Musculoskeletal Flashcards
Define amyloidosis
Heterogenous group of diseases characterised by extracellular deposition of amyloid fibrils
Recall the subtypes of amyloidosis
Type AA: serum Amyloid A protein
Type AL: monoclonal Ig Light chains
Type ATTR: genetic variant TransThyRetin
Which are the main 2 organs affected by amyloidosis?
Kidneys
Heart
What sort of cardiomyopathy do you get in amyloidosis?
Restrictive
Exactly define ankylosing spondylitis
Seronegative inflammatory arthropathy preferentially affecting the axial skeleton and large proximal joints
What is the HLA association of ankylosing spondylitis?
HLA-B27
What is the main symptom of ankylosing spondylitis?
Lower back and sacral pain that is worse in the morning and better with exercise
What is the Schober test and what is it used for?
Mark at 5th lumbar spinous process Mark at 10cm above this Get patient to lean forwards Gap --> 15cm = test for ankylosing spondylitis
Recall the 5 As of extraarticular disease that may be seen alongside ankylosing spondylitis
Anterior uveitis Apical lung fibrosis Aortic regurgitation Amyloidosis Achilles tendonitis
Recall two x ray findings in ankylosing spondylitis
Bamboo spine
Sacroiliac joint fusion
Define anti-phospholipid syndrome (mnemonic = APL)
Arterial and venous thrombi
Platelet-producing cells decrease
Loss of foetuses
Describe the pathophysiology of anti-phospholipid syndrome
Develops secondary to infection in susceptible individuals
Recall the triad of symptoms in anti-phospholipid syndrome
Headaches
Chorea
Epilepsy
What would an FBC show in anti-phospholipid syndrome?
Thrombocytopaenia
What is Bechet’s disease?
Multisystem inflammatory disease that causes uveitis and orogenital ulceration
What is the HLA association of Bechet’s disease?
HLA-B51
What is the pethergy test and what is it used to diagnose?
Prick skin with needle and it will form a sterile pustule within 48 hours
Bechet’s disease
What is carpal tunnel syndrome?
Compression of median nerve by the flexor reticulum
Recall 3 signs of carpal tunnel syndrome
- Thenar eminence wasting
- Tinel’s sign (symptoms come on when you tap carpal tunnel)
- Phalen’s test (symptoms come on following flexion of wrist for one min)
Recall the aetiology of cervical spondylitis
Osteoarthritic degeneration –> osteophyte formation –> protrusion into spinal foramina
Nerve root compression –> radiculopathy
Anterior spinal cord compression –> myelopathy
What is the most common symptom of cervical spondolysis?
Pain in neck and arms with paraesthesia
How do the arms appear in cervical spondylitis?
Forearm and hand may be wasted but upper arm spared
What investigation is required to diagnose cervical spondylitis?
Lateral X ray of spine
How long do fibromyalgia symptoms have to persist in order for a diagnosis to be made?
More than 3 months