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Core Conditions > Locomotor Conditions > Flashcards

Locomotor Conditions Flashcards

1
Q

Who is mostly likely to be affected by gout?

A

MALES

aged 30 to 60

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2
Q

What is the primary cause of gout?

A

It is the build up and deposition of uric acid

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3
Q

What are the main risk factors associated with gout?

A

NON-MODIFIABLE- Male gender
MODIFIABLE- alcohol, obesity, high triglycerides
PMH- hypertension, CHD, diabetes, CKD, heart failure, psoriasis, chemotherapy

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4
Q

What are the symptoms of gout?

A 
SWOLLEN, RED, TENDER joints
acute joint pain
usually at the:
-knee
-midtarsal joints
-wrists
-ankles
-elbows
-hand joints
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5
Q

What are the clinical signs of gout?

A

Synovitis

Deposition of tophi

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6
Q

What are some differential diagnoses associated with gout?

A 
Septic arthritis
Non-urate crystal induced arthropathy
Arthritis: osteo, psoriatic, reactive, rhematoid
Seronegative spondyloarthropathy
Haemochromatosis
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7
Q

What investigations should be carried out in suspected cases of gout?

A

BLOODS: Serum uric acid, plasma urate
IMAGING: joint x-ray, USS, MRI
SAMPLING: joint fluid microscopy and culture, renal acid secretion

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8
Q

Treatment options for gout include:

A

ALLOPURINOL - urate lowering drugs
PAIN MANAGEMENT- NSAIDs, colchicine, corticosteroids, analgesia
LIFESTYLE MODIFICATION
REST AND ICE PACK

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9
Q

Who is typically affected by osteoarthritis?

A

WOMEN

those over 50

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10
Q

What is the cause of osteoarthritis?

A

Repair processes do not occur after trauma/damage.

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11
Q

What are some of the risk factors of osteoarthritis?

A

NON-MODIFIABLE: genetic factors, ageing, female gender, high/low bone density
MODIFIABLE: obesity, joint stresses.
PMH- joint injury, joint laxity, joint malalignent, reduced muscle strength

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12
Q

What are the symptoms of osteoarthritis?

A

Joint pain- exacerbated by exercise and relieved by rest
Joint stiffness in the MORNING/straight after rest
Reduced function and participation

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13
Q

What are the clinical signs of osteoarthritis?

A 
Reduced range of movement on examination
Joint swelling/synovitis
Periarticular tenderness
Crepitus
Absence of systemic features
Bony swelling/deformity due to osteophytes
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14
Q

What are the differentials associated with osteoarthritis?

A 
Prepatellar bursitis
Bursitis
Pseudogout
Other arthritis (psoriatic, septic, viral, reactive, rheumatoid)
Connective tissue disease
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15
Q

What investigations would be necessary in suspected osteoarthritis?

A

IMAGING: joint x-ray, MRI,
SAMPLING: joint aspiration to exclude other diseases.

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16
Q

What is the treatment line for osteoarthritis?

A

PAIN RELIEF- NSAIDs, paracetamol
Comorbidity management
LIFESTYLE MANAGEMENT: exercise, weight loss advice,
Thermotherapy

17
Q

Who suffers from prolapsed disc and back pain?

A

Slightly higher incidence in MEN

More common in those under 40

18
Q

What is the cause of prolapsed disc?

A

Trauma
Disc degeneration
General wear and tear

19
Q

What are the risk factors associated with prolapsed disc?

A

Ageing
Sedentary lifestyle
Professional athletes
Genetic predisposition

20
Q

What are the symptoms of a prolapsed disc?

A 
Lower back pain
Unilateral leg pain which radiates below the knee to the foot/toes
Leg pain more severe than back pain
Numbness and parasthesia
Pain relieved by lying down
21
Q

What are the clinical signs of prolapsed disc?

A

POSITIVE STRAIGHT LEG TEST- greater leg pain/nerve compression symptoms on raising the leg

22
Q

What are some differential diagnoses associated with prolapsed disc?

A 
Spondylolisthesis
Dengeneration
Tumours
Metastases
Abscess
Haematoma
Osteomyelitis
23
Q

What investigations would be done in suspected prolapsed disc?

A

IMAGING: X-ray, CT myelography, MRI

24
Q

What is the treatment available for prolapsed disc?

A 
PAIN MANAGEMENT
Exercise
Heat and massage
Physiotherapy
Intradiscal laser ablation
25
Q

What is the predominant cause of septic arthritis?

A

STAPHYLOCOCCUS AUREUS
STREPTOCOCCI
Pathogens reach the synovial membrane of a joint via various entry points (penetrating trauma, iatrogenic, dissemination from soft tissue infection, blood etc.)

26
Q

What are the risk factors associated with septic arthritis?

A

NON-MODIFIABLE- ageing
PMH- diabetes mellitus, prior joint damage, joint surgery, hip/knee prosthesis, skin infection in combination with joint prosthesis, immunodeficiency.

27
Q

What are the symptoms of septic arthritis?

A 
Single swollen joint
Fever 
Rigors
Chest wall pain
Thigh pain
28
Q

What are the clinical signs indicative of septic arthritis?

A

Swollen, warm tender joints on examination
Painful on movement
Abscess around the joint

29
Q

What are some of the differential diagnoses associated with septic arthritis?

A 
Rheumatological disorders
Gout, pseudogout
Reactive arthritis
Lyme disease
Viral arthritis
Infective endocarditis
30
Q

What investigations are appropriate in suspected septic arthritis?

A 
BLOODS: FBC, culture
IMAGING: radiographs, CT, MRI,
SAMPLING: synovial fluid examination, synovial tissue culture
Test for lyme disease
PCR
31
Q

Which treatments are available for septic arthritis?

A

ANTIBIOTICS- flucloxacillin, clindamycin, vancomycin, cefotaxime
JOINT DRAINAGE
SPLINTING
IRRIGATION of the prosthetic joint

Core Conditions (11 decks)

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