Medical conditions

Question 1

Cerebral Palsy

Answer 1

Group of permanent movement disorder that appear in early childhood. Symptoms include poor coordination, stiff muscles, weak muscles and tremors. There may be problem with sensation, vision, hearing, swallowing and speaking. Other symptoms include seizures.

CP is caused by abnormal development or damage to the parts of the brain that control movement, balance and posture.

Question 2

Crystal Arthropathy

Answer 2

Can present as unilateral arthritis which may include joint pain and effusion not related to trauma or activity. Local erythema, warmth, joint pain and effusion are common examination findings.

Question 3

Infectious (septic) arthritis

Answer 3

Typically present with local erythema, warmth, joint pain and effusion. Bacterial joint infection is a medical emergency, as extensive cartilage damage can occur within hours of infection onset.
Definitive diagnosis is made by joint aspiration and fluid anaylsis.

Question 4

Reactive arthritis

Answer 4

Reactive arthritis is conventionally defined as an arthritis that arises following an infection, although the pathogens cannot be cultured from the affected joints. It is generally regarded as a form of spondyloarthritis.

2 major clinical features that characterise reactive arhtritis are

• An interval ranging from several days to weeks between the antecedent infection and arthritis
• A typically mono- or oligoarticular pattern of arthritis, often involving the lower extremities.

The onset of reactive arthritis is usually acute. Patients typically present with an asymmetric oligoarthritis, usually 1-4 weeks following the inciting infection. In most patients all symptoms resolve within one year.

Question 5

Osteochondritis dissecans

Answer 5

OCD is defined as osteonecrosis of subchondral bone. Specificially, OCD is a localised lesion in which a segment of subchondral bone and articular cartilage separates from the underlying bone, leaving either a stable or unstable fragment that may result in premature osteoarthritis.

The cause of OCD is unknown. Proposed etiologies include repetitive micro-trauma, vascular failure of the vascular architecture at the perichondirum, local ischemia after a single injury and genetic predisposition.

Juvenile OCD is associated with high activity level with repetitive trauma as a primary mechanism. With initial trauma a focal area of hypovascularity, necrosis, and collapse of the bone develops that can lead to chondromalacia. The necrotic bone is then replaced by subchondral trabeculae or cartilage. As the lesion progresses, focal areas of demineralisation and repeated shear forces cause detachment of the bone and overlying cartilage.