MSK Cortext Mix Flashcards
between giant cell and Takayasu arteritis, which is more common in over 50s?
giant cell
what forms the carpal tunnel?
carpal bones
flexor retinaculum
what can cause carpal tunnel syndrome?
idiopathic swelling in the carpal tunnel - RA (synovitis) fluid retention - pregnancy - diabetes - chronic renal disease - hypothyroidism fracture - e.g distal radius fracture
what tests can confirm carpal tunnel syndrome?
tinels test (tapping over median nerve) and phalens test (holding wrists hyperflexed) can recreate symptoms nerve conduction studies
main sign of extensor mechanism rupture and how is this managed?
cant do straight leg raise
usually surgically managed
WHO definition of osteoporosis?
reduced bone mineral density and increased porosity of bone
bone mineral density less than 2.5 standard deviations below mean peak value for young adults of same age race and sex
what is osteopaenia?
intermediate stage before osteoporosis
bone mineral density between 1-2.5 standard deviations below mean peak value
polymyalgia rheumatica vs polymyositis?
PR = significant pain and stiffness in proximal limb muscles, significantly raised inflammatory markers, improves with exercise polymyositis = mainly weakness rather than pain, worsens with exercise
describe scaphoid blood supply?
retrograde
what can cause plantar fasciitis?
diabetes
obesity
walking on hard floors without cushioned soles
how is plantar fasciitis managed?
gel heel cushions
achilles and plantar fascia stretching exercises
corticosteroid injections
avoid plantar fascia surgical release due to risk to plantar nerves
modified new York criteria for diagnosis of ankylosing spondylitis?
pain for more than 3 months
worse at rest, relieved by movement
X ray changes of sacroiliitis
visible line surrounding the osteon is called what?
cement line
risk factors for DDH?
female first born breech presentation left leg down syndrome family history of DDH other congenital disorders (talipes etc)
blood supply to femoral head?
medial and lateral circumflex artery branches of profundal femoris artery
small amount from obturator artery (goes directly to femoral head at the top)
lightbulb sign?
posterior shoulder dislocation
6 risk factors for osteoporosis?
female inactivity smoking alcohol reduced exposure to sunlight diet
boxers fracture can often be managed conservatively, what type of deformity cannot and must be fixed?
rotational
A lucent, multi-loculated cyst found within the medulla of many different bones, often with associated cortical expansion?
aneurysmal bone cyst
A mostly lucent lesion, with a patchy sclerosis, found within the metaphyseal region of long bones?
enchondroma
klumpkes palsy is caused by damage to which nerve roots?
C8 and T1
how does klumpkes palsy present?
paralysis of intrinsic hand muscles and finger/wrist flexors
fingers are typically flexed due to paralysis of interossei and lumbricals which assist in extension at PIPs
4 risk factors for talipes equinovarus?
male
breech presentation
oligohydramnios
family history
what is the target serum urate level?
<360
management of acute gout?
colchicine and steroids
don’t start allopurinol until 2 weeks after flare up
if already on allopurinol, don’t stop it during an acute flare
how does allopurinol work?
inhibits xanthine oxidase
how does DMARD therapy affect immunisations?
cant have live vaccinations while taking DMARDs
must have influenza and pneumococcal vaccines before starting treatment
describe ganglion cysts
smooth
firm
rubbery
transilluminate
how is a ganglion cyst managed?
needle aspiration often not successful due to thick gelatinous material in cyst
whacking with a bible often has high recurrence as wall of cyst isn’t removed
surgical removal = definitive management
what is peyronie’s disease?
fibromatosis (like dupytrens) of the penis
what is ledderhose disease?
fibromatosis (like dupytrens) of the plantar aspect of the foot
what is a greenstick fracture?
occurs in children
when the bone bends and the tension side (part being stretched) breaks while the side being compressed remains intact
3 risk factors for dupytrens?
male
alcohol
diabetes
MSK development stages from 6-9 months to 3 years?
6-9 months = sits alone, crawls 8-12 months = stands 14-17 months = walks 2 years = jumps 3 years = manages stairs alone
where do stress fractures normally occur and how are they diagnosed?
2nd followed by 3rd metatarsal
not visible on X ray until 3 weeks after when callus forms
how is a metatarsal stress fracture managed?
6-12 weeks rest in a rigid soled boot
what are the 2 types of chronic regional pain syndrome?
type 1 = not caused by peripheral nerve injury
type 2 = caused by peripheral nerve injury
how is chronic regional pain syndrome managed?
analgesics antidepressants anticonvulsants steroids sympathetic nerve blocking
what are osteoprogenitor cells?
cells on surface of bone which serve as a reserve pool of osteoblasts
what is osteochondritis dissecans?
fragmentation with separation of bone and cartilage within a joint
what sites are particularly pre-disposed to osteochondritis?
lateral part of medial femoral condyle in the knee
anteromedial talar done
superomedial femoral head
humeral capitellum
how might osteochondritis present?
pain
effusions
locking
giving way
