Diseases of the musculoskeletal system Flashcards
1
Q
Osteoarthritis
A
- Commonest type of joint disease, progressive erosion of articular cartilage
- Results in the formation of bony spurs and cysts at the margins of joints
2
Q
Primary OA
A
- Abnormal stresses in weight bearing joints
- Affects fingers, knees, cervical and lumbar spines
- Involves fingers – Bouchard’s (proximal) or Heberden’s (distal) nodes
3
Q
Secondary OA
A
- Knee in basketball players and elbow in baseball players
- Caused by another disease e.g. obesity, trauma
- More commonly affected = knees and hands in women, hips in men
4
Q
Secondary OA pathogenesis
A
- Deterioration or loss of cartilage that acts as a protective cushion in between bones = as the cartilage is worn away, bone forms spurs = fluid filled cysts in the marrow form (subchondral cysts)
- At the cellular level = chondrocytes produce IL-1 that initiates matrix breakdown, and prostaglandin derivatives induce the release of lytic enzymes that prevent matrix synthesis
5
Q
Rheumatoid Arthritis definiton
A
- Chronic systemic disorder producing non-suppurative proliferative synovitis which leads to the destruction of articular cartilage and ankylosis of joints.
- Also affects skin, muscles, heart, lungs, blood vessels
- Women 3-5 times more likely to be affected than men
6
Q
Rheumatoid Arthritis clinical features
A
- Malaise, fatigue, general MSK pain
- Involved joints are swollen, warm, painful, stiff in the morning or after activity. Small joints of the hands and feet are frequently affected deformity of joints
- Slow or rapid onset of disease – fluctuates over 4-5 years
7
Q
Rheumatoid Arthritis aetiology
A
- Genetic susceptibility
- Primary exogenous arthritogen – EBV, other viruses, Borrelia
- Autoimmune reaction within the synovial membranes – CD4+ T cells
- Mediators of joint damage e.g. cytokines
8
Q
Rheumatoid Arthritis criteria for diagnosis
A
4 of the following:
- Morning stiffness
- Arthritis in 3 or more joint areas
- Arthritis of hand joints
- Symmetrical
- Rheumatoid nodules
- Serum Rheumatoid Factor
- Typical radiographic changes-narrowing of joint space, loss of articular cartilage
9
Q
Ankylosis of joint space =
A
- Abnormal stiffening and immobility due to fusion of the bone. This occurs due to formation of pannus (fibrovascular tissue) in the joint space
10
Q
Gout
A
- End point of a group of disorders producing hyperuricaemia
- Uric acid is the end product of purine metabolism
11
Q
Gout clinical features
A
- Acute arthritis
- Chronic arthritis
- Tophi in various sites – transient attacks of acute arthritis
- Crystallisation of urates within and about joints, leading to chronic gouty arthritis
- Gouty nephropathy
12
Q
Benign tumours of the soft tissue
A
- Lipoma – fat tissue
- Fibroma – fibrous tissue
- Leiomyoma – smooth muscle
- Haemangioma – blood vessel
- Lymphangioma – lymphatics
- Neuroma – peripheral nerve
13
Q
Malignant tumours of the soft tissue
A
- Sarcoma
- Lymph node involvement uncommon, haematogenous spread more common
- Associated syndromes = Gardner syndrome, Carney syndrome, Turner syndrome
- Diagnosis = ultrasound, wide excision, molecular genetics
14
Q
Benign bone tumours
A
osteoma/osteoblastoma
15
Q
Benign cartilage tumours
A
chondroma
