MSK disease Flashcards
what is arthritides
pain and stiffness of a joint /inflammation of the joint - multiple diseases
what are the acute symptoms of arthritis
pain, heat, redness and swelling
what are the two most common types of chronic arthritis
OA and RA - pain but no heat or redness
what is the most common type of joint disease
osteoarthritis - degenerative joint disease - progressive erosion of articular cartilage
what is the cause and result of osteoarthritis
associated with age - no initiating cause
formation of bony spurs and cysts at the margin of joint
which disease would you get bouchards and herberdens nodes
primary osteoarthritis - B = proximal nodes
H = distal nodes
which bones are primary OA affected by
fingers knees C and L spines
which types of sports are commonly affected by secondary OA
knee in basketball players and elbow in baseball players
what is the pathogenesis of secondary OA
loss of cartilage, forms spurs for fluid filled cysts in the marrow - subchondral cyst
what happens at the cellular level in secondary OA
chrondorcytes produce IL-1 that initiates matrix breakdown
prostaglandin derivatives induce release of lytic enzymes that prevent matrix synthesis
what is rheumatoid arthritis and what does it affect
chronic disorder producing non-suppurative proliferative synovitis - results in destruction of articular cartilage and ankylosis of joints
affects skin, muscles, heart lungs
what is ankylosis of joint spaces in RA
stiffening due to fusion of bone - due to formation of pannus (fibrovascular tissue) in the joint space
what are the various causes of RA
genetics HLADR4
primary exogenous arthritogen eg EBV
autoimmune
mediators of joint damage - cytokines
what is the criteria for diagnosis of RA
4 things morning stiffness arthritis hands/joints symmetrical nodules serum RA factor radiological narrowing
what is rheumatoid factor
present in most patients with RA
what is a more specific test for RA than rheumatoid factor
anti CCP - ACPA test
what is present in synovial fluid which tests for RA
neutrophils
what is seronegative arthritis and give example
lacks Rheumatoid factor
ankylosing spondylitis or reiters syndrome
what is the cause of infective arthritis and signs
bacterial staphylococcus
fever, leucocytosis and elevated ESR
what is GOUT and the causes
end point of group of disorders producing hyperuricaemia
uric acid is the end product of purine metabolism
what are the clinical features of gout
acute/chronic arthritis
tophi in various sites - cyrtsallisation of rates within and about joints
gouty nephrophathy
what is pyogenic osteomyelitis and its cause
systemic illness - bone destruction surrounded by sclerosis - bacterial causes
sheet of neutrophils present
what is the risk of pyogenic osteomyelitis
haematogenous spread to joints
what is osteoporosis
increased porosity of skeletal system - reduction in bone mass
what are the causes and clinical features of osetoporosis
primary - age/menopause
secondary - hyperparathyroidism or T1DM
vertebral fractures, kyphosis scoliosis
what is pagets disease of bone
dysregulated bone remodelling - excessive bone breakdown and disorganised new bone formation
what is osteomalacia and its accuses
defects in matrix mineralisation - related to lack vitamin D
decreased bone density (small bones osteopenia )
how does hyperparathyroidism affects bones
excessive PTH - increase bone reabsorption from skeleton = increases renal tubular reabsorption and retention of calcium = hypercalcaemia
what is renal osteodystrophy
consequence of chronic renal disease - increased osteoporosis clastic bone resorption
what types of tissues are soft tissue
tendons, ligaments fascia skin - not bone - mesodermal origin
what are these tumours tissues lipoma fibroma leiomyoma haemangioma lymphangioma neuroma
fat fibrous tissue skeletal muscle blood vessels lymphatics peripheral nerve
what is the most common malignant bone tumour
osteosarcoma
what are these tumours
osetoma
chondroma
osteochondroma
benign bone tumour
benign cartilage tumour
mixed benign bone and cartilage tumour
what is the most common site for osteosarcoma and who does it affect more
knee
young people
what is ewings sarcoma
malignant small, round, blue cell tumour
type of bone tumour
where to most metastatic bone tumours arise from
breast or prostate
what is the classification criteria of SLE
american college of rheumatology
4 of
malar rash, discord rash, photosensitivity, oral ulcers, renal disorder, immune/neurolgic disorder
what are the 4 clinical features of SLE
cutaneous - butterfly rash - bridge of nose and cheeks
cardiac - cardiomegaly / endocarditis
CNS - convulsions, hemiplegia
renal - nephrotic syndrome
what is systemic sclerosis and the prognosis
vessel damage, inflammatory response due to cytokines
osteoarticular involvement
poor prognosis
what is crest syndrome associated with and what is it
systemic sclerosis
Calincosis - calcium deposits in the skin
raynauds
oesophageal dysmobility
sclerodactyly - thinking og skin on fingers and toes
telangiectasia - spider veins
what is polymyalgia rheumatica and what is it associated with
stiffening, weakness, aching, pain in neck
associated with giant cell arteritis - affects occipital or facial arteries - headache and scalp pain
immunological mechanism
what is myopathy vs myositis
muscle disease unrelated to any disorder of innervation or neuromuscular junction
muscle fibres and overlying skin are inflamed and damaged resulting in muscle weakness
describe the cause of msucular dystrophy and the features
genetic - progressively severe muscle weakness and wasting beginning in childhood
what is the most common form of muscular dystrophy
deuchenne
what is the pathogenesis of malignant hyperthermia
inherited disease
fast rise in body temp with severe muscle contraction when the affected person get general anaesthesia
what are the complications of malignant hyperthermia
rhabdomyolysis and high blood potassium
what is rhabdomyolysis and causes
destruction of skeletal muscle - myoglobin release into the blood and myoglobinuria = brown urine
caused by trauma, drugs, high temp
what are two examples of metabolic myopathies
glycogen synthesis and degradation - disorders of mitochondrial metabolism
