MSK Signs and Symptoms

Question 1

Inflammatory joint pain

Answer 1

AI: RA, Spondyloarthropathies, Connective tissue disease, vasculitis
Crystal arthritis
Infection

Question 2

Non- inflammatory pain

Answer 2

Degenerative eg osteoarthritis
Non degenerative - CWPS, hypermobility

Question 3

Inflammatory joint disease points

Answer 3

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

Question 4

Degenerative disease points

Answer 4

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

Question 5

What to ask in a MSK history?

Answer 5

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

Question 6

Associated symptoms with MSK?

Answer 6

Rash
Raynaud’s
Mouth ulcers
Sicca symptoms (dry eyes & mouth)
Diarrhoea
Preceding factors
Recent infection

Question 7

Family history which is associated with MSK issues

Answer 7

Thyroid
Vitiligo
Type I diabetes
Pernicious anaemia
RA/ CTD/ MS

Question 8

Lifestyle factors assosciated with MSK issues

Answer 8

Smoking
Occupation
Alcohol

Question 9

HLA B27 spectrum

Answer 9

Psoriasis
Crohns/ Ulcerative colitis
Ankylosing spondylitis
Reactive arthritis/ reiter’s

Question 10

S + S of RA

Answer 10

Symmetrical
Polyarthritis
Deformity
Erosion on X-ray
Ulnar deviation
Swan neck
Boutonniere
Digital vasculitis

Question 11

What are the spondyloarthropathies?

Answer 11

AS
Reactive arthritis
Psoriatic arthritis
Enteropathic arhtritis (Crohns/ UC)

Question 12

What is AS?

Answer 12

Progressive new bone formation/ calcification in spine = severe limitation of movement

Question 13

What is enthesitis?

Answer 13

Inflammation of the heel

Question 14

Signs of Psoriatic arthritis

Answer 14

Nail pitting
Dactylitis

Question 15

Skin and joint involvement in psoriatic arthritis

Answer 15

Scalp
Behind ears
Umbilicus
Nails
Hands & feet

Question 16

Examples of connective tissue disorders

Answer 16

SLE
Scleroderma
Polymyositis, Dermatomyositis

Question 17

Features of Connective tissue disorders

Answer 17

Multi-system disorders
(+) ANA
Systemic features

Question 18

Features of SLE

Answer 18

Non - erosive arthritis
Butterfly rash
Photosensitivity
Mouth ulcers

Question 19

Examples of Nodal OA hands

Answer 19

Bouchard node
Heberden’s node