MSB pathology Flashcards
How to treat trochanteric bursitis? (Inlammation of gluteal tendon and bursa lateral to greater trochanter)
NSAIDs, heat, stretching
Housemaids knee AKA..
prepateller bursitis
Causes of housemaids knee?
repeated trauma/pressure from excessive kneeling
Can be from gout/infection as well
What is a bakers cyst?
popliteal fluid collection that commonly communicates with synovial space
What pathologies is bakers cyst related to?
Rheumatoid and osteoarthritis
How does a rupture of a bakers cyst present?
similar to DVT
What is De Quervain tenosynovitis?
Thickening of abductor pollicis longus and extensor policies brevis. Pain or tenderness at radial styloid
What is a positive Finkelstein test
pain at radial styloid with active or passive stretch of thumb tendons
Presentation of gangliion cyst
fluid-filled swelling overlying joint or tendon sheeth, most commonly on dorsal side of wrists
Presentation of illiotibial band syndrome
pain at lateral femoral epicondyle from overuse of lateral knee (common in runners)
Limb compartment syndrome defining criteria
Difference than 30 mmhg or less between the tissue compartment and diastolic bp
Medial tibial stress syndrome presentation
Shin pain in runners and military recruits
Medial tibial stress syndrome aka
shin splints
Plantar fascitis
Inflammation of plantar aponeurosis characterized by heel pain - worse with first steps in the morning
What is developmental dysplasia of the hip?
Abnormal acetabulum development in newborns that results in hip instability/dislocation
What is the confirmatory test for developmental dysplasia of the hip?
ULTRASOUND (not xray bc cartilage isn’t ossified)
What is Legg-Calve-Perthes disease?
Idiopathic avascular necrosis of the femoral head
who gets Legg-Calve-Perthes disease?
Children aged 5-7,more commonly males
What will the initial XRAY of Legg-Calve-Perthes disease look like?
Normal, initially
What is Osgood-Schlatter disease (traction apophysitis)?
Overuse injury caused by repetitive strain and chronic avulsion of secondary ossification center of proximal tibial tubercle
Who gets Osgood-Schlatter disease ?
teengers after their growth spurt. Common in runners and jumping atheletes
What is patellofemoral syndrome and who gets it?
overuse injury that commonly presents in young, female athletes as anterior knee pain
-gets worse with prolonged sitting or weight-bearing on flexed knee
How to treat patellofemoral syndrome?
NSAIDs and thigh muscle strengthening
Slipped capital femoral epiphysis presentation?
Seen in obese preteens early adolescent children with hip/knee pain and altered gait
Slipped capital femoral epiphysis treatment
surgery
What is a greenstick fracture?
incomplete fracture following bending stress
What is a torus fracture?
when the cortex buckles on one side due to compression
Pathophys of achondroplasia
Constitutive activation of fibroblast growth factor receptor inhibits chondrocyte proliferation -often from autosomal dominant mutation
Osteoporosis pathophys
trabecular and cortical bone los mass and interconnections
- due to increased bone resorption related to decreased estrogen and old age
- may be secondary to drugs
Which drugs may promote osteoporosis?
Steroids, alcohol, anticonvulsants, anticoagulatnts, etc.
Why do many anticonvulsants promote bone loss?
They upregulate CYP450 which increases vit D breakdown
Diagnosis of osteoporosis
DEXA scan with T-score <2.5 or by fragility fracture (hip or vertebra fracture from fall at normal height)
Treatment of osteoporosis
bisphosphonates, teriparatide, SERMs, rarely calcitonin, denosumab
Osteopetrosis pathophys
Defective osteoclasts lead to failure of normal bone resorption
->thickened, dense bones that are prone to fracture
Caused by mutations in carbonic anyhydrase II
What mutation occurs in osteopetrosis?
Carbonic anyhdrase II
Osteopetrosis complications
overgrowth of cortical bone fils. marrowspace –> pancytopenia, intramedullary hematopoiesis, may result in cranial nerve impingement and palsies
Treatment for osteopetrosis
Bone marrow transplant - may be curative as osteoclasts derive from monocytes
Infantile form of osteopetrosis inheritance
autosomal recessive
Albers-Schonberg disease
autosomal dominant form of osteopetrosis
Pathophys of osteomalacia/rickets
Defective mineralization of osteoid or cartilaginous growth plates
Xray findings in osteomalacia
Looser zones (pseudofractures)
Xray findings in rickets
epiphyseal widening and metaphyseal cupping/fraying
clinical findings in children with rickets
Bow legs (genu varum), bead-like costochondral junctions(rachitic rosary), craniotabes (soft skull)
Labratory findings in osteomalacia/rickets
Low vitamin D Low serum Ca Increased PTH Decreased serum phosphate Increased ALP from osteoblasts
Osteitis deformans aka
Pagets disease
Pagets disease pathophys
Increased osteoclast and osteoblastic activity causes increased bone remodelling. Forms poor quality bone.
Lab values in pagets disease
everything normal except increased ALP
Complictions of pagets disease
Chalk stick fractures
High output heart failure (arteriovenous shunts)
Osteosarcoma
Hearing loss
Four stages of pagets disease
Lytic - osteoclasts
Mixed - osteoclasts + osteoblasts
Sclerotic - osteoblasts
Quiescent - minimal osteoclast/osteoblast activity
Treatment of pagets
bisphosphonates
