MSK Signs and Symptoms Flashcards
Inflammatory joint pain
AI: RA, Spondyloarthropathies, Connective tissue disease, vasculitis
Crystal arthritis
Infection
Non- inflammatory pain
Degenerative eg osteoarthritis
Non degenerative - CWPS, hypermobility
Inflammatory joint disease points
Pain eases with movement
Stiffness - more than 60 mins
Early morning or at rest
Swelling
Synovial/ bony
Hot and red
Young, psoriasis, FH
Hands and feet
Responds to NSAIDs
Degenerative disease points
Pain increases with use
Stiffness - less than 30 mins
Morning evening
Swelling
No inflamamtion
Older, sport, job
1st CMCJ, DIPJ, knees
No response to NSAIDs
What to ask in a MSK history?
Where is the pain?
What is the nature of the pain?
Is there any stiffness?
Is there any swelling?
What is the history of these symptoms?
How has this affected function
Associated symptoms with MSK?
Rash
Raynaud’s
Mouth ulcers
Sicca symptoms (dry eyes & mouth)
Diarrhoea
Preceding factors
Recent infection
Family history which is associated with MSK issues
Thyroid
Vitiligo
Type I diabetes
Pernicious anaemia
RA/ CTD/ MS
Lifestyle factors assosciated with MSK issues
Smoking
Occupation
Alcohol
HLA B27 spectrum
Psoriasis
Crohns/ Ulcerative colitis
Ankylosing spondylitis
Reactive arthritis/ reiter’s
S + S of RA
Symmetrical
Polyarthritis
Deformity
Erosion on X-ray
Ulnar deviation
Swan neck
Boutonniere
Digital vasculitis
What are the spondyloarthropathies?
AS
Reactive arthritis
Psoriatic arthritis
Enteropathic arhtritis (Crohns/ UC)
What is AS?
Progressive new bone formation/ calcification in spine = severe limitation of movement
What is enthesitis?
Inflammation of the heel
Signs of Psoriatic arthritis
Nail pitting
Dactylitis
Skin and joint involvement in psoriatic arthritis
Scalp
Behind ears
Umbilicus
Nails
Hands & feet