MSK Flashcards
Acromioclavicular (AC) Joint Dislocations CAUSE AND CLASSIFICATION?
a direct blow to the shoulder, like falling directly onto the shoulder with the arm at the side. This force pushes the acromion downward while the clavicle stays in place, tearing ligaments and causing the dislocation.
Classification: AC joint dislocations are classified based on the extent of damage to the surrounding ligaments, which are critical for stabilizing the joint. The Rockwood classification (Types I-VI) is most commonly used:
Type I: Mild sprain of the AC ligament without any visible separation. Pain but no displacement.
Type II: Tear of the AC ligament, but the coracoclavicular (CC) ligament is intact. Some displacement of the joint.
Type III: Both AC and CC ligaments are torn, leading to a significant displacement of the clavicle (often noticeable as a “bump”).
Type IV-VI: More severe displacements with the clavicle being displaced in unusual directions (backward, upward, downward), indicating severe ligament damage and potential muscle involvement.
HILL SACHS LESION?
a compression fracture of the posterolateral aspect of the humeral head (the ball part of the shoulder joint). It typically occurs in the context of an anterior shoulder dislocation, which is the most common type of shoulder dislocation.
How Does It Happen?
Mechanism of Injury:
When the shoulder dislocates anteriorly, the humeral head (ball) moves forward out of the glenoid fossa (socket).
As the head of the humerus dislocates, it can forcibly impact the hard edge of the glenoid (the bony rim of the shoulder socket).
This impact results in a “dent” or compression fracture on the posterolateral side of the humeral head.
stills disease is similar to what condition
what three features does it present with
what are the differentials
how common is it
how is it diagnosed
how is it treated?
juvenille arthritis due to triad of symptoms: fever at night (which can be high up to 39) with a coinciding transient truncal and limb salmon pink bumpy rash AND athralgia- MAINLY IN WRISTS which can be destructive
differentials: 1. lupus, 2. haemachromatosis, 3. rheuamtoid arthritis 4. lymphomas
rare- literaly like 1-36 million people have it
exclusion of other disorders- 1. it is characterised by the absence of autoimmune antibodies (ANA and RF negative). Ferritin is really high (inflammation), and hepatosplenomegaly, lymphocytosis, cervical lymphadenopathy. Yamaguchi criteria is the most widely used criteria and has a sensitivity of 93.5% requiring the presence of 5 or more features, including 2 major criteria (fever, arthritis, rash, leukocytosis).
Dermatomyositis features
gottrons papules- red bumpy bits on the PIPS, red eyes - periorbital rash like that ginger girl in comms skills once in our year, and shawl sign/macular rash over sholders, and it is photosensitive
and nail fold capillary dilatation causing raynaulds,
+/- interstitial lung disease: e.g. Fibrosing alveolitis or organising pneumonia
dysphagia, dysphonia- Dysphagia and dysphonia in dermatomyositis are manifestations of underlying muscle involvement, particularly affecting the oropharyngeal and laryngeal muscles.
adults- malignancy related 50-60s
children- not malignancy related- 5-15 years. Juvenile dermatomyositis is a lifelong disease. It’s important to make sure your child sticks to their treatment plan and remains in the best possible health
treatment= steroids and steroid sparing, physio, vit D calcium and reduce sun exposure (to stop flares)
