MSK emergencies :) Flashcards
what is osteoporosis?
weakening of bones - making them more likely to break
what is the first sign of osteoporosis
stooped back
how long does it take to develop osteoporosis
slowly over several years
what causes osteoporosis
reduced bone density
who has an increased risk of osteoporosis?
women - after menopause
what is the relationship of oestrogen and bones?
oestrogen slows bone loss => improving the bodies absorption and retention of calcium
what are corticosteroids?
anti-inflammatory steroids
what scanning technique can look at bone density?
DEXA scanning
how does DEXA scanning work?
sends X-rays which get absorbed by bones => then compared to healthy adult
what does a score of >-1 in DEXA scanning mean
normal
what does a score of -1 => -2.5 in DEXA scanning mean
osteomalacia
what does a score of <-2.5 in DEXA scanning mean
osteoporosis
more -ve DEXA score =
reduced bone density
what is the treatment strategy for Osteoporosis
medications increase bone density OR slows bone density thinning
what is osteomalacia?
the inadequate mineralisation of bone => causing bone softening
what causes osteomalacia?
insufficient calcium absorption or dietary intake of vitamin D
link between osteomalacia and kidney disorder
kidney failure => body needs to work harder to remove phosphorus => more phosphorus = less calcium
what deficiency is often seen with osteomalacia?
phosphate deficiency
what is renal tubular acidosis
when the kidneys do not remove acids from the blood into the urine as they should.
what is the diagnosis of osteomalacia?
low Vitamin D concentration
feature of osteomalacia on X-ray
pseudo fractures and protrusion acetabula
what is a pseudo fracture?
formation of new bone with thickening of periosteum at site of an injury to bone
how treatment for osteomalacia works
increase vitamin D concentration
define optimal management
define evidence based medicine
what are the 3 categorical causes of the limping child?
inflammation, infection and trauma
what is transient synovitis?
inflammation in the hip joint that causes pain, limp and sometimes refusal to bear weight.
what is osteomyelitis
bone infection caused by bacteria
what is perthes disease?
a childhood condition that occurs when blood supply to the ball part (femoral head) of the hip joint is temporarily interrupted and the bone begins to die.
what is a shared common cause of hip pain between under 4s -16 yr olds
osteomyelitis
what fractures are a common cause of hip pains in 10-16 year olds
avulsion fractures
what are avulsion fractures
occurs when a small chunk of bone attached to a tendon or ligament gets pulled away from the main part of the bone.
what is an slipped femoral epiphysis?
a disorder of adolescents in which the growth plate is damaged and the femoral head moves (“slips”) with respect to the rest of the femur
what age group is transient synovitis a common cause of hip pain
0-10 years
what age group is slipped femoral epiphysis and avulsion fractures common
10-16 yrs
what tests do we do for limping child? - 3
1 - bloods
2 - X-Ray
3 - MRI
What are the two inflammatory markers which are commonly tested for in blood?
C Reactive Protein
ESR - Erythrocyte sedimentation Rate
what is the Kocher Criteria for Septic Arthritis - 4
Must be non-weight bearing
Fever
High ESR
High White Blood Cell Count
state the treatment of septic arthritis - 2
drainage => culture pus sample and analyse
IV antibiotics
What are the cardinal signs of inflammation? - 5
rubor = redness
tumor = swelling
calor = hot
dalor = pain
funcio laesa = loss of function
how can you tell the joint fluid is infected?
cloudy with increased viscousity
how can infection be reflected in blood tests?
white cell count, ESR and C-Reactive protein will be high
spread of bacteria to bone
blood and inoculation
what is inoculation
implanting a pathogen or other microbe or virus into a person or other organism
treatment stages of infected joint - 3
- aspirate
- antibiotics
- if infection confirmed = wash out
what method is used to wash out infection?
keyhole arthrscopy
