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T R E A T M E N T S > MSK Rx > Flashcards

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
Q

Pseudogout

A

NSAIDs

Intra-articular steroids

26
Q

Polymyalgia Rheumatica

A

Prednisolone

Bone prophylaxis

27
Q

Ankylosing Spondylitis

A 
Physiotherapy
NSAIDs
DMARDs - sulfasalazine
Anti-TNF - infliximab
Anti-IL-17
Joint replacements / spinal surgery
28
Q

Psoriatic Arthritis

A 
DMARDs - sulfasalazine / methotrexate 
Cyclosporine
Anti-TNF - infliximab
Anti-IL-17 and IL-23
Steroids - prednisolone
Physiotherapy 
Occupational therapy
29
Q

Reactive Arthritis

Reiter’s Syndrome

A

Acute

  • NSAIDs
  • joint injection
  • Abx in chlamydia infection

Chronic

  • NSAIDs
  • DMARD - sulfasalazine / methotrexate
30
Q

Systemic Lupus Erythematosus

A

Mild

  • topical NSAIDs
  • lifestyle changes - less time in the sun
  • hydroxychloroquine

Moderate

  • methotrexate
  • steroid injections for flare ups

Severe

  • cyclophosphamide
  • rituximab
31
Q

Sjogren’s Syndrome

A

Mild - hydroxychloroquine

Moderate - methotrexate

Severe - cyclophosphamide

32
Q

Polymyositis

A

Mild - hydroxychloroquine

Moderate - methotrexate

Severe - cyclophosphamide

IV immunoglobulin

33
Q

Dermatomyositis

A

Mild - hydroxychloroquine

Moderate - methotrexate

Severe - cyclophosphamide

34
Q

Giant Cell Arteritis

A

Prednisolone

IV methylprednisolone if visual loss

35
Q

Juvenile Idiopathic Arthritis

A

1st line

  • simple pain kilers
  • NSAIDs

2nd line

  • methotrexate
  • Anti-TNF
36
Q

Developmental Dysplasia of the Hip

A

Pavlik harness if <6 months

Open / closed reduction surgery if >6 months

37
Q

Perthes’ Disease

A 
Maintain hip motion
Analgesia - NSAIDs
Crutches
Restrict painful activities
Consider osteotomy
38
Q

Slipper Upper / Capital Femoral Epiphysis

A
  • in situ screw fixation
  • open reduction + internal fixation with surgical hip disloacation
  • bone graft epiphysiodesis
  • prophylactic fixation of contralateral hip
39
Q

Benign / Malignant Bone Tumour

A

Chemotherapy
Surgical removal
Radiotherapy

40
Q

Osteoarthritis

A

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
Q

Achilles Tendinosis

A

Non-operative

  • activity modification
  • weight loss
  • shoe wear modification
  • physiotherapy
  • extra-corporeal shockwave therapy
  • immobilisation

Operative

  • gastrocnemius recession
  • release and debridement of tendon
42
Q

Plantar Fasciosis / Fasciitis

A 
Rest, ice, change training
Stretching
NSAIDs 
Orthoses - heel pads
Physiotherapy
Weight loss
Injections - corticosteroid
Night splinting
43
Q

Charcot’s Neuroarthropathy

A

Prevention - good diabetic control

Acute fragmentation:
- immobilisation / non-weight bearing

Correct deformity

44
Q

Trochanteric Bursitis

A 
NSAIDs
Relative rest / activity modification
Physiotherapy
Corticosteroid injection
Surgery
45
Q

Avascular Necrosis

A

Non-operative

  • reduce weight-bearing
  • NSAIDs
  • bisphosphonates
  • anticoagulants
  • physiotherapy

Operative

  • restore blood supply w/ cord decompression ± vascularised graft
  • rotational osteotomy
  • total hip replacement
46
Q

Femoroacetabular Impingement

A

Non-operative

  • activity modification
  • NSAIDs
  • physiotherapy

Operative

  • arthroscopy
  • open surgery - resection / osteotomy / hip arthroplasty
47
Q

Labral Tear of the Hip

A

Non-operative

  • activity modification
  • NSAIDs
  • physiotherapy
  • steroid injections

Operative
- arthroscopy

48
Q

Meniscal Tear of the Knee

A

Non-operative

  • rest
  • NSAIDs
  • physiotherapy

Operative
- arthroscopy

49
Q

Anterior Cruciate Ligament Rupture

A

Non-operative
- quadriceps focussed training programme

Operative
- ACL reconstruction
± partial meniscectomy
± ligament repair or augmentation
- hamstring graft
50
Q

Medial Collateral Ligament Rupture

A

Non-operative

  • rest and NSAIDs
  • physiotherapy
  • knee brace for comfort

Operative
- repair + reconstruction

51
Q

Osteochondritis dissecans

A

Non-operative

  • restricted weight-bearing
  • ROM brace

Operative

  • arthroscopy
  • open fixation
52
Q

Sciatica

A 
Analgesia - paracetamol / NSAIDs
Exercise
Heat / cold compression packs / ice
Physiotherapy
Surgery - lumbar laminectomy / discectomy
53
Q

Osteogenica imperfecta

A

Bisphosphonates

Pre-emptive surgical pinning

T R E A T M E N T S (5 decks)

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