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MSK Rx Flashcards

1
Q

Acute Osteomyelitis

A

Supportive care
Rest + splintage
Abx - flucloxacillin + benzylpenicillin
Surgical drainage / lavage

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2
Q

Chronic Osteomyelitis

A

Long-term Abx - gentamicin
Surgically eradicate infection
? Amputation

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3
Q

Tuberculosis in bone and joint

A

8w - rifampicin, isoniazid, pyrazinamide, ethambutol
6m - rifampicin, isoniazid
Rest + splint age
Operative drainage

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4
Q

Acute Septic Arthritis

A 
General supportive measures
Abx 3-4w
Surgical drainage
Open / arthroscopic lavage
Infected joint replacements
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5
Q

Adhesive Capsulitis

frozen shoulder

A

Hydrodilatation (early presentation)

Surgery (later presentation)

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6
Q

Subacromial Impingement Syndrome

A

Subacromial steroid injection
Physiotherapy
Arthroscopic subacromial decompression

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7
Q

Rotator Cuff Tear

A

Early surgery

Superior capsular reconstruction (in massive irreparable tear - cadaveric skin graft used to reconstruct capsule)

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8
Q

Shoulder Dislocation

A

Manipulation
Immobilisation
Physiotherapy
Surgery

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9
Q

Lateral Epicondylitis

tennis elbow

A

Rest + massage
Analgesia (NSAIDs)
Local corticosteroid injection
Surgery

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10
Q

Medial Epicondylitis

golfers elbow

A

Rest + massage
Analgesia (NSAIDs)
Local corticosteroid injection
Surgery

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11
Q

Olecranon Bursitis

A

Aspiration
Avoidance of activities causing pressure to elbow
Analgesia (NSAIDs)

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12
Q

Dupuytren’s Disease

A

Non-operative

  • observe
  • radiotherapy

Operative

  • partial fasciectomy
  • dermo-fasciecotmy
  • arthrodesis (fusion of joint)
  • amputation

Percutaneous needle fasciotomy

Collagenase

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13
Q

Trigger Finger

A

Non-operative

  • splintage
  • steroids

Operative

  • percutaneous release
  • open surgery
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14
Q

De Quervain’s Tenovaginitis

A

Non-operative

  • splintage
  • steroid injection

Operative
- decompression

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15
Q

Basal Thumb Osteoarthritis

A

Non-operative

  • lifestyle modifications
  • NSAIDs
  • splint
  • steroid injections

Operative

  • trapeziectomy
  • fusion
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16
Q

Carpal Tunnel Syndrome

A

Bracing or splinting
NSAIDs
Steroid inejctions
Open / endoscopic carpal tunnel release

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17
Q

Cubital Tunnel Syndrome

A

Avoidance of actions which cause Sx
Hand therapist
Surgery

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18
Q

Osgood Schlatter’s Disease

A

Rest
Stretching exercises
NSAIDs

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19
Q

Rheumatoid Arthritis

A

DMARDs

  • methotrexate
  • hydroxychloroquine

Biologics

  • rituximab
  • infliximab

Corticosteroids (for pain relief)

  • prednisolone
  • prednisone

JAK inhibitors

Pain relief

  • paracetamol
  • NSAIDs
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20
Q

Osteoporosis

A 
Hormone replacement therapy
Selective oestrogen receptor modulator (SERM)
Bisphosphonates
Denosumab
Teriparatide
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21
Q

Osteomalacia

A

Vitamin D supplements
Calcium supplements
Phosphorus supplements

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22
Q

Rickets

A

Vitamin D supplements

Spend time in the sun

23
Q

Paget’s Disease

A

Don’t treat asymptomatic

IV bisphosphonate therapy

24
Q

Gout

A

Acute attack

  • NSAIDs
  • colchicine
  • steroids

Xanthine oxidase inhibitors - allopurinol

25
Pseudogout
NSAIDs | Intra-articular steroids
26
Polymyalgia Rheumatica
Prednisolone | Bone prophylaxis
27
Ankylosing Spondylitis
``` Physiotherapy NSAIDs DMARDs - sulfasalazine Anti-TNF - infliximab Anti-IL-17 Joint replacements / spinal surgery ```
28
Psoriatic Arthritis
``` DMARDs - sulfasalazine / methotrexate Cyclosporine Anti-TNF - infliximab Anti-IL-17 and IL-23 Steroids - prednisolone Physiotherapy Occupational therapy ```
29
Reactive Arthritis | Reiter's Syndrome
Acute - NSAIDs - joint injection - Abx in chlamydia infection Chronic - NSAIDs - DMARD - sulfasalazine / methotrexate
30
Systemic Lupus Erythematosus
Mild - topical NSAIDs - lifestyle changes - less time in the sun - hydroxychloroquine Moderate - methotrexate - steroid injections for flare ups Severe - cyclophosphamide - rituximab
31
Sjogren's Syndrome
Mild - hydroxychloroquine Moderate - methotrexate Severe - cyclophosphamide
32
Polymyositis
Mild - hydroxychloroquine Moderate - methotrexate Severe - cyclophosphamide IV immunoglobulin
33
Dermatomyositis
Mild - hydroxychloroquine Moderate - methotrexate Severe - cyclophosphamide
34
Giant Cell Arteritis
Prednisolone IV methylprednisolone if visual loss
35
Juvenile Idiopathic Arthritis
1st line - simple pain kilers - NSAIDs 2nd line - methotrexate - Anti-TNF
36
Developmental Dysplasia of the Hip
Pavlik harness if <6 months Open / closed reduction surgery if >6 months
37
Perthes' Disease
``` Maintain hip motion Analgesia - NSAIDs Crutches Restrict painful activities Consider osteotomy ```
38
Slipper Upper / Capital Femoral Epiphysis
- in situ screw fixation - open reduction + internal fixation with surgical hip disloacation - bone graft epiphysiodesis - prophylactic fixation of contralateral hip
39
Benign / Malignant Bone Tumour
Chemotherapy Surgical removal Radiotherapy
40
Osteoarthritis
Non-pharma - thermotherapy - electrotherapy - aids and devices - manual therapy Pharma - oral analgesia - paracetamol / NSAIDs - topical treatments - NSAIDs / capsaicin - intra-articular injections - steroids / hyaluronic acid Joint replacement surgery Arthrodesis (joint immobilisation)
41
Achilles Tendinosis
Non-operative - activity modification - weight loss - shoe wear modification - physiotherapy - extra-corporeal shockwave therapy - immobilisation Operative - gastrocnemius recession - release and debridement of tendon
42
Plantar Fasciosis / Fasciitis
``` Rest, ice, change training Stretching NSAIDs Orthoses - heel pads Physiotherapy Weight loss Injections - corticosteroid Night splinting ```
43
Charcot's Neuroarthropathy
Prevention - good diabetic control Acute fragmentation: - immobilisation / non-weight bearing Correct deformity
44
Trochanteric Bursitis
``` NSAIDs Relative rest / activity modification Physiotherapy Corticosteroid injection Surgery ```
45
Avascular Necrosis
Non-operative - reduce weight-bearing - NSAIDs - bisphosphonates - anticoagulants - physiotherapy Operative - restore blood supply w/ cord decompression ± vascularised graft - rotational osteotomy - total hip replacement
46
Femoroacetabular Impingement
Non-operative - activity modification - NSAIDs - physiotherapy Operative - arthroscopy - open surgery - resection / osteotomy / hip arthroplasty
47
Labral Tear of the Hip
Non-operative - activity modification - NSAIDs - physiotherapy - steroid injections Operative - arthroscopy
48
Meniscal Tear of the Knee
Non-operative - rest - NSAIDs - physiotherapy Operative - arthroscopy
49
Anterior Cruciate Ligament Rupture
Non-operative - quadriceps focussed training programme ``` Operative - ACL reconstruction ± partial meniscectomy ± ligament repair or augmentation - hamstring graft ```
50
Medial Collateral Ligament Rupture
Non-operative - rest and NSAIDs - physiotherapy - knee brace for comfort Operative - repair + reconstruction
51
Osteochondritis dissecans
Non-operative - restricted weight-bearing - ROM brace Operative - arthroscopy - open fixation
52
Sciatica
``` Analgesia - paracetamol / NSAIDs Exercise Heat / cold compression packs / ice Physiotherapy Surgery - lumbar laminectomy / discectomy ```
53
Osteogenica imperfecta
Bisphosphonates | Pre-emptive surgical pinning

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