Intro to MSK diseases

Question 1

Define osteomalacia

Answer 1

Reduced bone mineralisation

Question 2

What is periarticular joint pain?

Answer 2

• Point tenderness over the involved structure

- Pain reproduced by movement

Question 3

What is articular joint pain?

Answer 3

Pain at the end range of movement in any direction

Question 4

Gout

Answer 4

Monosodium urate abouve 408

these forms crystals and deposit in joints

Question 5

Risk factors for gout

Answer 5

Male 
age 
CKD
Genetic
metabolic syndrome
OA
Diet

Question 6

Pseudogout

-how does it differ

Answer 6

calcium pyrophosphate

affects larger joints such as knee and not toes like in gout

Question 7

Management of gout

Answer 7

Acute: NSAIDS, Colchicine, Steroids

Long Term: Urate lowering therapy e.g. allopurinol

Question 8

In rheumatoid arthritis which is the first joint component affected?

Answer 8

Synovium

Synovial fluid is usually hypocellular, in RA it becomes infiltrated with cells

Question 9

In OA which is the first joint component affected?

Answer 9

Cartiliage

Question 10

RA treatment

Answer 10

Gold standard: DMARDs Methotrexate

Biologic agents

• Infliximab
• Rituximab

Question 11

Infliximab

Answer 11

Anti-TNF agent

Question 12

Rituximab

Answer 12

Anti B-cell

Question 13

RA

Answer 13

MCP AND PIP (DIPS usually spared)

Polyarticular

Symmetrical

presence of: Anti CCP antibodies - cyclic citrullinated peptide antibodies, Rf+ive

Question 14

OA

Answer 14

Cartiliage disease

• Focal destruction of articular cartilage
• Remodelling of adjacent bone = hypertrophic reaction at joint margins (osteophytes)
• Secondary synovial inflammation and crystal deposition

Most commonly clinically affects the knees, hips and small joints of the hands (DIP, PIP, 1st CMCJ)