MSK general points Flashcards
IgA inflammatory vasculitis causing red spots on buttocks after infection - self limiting - seen in children
Hinoch Scholein purpura (vasculitis)
Pain in posterior ankle seen in older people after exercise (or athletes) - associated with overuse
Achilles tendonitis
Sudden pain in posterior leg (like being kicked) - simmonds test positive
Achilles rupture
Knee pain and swelling after “twisting” injury - Lachmans test +ve
ACL rupture
Lower back pain & reduced movement - wall to occput test & Schober test - HLA-B27
Ankylosing spondylitis
Seen in teenage girls - NSAIDs & reassurance needed
Anterior knee pain
Disruption of blood supply to bone
Avascular necrosis (AVN)
Pain in elbow, hip (over greater trochanter) - NSAIDs, rest, Corticosteroids
Bursitis
Pain in elbow, hip (over greater trochanter) - NSAIDs, rest, Corticosteroids
Bursitis
Saddle anasthesia, urinary retention, faecal incontinence - urgent MRI & surgery
Cauda equina syndrome
Lack of oxygen during or shortly after birth
Cerebral palsy
Malignant tumour producing cartilage
Chonrosarcoma
Surgical emergency of the knee - may cause damage to popliteal artery
Combined knee ligament ruptures & knee dislocation
Hip displacement in children - seen more commonly in female babies - Pavlik harness
Development dysplasia of the hip
Common - usually medial - pops back in itself
Dislocation and subluxation of the patella
Trisomy 21 - atlanto-axial subluxation - may cause nerve compression
Downs syndrome
Trisomy 21 - atlanto-axial subluxation - may cause nerve compression
Downs syndrome
Mutation of type 3 collagen - causes stretchy skin & recurrent joint dislocation - boney fixation
Ehlers‐Danlos syndrome
Joint pain related to IBD - HLA-B27
Enteropathic arthritis
Small vessel vasculitis - especially in the nose - P-ANCA with to EPO
Eosinophilic granulomatosis with polyangitis - churg-strauss
Damage to C5,6 - medially rotated arm with waiters tip posture
Erb’s palsy
Bone tumour of the neural crest cells
Ewing’s sarcoma
Chronic pain syndrome - pain, depression, non restorative sleep
Fibromyalgia
Failure of the medial arch
Flat feet
Outpouching of synovial fluid - leave or surgical removal
Ganglion cyst
Knock knees
Genu Valgus
Bow leg
Genu Varum
Large vessel vasculitis seen in >50s - granulomatous inflammation may lead to blindness
Giant cell arteritis - high dose steroids
Uric acid deposition in joints - red, hot, swollen & painful - -ve bifrignement crystals on aspiration - colchicine & allopuril
Gout
C-ANCA - PR3 - small vessel vasculitis affecting lungs - steroids
Granulmoatosis with polyangitis - Wegners
OA in the big toe - painful - analgesic & arthrodesis
Hallux rigidus: 1st MTPJ OA
Medial displacement of the big toe - conservative treatment –> surgery (bunion)
Hallux valgus
OA of the hip - pain on movement
Hip replacement in suitable candidates
Hip arthritis & Total Hip Arthroplasty
Damage to c8 & t1 - causes paralysis of intrinsic hand muscles & horners
Klumpke’s palsy
Arthritis is common in this joint (OA & RA) - However replacement is often unsatisfactory
Knee arthritis & Knee replacements
Dash board injury uncommon in isolation - posterior sag test positive
LCL tears / ruptures
Benign collection of fat cells - can be removed
lipoma
Malignant collection of fat cells
Liposarcoma
Young woman with joint pain and malar rash - +ve for ANA, anti-dsDNA & anti-SM
Immunosupression & hydroxychloroquine
SLE
Autosomal dominant issue with fibrillin - long arms, high arched pallet, aortic insufficiency
Marfan’s syndrome
Skiing injury
MCL tears
Common cause of lower back pain - analgesia and exercise
Mechanical back pain
Twisting injury - joint line pain - MRI needed
Meniscal tear
Seen after overuse - can be hard to see on x-ray until callus forms - repeat x-ray if clinically suspicious
Metatarsal stress fractures
ANCA associated small vessel vasculitis
Microscopic polyangitits
Swelling of nerve in toe - painful - conservative treatment –> surgery
Morton’s neuroma
OA due to cartilage wear and tear - painful - LOSS on x-ray however it is a clinical diagnosis - pain relief –> joint replacement
Osteoarthritis
Floating cartilage behind knee - causes pain and joint locking - NSAIDs & surgery
Osteochondritis dissecans
collagen disorder causing brittle bones - multiple fractures –> suspicion of NAI – Blue sclera
Osteogenesis imperfecta
Benign bone tumour with sclerotic halo
osteoid osteoma
Weakened bones due to low vitamin d - causes low calcium absorption - replacement
Osteomalacia & rickets
Bone infection - systemic illness & bone pain more common in children
S.aureus
Osteomyelitis