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
What is the predominant cause of septic arthritis?
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
What are the risk factors associated with septic arthritis?
NON-MODIFIABLE- ageing PMH- diabetes mellitus, prior joint damage, joint surgery, hip/knee prosthesis, skin infection in combination with joint prosthesis, immunodeficiency.
27
What are the symptoms of septic arthritis?
``` Single swollen joint Fever Rigors Chest wall pain Thigh pain ```
28
What are the clinical signs indicative of septic arthritis?
Swollen, warm tender joints on examination Painful on movement Abscess around the joint
29
What are some of the differential diagnoses associated with septic arthritis?
``` Rheumatological disorders Gout, pseudogout Reactive arthritis Lyme disease Viral arthritis Infective endocarditis ```
30
What investigations are appropriate in suspected septic arthritis?
``` BLOODS: FBC, culture IMAGING: radiographs, CT, MRI, SAMPLING: synovial fluid examination, synovial tissue culture Test for lyme disease PCR ```
31
Which treatments are available for septic arthritis?
ANTIBIOTICS- flucloxacillin, clindamycin, vancomycin, cefotaxime JOINT DRAINAGE SPLINTING IRRIGATION of the prosthetic joint