Musculoskeletal and Connective Tissue Disorders Flashcards
What are the 3 main bone diseases?
Arthritis
Arthritis
Arthralgia
What is arthritis?
Inflammation of the joints
What is arthrosis?
Non inflammatory bone disease
What is arthralgia?
Joint pain
What is bone?
Mineralised connective tissues
What 3 things would you find in bone?
Calcium
Phosphate
Vitamin D
What happens during the turnover cycle?
- Bone removed by osteoclasts
- Bone deposited by osteoblasts
- Osteoclasts eat matrix
- Matrix replaced by osteaoblats
- Mineralised
How long does turnover cycle last?
3-6 months
What is calcium involved in that makes it important to keep it in the blood?
Nerve function
What does the parathyroid hormone do in regards to bone?
Maines calcium level and increased calcium release from bone
What do hyperparathyroidism and hypoparathyroidism cause?
Increased bone reabsorption
Where does vitamin D get processed?
In the blood and liver
What is oestomalacia?
Poorly mineralised osteoid matrix and cartilage growth plage
What is oestroporsis?
Reduced bone mass
What causes oestomalakia?
Calcium deficiency
Symptoms of oestomalakia/ rickets ?
Sore legs to touch
Muscle weakness
Facial twitching
Bow legs
What is the management of lack of vitamin D?
Sunlight exposure 30 mins x 5 weekly
Diet
What are the risk factors of oestoprosis?
Age
Female
Hormone deficiency
What age is peak bone mass?
24-35
What are the effects of bone mass loss?
Fracture risk
Height loss
Kyphosis + scoliosis
Nerve foot compression
What does bisphosphonates do?
Reduces vertebral fracture by 50%
What is MRONJ?
Medication
Related
Osteonecrosis
Of the
Jaw
If the patient has been on bisphosonates for >5 years what risk are they of MRONJ?
High risk
If a patient has been taking bisphosphonates for <5 years what risk are they of MRONJ?
Low risk
What is osteonceosis of the jaw?
Bone is exposed and begins to starve from lack of blood
Symptoms of joint disease
Pain
Immobility stiffness
Loss of function
Signs of joint disease
Swelling
Deformity
Redness
Crepitus
Investigations for joint disease
Radiography
Blood tests
Biopsy
What is crystal arthropathies?
Gout
What is gout?
Single joint acute arthritis
What is hyperuricaemia?
High uric acid levels
Where does gout most commonly affect?
The big toe
What type of onset is gout?
Rapid
What is used to treat gout?
NSAIDs
Avoid aspirin
What joints does oestoarthirits affect?
weight bearing joints
Symptoms of oestoarthirits
Pain
Morning stiffness
Signs of oestoarthirits
loss of joint space
lipping at joint edges
swelling and deformity
Treatment for oestoarthirits
Weight loss
Increase muscle
NSAIDs
Prosthetic replacement for pain NOT function
What does sero postive RA mean?
Rheumatoid factors are present
What does sero negative RA mean?
Rheumatoid factors are not present
Who is most commonly affected by rheumatoid arthritis?
Females age 20-50
What type is onset is rheumatoid arthritis?
Slow starting in hands and feet
Symptoms of rheumatoid arthritis
Fatigue
Morning stiffness in joints
Joint pain
Minor joint swelling
Numbness or tingling
Decreased range of motion
What are the early signs of rheumatoid arthritis?
Symmetrical synoyitis of MCP, PIP and wrist joints
What are late signs of rheumatoid arthritis?
Dysfunction of the joint - cannot hyperextend
Swan neck
Ulner deviation
What are some extra articulate features of rheumatoid arthritis?
changes to eyes or moth = sjorgrens syndrome
How is rheumatoid arthritis investigated?
Radiographs
Blood
What is the treatment options for rheumatoid arthritis?
Physiotherapy
Occupational therapy
Drug
Surgary
What is the aim of drug use in rheumatoid arthritis?
Slow down the effects and pain
What would happen during surgery for rheumatoid arthritis?
Replacement of the joint
What drugs are given for rheumatoid arthritis?
Analgesics
NSAIDs - Methotrexate
Steroid injection for inflammation
What drugs would be used in more severe cases of rheumatoid arthritis?
Biologics
What type of disease is rheumatoid arthritis?
Immune disease
Dental SE to drugs used for rheumatoid arthritis?
NSAIDs = bleeding
Steroids = infection risk
Hydroxychoroquine = oral lichenoid
Methotrexate = ulcerstion
What is ankylosing spondylitis?
Chronic condition that affects the spine and becomes inflamed
Ankylosing spondylitis dental aspects
Limited mouth opening
Limited neck flextion
What is sjögren’s syndrome?
Condition that affects parts of the body that produces fluids
What are symptoms of sjögren’s syndrome?
Dry eyes
Dry mouth
Dry skin
What causes sjögren’s syndrome?
The immune system mistakenly attacks the body
What is dry mouth?
There’s not enough salvia production
Causes of dry mouth
Psychogenic
Drugs
Radiotherapy
Dehydration
Management of dry mouth?
Artificial saliva from -
Orthana spray
Glandosane spray
BioXtra gel
What is the pH of orthana?
Neutral
What is the pH of BioXtra?
Neutral
What is the pH of glandosane?
5.75
What can dry mouth lead to?
Oral infections
Perio disease
Caries
What advice would you give to someone with dry mouth?
Topical fluoride
OHI
Dietary advice
Water