GALS screen Flashcards
What is subluxation?
Partial dislocation
What is arthralgia?
Subjective joint pain without demonstrative inflammation
What is arthritis?
Inflammation of a joint seen in a clinical setting
Give an example of acute arthritis
Gout
Explain the pathophysiology of gout and give the name used to describe this phenomenon
Depositions of monosodium urate crystals (TOPHI) causes pain
Which joint is commonly affected in gout?
Knee
Ankle
1st MTP (big toe)
What is another name for the 1st MTP being affected in gout?
Podagra
Which joints are typically spared in polyarticular gout?
Axial joints (spine)
List four sites of swelling
Bone
Articular soft tissue
Periarticular soft tissue
Non - articular synovial areas
Which tissue is involved in swelling of the articular soft tissue?
Synovium or effusion
Which tissue is involved in swelling of the periarticular soft tissue?
Subcutaneous tissue
Give two examples of tissues involved in non-articular synovial swelling
Bursa
Tendon sheaths
Swelling of which sites would be indicative of osteoarthritis?
Swelling of the articular ends of bones
Swelling of which sites would be indicative of inflammatory joint disease?
Synovium/periarticular soft tissue/subcutaneous tissue
What would swelling of non-articular synovial areas e.g. bursa and tendon sheath suggest?
Inflammation of the structure involved
Give three signs of irreversible joint damage
Joint deformity
Crepitus
Loss of joint range or movement
What is Reiter’s syndrome?
Triad of:
Conjunctivitis
Urethritis
Arthritis following infection
In which condition does one see Reiter’s syndrome?
Reactive arthritis
Give two signs of mechanical defect
Instability e.g. side to side movement of tibia on femur
Painful restriction of movement in absence of inflammation
What is the official name for synovial fluid examination?
Arthrocentesis
When would you do arthrocentesis?
To confirm suspected crystal arthritis e.g. gout
If joint infection is suspected
What are the contraindications for arthrocentesis?
Bleeding disorders
Low platelet count
Anti coagulant drugs
Overlying skin infection
List three complications of arthrocentesis
Introduction of infection into joint
Haemarthrosis (bleeding into joint)
Damage to structures within joint
What examinations are done on the fluid?
Gram staining
Ab sensitivity assay
Polarising light microscopy (birefringence)
What is the birefringence outcome for gout crystals?
Negative
What is the differential for gout and what is the birefringence of this?
Pseudogout, positive
What shape are the crystals in pseudogout and what crystals are these?
Brick shaped
Calcium pyrophosphate dihydrate crystals
What shape are the crystals in gout and what crystals are these?
Urate crystals
Needle shaped
What colour is normal aspirated fluid and what causes this colour?
Clear/pale yellow - due to hyaluronic acid
If the fluid is slightly turbid, what does this suggest?
Non inflammatory condition such as osteoarthritis or mechanical defects
If the fluid is quite turbid, what does this suggest?
Inflammation; gout or RA
If the fluid is very turbid, what does this suggest?
Bacterial infection
List three risk factors for septic arthritis
Impaired host defence
Direct penetration
Joint damage
Explain Raynaud’s phenomenon
White - vasospasm
Blue - venous blood
red - reactive hyperaemia
