MSK Pathologies (not joint specific) Flashcards

1
Q

What are some examples of rheumatic diseases?

A
  • Rheumatoid arthritis
  • Osteoarthritis
  • Axial spondyloarthritis (e.g. ankylosing spondylitis)
  • Gout
  • Psoriatic arthritis
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2
Q

What are rheumatological diseases be caused by?

A
  • Problems in the immune system
  • Inflammation
  • Gradual deterioration joints, muscles and bones
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3
Q

What are indicators of rheumatological conditions?

A
  • More than one joint affected
  • Family history of RA or other rheumatological condition
  • Early morning stiffness which lasts more than 30 minutes
  • Fatigue
  • Swollen joints
  • Joints feel better after light activity
  • Uveitis, psoriasis
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4
Q

What is the Axial Spondyloarthritis referreal criteria?

A

LBP starting before the age of 45, has lasted for longer than 3 months and 4 or more of the following are present:
- LBP started before the age of 35
-Waking during the second half of the night due to symptoms
- Buttock pain
- Improvement with movement
- Improvement within 48 hours of taking NSAID’s
- A first degree relative with spondyloarthritis
- Current or past arthritis
- Current or past enthesitis
- Current or past psoriasis

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5
Q

Who is osteoporosis more common in?

A

women

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6
Q

Osteoporosis.

A

reduced bone mineral density (BMD)

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7
Q

What are the most common sites for osteoporotic fractures?

A
  • Spine
  • Wrist
  • Hip
  • Pelvis
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8
Q

What are risk factors for osteoporosis?

A
  • Female
  • Over 50
  • Low body weight
  • Previous fracture or height loss
  • Smoking
  • High intake of alcohol
  • Amenorrhea
  • Early menopause (before 45)
  • Inflammatory conditions (e.g. RA, Crohn’s)
  • Conditions affecting hormone producing glands
  • Family history of osteoporosis
  • Long term use of medications which affect bone strength e.g. prednisolone
  • Poor diet lacking calcium, vitamin D, fruit and vegetables
  • Too much protein, sodium and caffeine
  • Malabsorption problems
  • Vitamin D deficiency
  • Inactive lifestyle
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9
Q

How can septic arthritis develop?

A

When an infection (such as a skin infection or urinary tract infection) spreads through your bloodstream to a joint

Less commonly:
- puncture wound
- drug injection
- surgery in or near a joint (including joint replacement surgery) - can give germs entry into the joint space

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10
Q

What is osteomylitis?

A

an infection in a bone (can affect more than 1 part of a bone)

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11
Q

How can osteomylitis occur in bone?

A
  • Infections can reach a bone through the bloodstream or from nearby infected tissue.
  • Infections also can begin in the bone if an injury opens the bone to germs.
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12
Q

What joints are commonly affected by septic arthritis?

A
  • Knee
  • Wrist
  • Ankle
  • Hips
  • Symphysis pubis
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13
Q

What are signs & symptoms (S&S) of septic arthritis?

A
  • Painful, red swollen joint
  • Reduced range of motion
  • Systematically unwell & fever
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14
Q

What are risk factors of septic arthritis?

A
  • Inflammatory joint
  • Disease
  • Diabetes
  • IV drug use
  • Alcoholism
  • Immunosuppression
  • Malignancy
  • Recent trauma or surgery
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15
Q

What must be done if patient has septic arthritis?

A

prompt medical intervention is needed to treat and prevent joint damage

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16
Q

Where and who is osteomylitis most common?

A

Children - the growing ends of long bones
Adults - the spine

17
Q

What is a signs & symptom (S&S) of osteomylitis?

A

present with fever & pain at the infection site

18
Q

How can osteomylitis be treated?

A
  • Antibiotics
  • Surgical drainage (infection of fixation devices can occur)
19
Q

What are signs & symptoms (S&S) to look out for spinal infections (Vertebral osteomylelitis, Discitis, Epidural abscess)?

A
  • Fever; systemically unwell.
  • Recent infection.
  • Diabetes mellitus.
  • History of intravenous drug use.
  • HIV infection (use of immunosuppressant drugs, or other cause of immunocompromise)
20
Q

What are some identifiable features of visceral pain?

A
  • Pain diffuses and is poorly defined
  • Non mechanical pattern
  • Associated autonomic responses (e.g.: palpitations, nausea, etc)
21
Q

What are the abdominal organs/anatomy that can refer to lower back/quadrant?

A
  • Kidney
  • Bladder
  • Bowel
  • Ovaries
  • Uterus
  • Prostate
  • Abdominal aorta
  • Hernias
22
Q

Which types of cancer have a higher chance of metastasising to bone?

A
  • Breast
  • Prostate
  • Lung
  • Kidney
  • Thyroid
23
Q

What are medications which can masquerade as an MSK problem?

A
  • Glucocorticoids
  • Steroids
  • Statins
  • Beta-blockers
  • Hormones
  • Diuretics
24
Q

Where does the liver contribute to pain distribution?

A
  • Right lower thoracic pain
  • Right shoulder pain
  • Right epigastric pain
  • Joint pain/back pain
25
Q

Where does the gall bladder contribute to pain distribution?

A
  • Epigastric pain
  • Right shoulder pain
  • Right lower thoracic pain
26
Q

Where does the gall bladder contribute to pain distribution?

A
  • Epigastric pain
  • Left or right shoulder pain
  • Mid-thoracic pain
27
Q

Where does the stomach contribute to pain distribution?

A
  • Mid-thoracic pain
  • Epigastric pain
28
Q

Where does the kidney contribute to pain distribution?

A
  • Loin pain
  • Lateral buttock & thigh pain
  • Groin pain
  • Lower quadrant abdominal pain
29
Q

Where does the bowel contribute to pain distribution?

A
  • Central & lower abdominal pain
  • Lower-quadrant abdominal pain (left>right)
30
Q

Where does the ovaries contribute to pain distribution?

A

Abdominal pain left or right mid-abdomen

31
Q

Where does the uterus contribute to pain distribution?

A
  • Central lower back pain
  • Posterior thigh pain
  • Abdominal pain
32
Q

Where does the bladder contribute to pain distribution?

A
  • Central suprapubic pain
  • Central pain over sacrum
  • Pain around gluteal crease (left or right, or both)
  • Perineal pain
33
Q

Where does the prostate contribute to pain distribution?

A
  • Genital pain
  • Lower back pain perineal pain
34
Q

Where does the abdominal aorta contribute to pain distribution?

A
  • Lower back pain
  • Groin pain