JB-Orthopaedics and Rheumatology Flashcards
Four key changes in OA
LOSS
Loss of joint space
Osteophytes (bone spurs)
Subarticular sclerosis (increased density of the bone along joint line)
Subchondral cysts (fluid filled holes)
How do X-ray changes (?acronym) correlate to OA symptoms
Do not
LOSS
Two nodes seen in OA in hand
Heberdens (DIP)
Bouchards (PIP)
Diagnosis for OA
Can be made if: over 45, typical pain, no morning stiffness
Most common organism in prosthetic joint infections
Staph A
What is a Colles fracture
Transverse fracture of distal causing posterior displacement causing dinner fork deformity
Common mechanism of Colles fracture
FOOSH
Classification of ankle fractures that involve lateral malleolus
Webber classification
Criteria to diagnose a fat embolism
Gurds
Respiratory distress, petechial rash, cerebral involvement + minor criteria
Best blood test for RA
anti-cyclic citrullinated peptide
Investigation for osteomyelitis
MRI
OsteoMRIlitis
Treatment of choice for SLE
Hydroxychloroquine
Pred (or cyclo) if organ involvement
Highly specific test for SLE
Anti-dsDNA
Joint aspirate in RA
High WBC (mainly polymorphic neutrophils), yellow, no crystals
Septic arthritis usually cloudy, positive gram stain (staph a), mainly neutrophils
Two key joints affected in AS
Vertebral column and sacroiliac
X-ray changes in AS
Squaring of VBs
Subchondral sclerosis and erosions
Syndesmophytes (bone growth where ligaments insert onto bone)
Ossification of ligaments
Fusion of joints
What does management of intracapsular hip fractures depend on
Undisplaced - Fixation
Displaced
Young - Reduction and fixation
Old
Low demand - hemi
High demand - THR
What should disproportion pain on assessment of tone vs power raise suspicion of
Compartment syndrome
Shoulder locked in internal rotation -> dx
Posterior shoulder dislocation
What do all patients need after a diagnosis with dermatomyositis
Malignancy screen
Most common joints in hand affected in OA
DIP and Carpometacarpal
What should be co-prescribed with allopurinol
Colchicine or NSAIDs
Second line urate lowering therapy
Febuxostat (xanthine oxidase inhibitor)
How is weakness described in PMR
Weakness is not a symptom of PMR
Aching and morning stiffness in proximal muscles (ESR raised, CK normal)
Good response to pred
Antibody associated with drug induced lupus
Anti-histone
Reactive arthritis joint aspiration
Sterile synovial fluid with a high white blood cell count
When should ?scaphoid fractures be seen in clinic/ have another x-ray
7-10 days
How are aspirin and sulflasalazine linked
If allergic, most patients allergic to both
Most common mechanism of ankle sprain
inversion
Treatment for ank spond that is not responsive to NSAIDS
Must fail 2 types of NSAIDs and have active disease
Anti-TNF
Infliximab and etanercept
