MSK Flashcards
Polyarthralgia
Early morning stiffness > 30 minutes, improves with activity
Reduced grip strength
Swollen joints
Bouchard’s nodes
Rheumatoid arthritis
Spinal / neck pain
Morning stiffness >30 minutes improving with activity
Reduced chest expansion Sometimes ‘question mark’ posture
Ankylosing spondylitis
Asymmetrical oligoarthritis
Nails involved (pitting, onycholysis)
‘pencil in a cup’ on x-ray
Psoriatic arthritis
Arthritis in several joints
Loose stools with mucous + blood
Weight loss
Pyoderma gangrenosum
Enthesitis
Enteropathic arthritis
Post infection
Fever, fatigue, malaise
Asymmetrical monoarthritis
Enthesitis
Mucocutaneous lesions
Reiter’s syndrome
Reactive arthritis
First MTP joint affected commonly
Severe pain, hot swollen joint
Abrupt onset
Monosodium urate crystals
Acute gout
Monoarthritis - swollen, painful
Commonly knee affected
Calcium pyrophosphate crystals
Pseudogout
Fever, fatigue, weight loss
Malar rash
Non-scarring alopecia
Raynaud’s
Arthritis
Arthralgia, myalgia
Other systemic involvement
ANA and anti-dsDNA antibodies
Systemic lupus erythematosus
SLE
Dry eyes - ‘gritty’
Dry mouth / throat
Vaginal dryness
Joint pains, fatigue
Parotid gland enlargement
Sjogren’s syndrome
Thickening / hardening of skin
Sclerodactyly
Raynaud’s
Ischaemic digital ulcers
Fatigue, weakness
Calcinosis of fingertips
Telangiectasia
‘beaking’ and ‘puckered lips’
Systemic sclerosis
DVT / PE
Recurrent pulmonary emboli
Livedo reticularis
Miscarriage
Migraine common
Anti-phospholipid syndrome
Vague systemic symptoms
Raynaud’s
Arthralgia
Myositis
Sclerodactyly
Pulmonary hypertension
Mixed connective tissue disease
Joint pain worse with use
Pain at night
Morning stiffness < 30 minutes
Instability
Joint line tenderness
Crepitus
Stiff joints, small ROM
Osteophytes
Heberden’s / Bouchard’s nodes
Osteoarthritis
Presents young
Joint pains after activity
Joint stiffness
Thin stretchy skin
Frequent sprains / dislocations
Joint hypermobility syndrome
Acute monoarthropathy
Reduced ROM
Swelling and tenderness
Systemic fever
Septic arthritis
Gradual onset pain in bone
Point tenderness
Swelling, redness, warmth
Malaise, fever, chills
Osteomyelitis
Bone pain
Symptoms of hypocalcaemia
Fractures easily
Bone deformities
Proximal myopathy
Osteomalacia / Rickett’s
Often asymptomatic or pain
Enlarged abnormally shaped bone
‘sabre tibia’
Increased metabolism
Paget’s disease of bone
Insidious onset of groin pain
Pain exacerbated by impact
Femoral head AVN
Persistent widespread pain
Fatigue
Headaches
Cognitive / memory impairment
Anxiety / depression
Non-cardiac chest pain
Fibromyalgia
Insidious onset
Ocular muscles affected
Fatigue
Progressive muscle weakness
Myasthenia Gravis
Disproportionate muscle pain
Massive oedema
Skin discolouration
Quickly progresses to systemic infection
Myonecrosis
Trismus - lock jaw
Risus sardonicus
Autonomic instability
Tetanus
Bilateral leg pain
Loss of bladder / bowel control
Perineal / saddle anaesthesia
Loss of anal sphincter tone
Cauda equina syndrome
Constant unremitting back pain
Paraspinal muscle spasms
Spinal tenderness
May have fever
Vertebral osteomyelitis
Pain in lumbosacral region
Pain in buttocks and thighs
Pain varies with time and activity
Mechanical back pain
Back pain worse on coughing
Acute disc tear
Unilateral leg pain
Low back pain
Sharp, shooting, electric pain
Numbness and paraesthesia
Sciatica
Inconsistent claudication
Burning pain
Spinal extension exacerbates pain
Pedal pulses preserved
Spinal stenosis + claudication
Severe shoulder pain
Inability to move shoulder
Empty glenoid fossa visible
Shoulder dislocation
Shoulder pain radiating down arm
Associated weakness
Tenderness in subdeltoid region
Rotator cuff tear
Gradual severe shoulder pain
Pain at night and at rest
Shoulder stiffness
Massive restriction in ROM
Adhesive capsulitis
Difficulty reaching up and lifting
Pain in anterior superior shoulder
Pain exacerbated by abduction
Shoulder impingement
Pain in anterior shoulder radiating to elbow
Snap with shoulder movement
‘Pop eye’ sign
Extensive bruising
Biceps tendinopathy
Paraesthesia in little and ring fingers
Night symptoms
Weakness of hand muscles
Cubital tunnel syndrome
Paraesthesia in thumb and radial 3 1/2 fingers
Loss of sensation
Weakness of the hand
Pain relieved by shaking hand
Clumsiness
Carpal tunnel syndrome
Pain and tenderness of lateral epicondyle
Pain worse upon opening a jar
Lateral epicondylitis
aka Tennis elbow
Pain and tenderness over medial epicondyle
Pain worse on wrist flexion and pronation
Medial epicondylitis
aka Golfer’s elbow
Ulnar fracture
Radial displacement
Pain and swelling
Loss of forearm / hand function
Monteggia fracture
Radial fracture
Ulnar displacement
Pain and swelling
Loss of forearm / hand function
Galeazzi fracture
Repetitive strain injury
Wrist swollen, may be red
Common in postpartum women
De Quervain’s tenosynovitis
Pain and tenderness in anatomical snuffbox
Scaphoid fracture
Flexion contracture of 4th/5th finger(s)
Starts as a palmer pit / nodule
Painless, gradual progression
Dupuytren’s contracture
Pain over A1 pulley
‘Sticking’ of finger in flexion
Triggering present
Trigger finger
Inflammation and redness around fingertip
Pus collection may be seen
Paronychia
Extremely painful
Limited extension in hand / digits due to pain
Flexor tendon sheath infection
Dorsal hand pain
Swelling
Affected finger shortened
Boxer’s fracture
Acute pain in base of thumb
Swelling
Ecchymosis
Pain with motion
Bennett’s fracture
General fullness of popliteal fossa
Soft and non-tender
Baker’s cyst
Pain and tenderness localised to the joint lines
Knee ‘about to give way’
Catching or locking sensation
Meniscal tears
Fever, malaise, night sweats
Weight loss
Arthralgia, fatigue
Claudication in limbs
More common in Asian population and women
Takayasu arteritis
Unilateral acute temporal headache
Jaw claudication
Tender enlarged temporal arteries
Scalp tenderness
Visual disturbance / loss
Giant cell arteritis
Arthralgia
ENT features - sinusitis
Resp features - cough
Cutaneous features - purpura
Multisystem involvement
Granulomas
NO asthma
NO eosinophilia
cANCA present
Granulomatosis with polyangiitis
GPA
Arthralgia
ENT features - sinusitis
Resp features - cough
Cutaneous features - purpura
Multisystem involvement
Granulomas
Late onset asthma
Eosinophilia
pANCA present
Eosinophilic granulomatosis with polyangiitis
EGPA
Arthralgia
ENT features - sinusitis
Resp features - cough
Cutaneous features - purpura
Necrotising glomerulonephritis
Multisystem involvement
pANCA present
Microscopic polyangiitis
MPA
Purpuric rash over buttocks and lower limbs
Colicky abdominal pain
Bloody diarrhoea
Joint pain and swelling
Sometimes renal involvement
Henoch-Schonlein purpura
Proximal myalgia of hip / shoulder girdles
Morning stiffness > 30 minutes
Pain worse with movement
Fatigue, anorexia, weight loss
Normal muscle strength
Pitting oedema
Carpal tunnel common
Polymyalgia rheumatica
Start up pain on instep of foot
Pain worse after activity
Swelling on plantarmedial heel
Tenderness
Plantar fasciitis
Burning foot pain
Tingling that radiates to toes
Loss of sensation in affected webspace
Mulder’s click test positive
Morton’s neuroma
Pain in Achilles tendon
Morning stiffness
Pain and stiffness eases with walking
Achilles tendonitis
Multiple fractures of childhood
Short stature
Deformities present
Blue sclera
Loss of hearing
Osteogenesis imperfecta
Progressive muscle weakness
Inability to walk
Only seen in males
Duchenne’s muscular dystrophy
Hip, groin, thigh or knee pain
Limp
Antalgic gait
Loss of internal rotation of hip
Slipped upper femoral epiphysis
SUFE
Asymmetry in hips
Loss of knee height
Less abduction in flexion
Young presentation
Developmental dysplasia
Ankle equinus
Supination of forefoot
Noticed at birth
Club foot
