteomalacia
Hyperparathyroidism
Renal osteodystrophy
What virus causes Paget’s Disease?
Paramyxovirus
What is Paget’s disease?
Cells are ‘mosaic’ or ‘chaotic’
Too much bone but weak due to irregular structure
What is a rare but serious complication of Pagets disease?
Tumours - can be benign or malignant
What is osteomalacia and what causes it?
Defect in matrix mineralisation
Related to lack of Vit Decreased bone density
What does ‘osteitis fibrosa cystica’ mean?
Loss of bone mineral with osteoporosis
What is renal osteodystrophy?
Skeletal changes that occur during chronic renal disease. Includes: Increased bone reabsorption Delayed matrix mineralisation Osteosclerosis Growth retardation Osteoporosis
Where does soft tissue originate from embryologically?
Mesoderm
What is a malignant soft tissue tumour called?
Sarcoma
How is diagnosis of soft tissue tumours done?
Ultrasound guided core biopsy
Wide excision
Karyotypic analysis
Molecular genetics via FISH/PCR
What is the comment site for malignant bone tumours (osteosarcoma) to arise?
the knee
How are the cells described in bone and soft tissue tumours?
Pleomorphic
What is the most common sign of SLE on the skin?
‘Butterfly rash’ - affects bridge of nose and cheeks
What other systems are affected in SLE?
Cardiac
Renal
CNS
What is systemic sclerosis?
Autoimmune disease of the connective tissue
Thickening of the skin caused by accumulation of collagen
Injuries to the smallest arteries
What body systems are affected in systemic sclerosis?
Renal
Cardiorespiratory
GI
MSK i.e. artharlgia, arthritis
What is Polymyalgia Rheumatica?
Pain, stiffness and inflammation in the muscles around the shoulders, neck and hips
Associated with giant cell artheritis
Immunological mechanism
What are the symptoms of polymyalgia rheumatica?
Affects occipital/facial arteries:
Pyrexia
Headache
Severe scalp pain
