MSK Flashcards
definition seronegative arthitides
inflammatory rheum disease, inflammation of axial and peripheral joitns and enthesitis (inflammtion where tnedon meets bone)
extra articular features seronegagive
anterior uveiitis and bowel lesions
3 conditions under umbrella sero -ve
ank spond, rieter’s, enteropathic, psoriatic, behcet’s, Junior idiopathic
RF sero -ve
fam hx, HLA b27
3 symptoms sero -ve
inflammatoy back pain, stiff in morning, sacroiliitis, enthesitis, sausage fingers, urethritis,
Inv for sero -ve
ESR and CRP, urte, RF, antinulcear, serology testing, xray sacroiliac joints (inflammation), bamboo spine, sqauring of vertebrae
management sero -ve
physio, NSAIDS< DMARDS, joint replacement
pathophys of Pagets
inc bone turnover, inc activity of osteoclasts, new bone weak and brittle
OLD PEOPLE
symptom pagets
bone pain, at night, bone deformity (bowing tibia, kyphosis, bossing skull), deafness and tinnitus
inv for pagets
raised ALP, normal ca and po4
xray - skull - cotton wool pattern - multifocal sclerotic patches
management pagets
orthotics, sticks, walkers
nsaids
BISPHOSPHONATES
osteomalacia
(is rickets when childern)
inadeqaute mineralisation VIT D!!!!, results in loss of skeletal mass
symptoms osteomalaci
pain, prox muscle weakness, skeletal deformity - vertebrae a skull, change in gait, fractures
bloods osteomalacia
high alk phos, FBC
xray - looser’s zones
management osteomalacia
vit D supps, dietary get ou in sun
primar y benign bone tumour
osteoid, cartilage – chondroma, firbous – fibroma, bone marrow – eosinophillic granuloma, vascular – haemoangioma
secondary malignant bone mets
osteosarcoma, chondrosarcoma, fibrosarcoma, ewings, angiosarcoma
symptoms bone tumour
patho fract, growth and malignany
SLE definition
chronic AI condition, multi system, antinuclear antibodies occur
RF SLE
DR2 DR3, UV light, methyldopa
sx SLE
relapses and remits (remember weird finnish woman)
maliaise, fever, fatigue, splenomegaly, lymphadenopathy, weight loss
joint muslce pains, EMstifness,
butterfly rash, sparing nasolabial folds,
discoid lupus - sun exposed areas, erythematous, well demarcated, scaling
headache,
raynauds
dry eyes and mouth
fucking everything
Inv SLE
anaemia, leukopenia, thrombocytopenia, auto ab - ANA, anti dsDNA
management SLE
avoid sun, (think weird white finnish woman) hydroxychloroquine, cyclophosphamide
scleroderma def
widespread small vessel damage, fibrosis in skin and systemic organs
types of scleroderma (3)
pre-scleroderma (raynauds +antinulcear ab)
diffuse cutaneous (worst - raynauds + lung, heart, GI, renal disease)
limited cutaneous (middle best - CREST - calcinosis, raynauds, esopageal dys, scelrodactyly, telangiectasia)
Lung issues scleroderma
pul fibrosis
heart issues scleroderma
pericarditis, pericardial effusion, myocardial fibrosis, heart failure
GI issues scleroderma
dry mouth, dysmotilithy, constipation, reflux, watermelon stomach,
blood tests sclero
antinuclear antobodies
anti centromer, anti scl 70 (anti topoisomerase)
other inv sclero (think about issues that arise)
ecg, echo, endoscopy, barium studies, U+E , radiography, skin biopsy§
management sclero
skin, raynauds, lung, GI, renal, myositis
skin - moisturisers, lasers,
raynauds - keep warm,long acting CCB (nifedipine) add phosphodiesterase i (sildenafil)
lung - pul hypertension - bosentan, sildenafil
GI - PPI, promotility, pancreatic supps, PEG feed,
renal - acei
most common causative agents septic arthritis
staph, haemophilus, coliforms
in septic arthritis of hip, how is joint held?
flexed, slightly externally rotated
sepsis in prosthetic joint
remove prosthesis before full eradication is possible
clinical features temporal arteritis
headache, temporal or occipital, severe, worse at night
visual manifestations of temporal arterial disease
blurred vision, amaurosis fugax
