Locomotor Conditions Flashcards
Who is mostly likely to be affected by gout?
MALES
aged 30 to 60
What is the primary cause of gout?
It is the build up and deposition of uric acid
What are the main risk factors associated with gout?
NON-MODIFIABLE- Male gender
MODIFIABLE- alcohol, obesity, high triglycerides
PMH- hypertension, CHD, diabetes, CKD, heart failure, psoriasis, chemotherapy
What are the symptoms of gout?
SWOLLEN, RED, TENDER joints acute joint pain usually at the: -knee -midtarsal joints -wrists -ankles -elbows -hand joints
What are the clinical signs of gout?
Synovitis
Deposition of tophi
What are some differential diagnoses associated with gout?
Septic arthritis Non-urate crystal induced arthropathy Arthritis: osteo, psoriatic, reactive, rhematoid Seronegative spondyloarthropathy Haemochromatosis
What investigations should be carried out in suspected cases of gout?
BLOODS: Serum uric acid, plasma urate
IMAGING: joint x-ray, USS, MRI
SAMPLING: joint fluid microscopy and culture, renal acid secretion
Treatment options for gout include:
ALLOPURINOL - urate lowering drugs
PAIN MANAGEMENT- NSAIDs, colchicine, corticosteroids, analgesia
LIFESTYLE MODIFICATION
REST AND ICE PACK
Who is typically affected by osteoarthritis?
WOMEN
those over 50
What is the cause of osteoarthritis?
Repair processes do not occur after trauma/damage.
What are some of the risk factors of osteoarthritis?
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
What are the symptoms of osteoarthritis?
Joint pain- exacerbated by exercise and relieved by rest
Joint stiffness in the MORNING/straight after rest
Reduced function and participation
What are the clinical signs of osteoarthritis?
Reduced range of movement on examination Joint swelling/synovitis Periarticular tenderness Crepitus Absence of systemic features Bony swelling/deformity due to osteophytes
What are the differentials associated with osteoarthritis?
Prepatellar bursitis Bursitis Pseudogout Other arthritis (psoriatic, septic, viral, reactive, rheumatoid) Connective tissue disease
What investigations would be necessary in suspected osteoarthritis?
IMAGING: joint x-ray, MRI,
SAMPLING: joint aspiration to exclude other diseases.
What is the treatment line for osteoarthritis?
PAIN RELIEF- NSAIDs, paracetamol
Comorbidity management
LIFESTYLE MANAGEMENT: exercise, weight loss advice,
Thermotherapy
Who suffers from prolapsed disc and back pain?
Slightly higher incidence in MEN
More common in those under 40
What is the cause of prolapsed disc?
Trauma
Disc degeneration
General wear and tear
What are the risk factors associated with prolapsed disc?
Ageing
Sedentary lifestyle
Professional athletes
Genetic predisposition
What are the symptoms of a prolapsed disc?
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
What are the clinical signs of prolapsed disc?
POSITIVE STRAIGHT LEG TEST- greater leg pain/nerve compression symptoms on raising the leg
What are some differential diagnoses associated with prolapsed disc?
Spondylolisthesis Dengeneration Tumours Metastases Abscess Haematoma Osteomyelitis
What investigations would be done in suspected prolapsed disc?
IMAGING: X-ray, CT myelography, MRI
What is the treatment available for prolapsed disc?
PAIN MANAGEMENT Exercise Heat and massage Physiotherapy Intradiscal laser ablation
