Locomotor Flashcards
Which is the most common form of arthritis
Osteoarthritis
Pathology of OA
Loss of cartilage and joint space, remodelling of bone and inflammation
Risk factors of OA
FH, Age, Female, Obese, Joint injury,
Symptoms OA Vs RA
OA - Weight bearing joints, activity related pain, no morning stiffness, exacerbated by exercise and relieved by rest
RA - Hands, and feet, morning stiffness - improves throughout the day with movement
OA investigations + treatment
X-ray - looking for osteophytes
Modify risk factors, analgesia and corticosteroids
Risk factors for Gout
Male, Red meal, Alcohol, Obesity, CKD, CHF, HTN, DM, Psoriasis
Gout Pathology
Hyperuricemia due to deficiency of HGPRT which increases the de-novo pathway for purine production leading to excess - This is broken down to uric acid, increasing blood conc.
Most common gout joint
MTP of the big toe
Confirmation of gout diagnosis
Monosodium urate crystals in joint fluid
Gout Treatment
Acute - NSAIDs and Colchicine
Prophylaxis - Allopurinol and lifestyle advice
Do not start Allopurinol in acute attack but if already established can continue
Most common organism responsible for septic arthritis
Staph Aureus
Risk factors for septic arthritis
Age, Diabetes, Joint Damage/ replacement, Skin Infections
Presentation of Septic Arthritis
Hot, Painful and Swollen Joint
2 Stages of Prosthetic joint septic arthritis
Early - Inflammation, discharge and effusion
Late - Pain and Mechanical dysfunction
Joint aspiration colours
Normal = Straw coloured Inflamed = Cloudy Septic = Opaque
Septic arthritis treatment
Flucloxacillin empirically (Erythromycin if allergic) + Fusidic acid + Gentamicin if immunosuppressed. Also joint drainage
A what ages does a prolapsed disc happen?
< 40yrs as disc degenerates with age and becomes unable to prolapse
Symptoms of prolapse
Strenuous exercise, acute back pain, sciatic pain, aggravated by movement
Which discs are most common?
L4/5
Investigations of prolapse
Usually clinical diagnosis - X-ray usually normal and MRI reserved for surgical patients
Treatment of prolapse
Bed rest, Analgesia, Epidural corticosteroids
Surgery if Bladder symptoms or foot drop
