Musculoskeletal Disease Flashcards
What parts of the body does osteoarthritis affect?
Hands and weight bearing joints
What is osteoarthritis associated with?
Obesity
Genetics
Previously damaged joint or bone
Does oteoarthritis affect part of a joint or the whole joint?
Whole joint
Is osteoarthritis more common in men or women?
Women
What are the symptoms of osteoarthritis?
Pain that is worse on movement
Immobility
Swelling
Deformity
How is osteoarthritis diagnosed?
Clinical exam
Radiology if disease is advanced
MRI scan
How is osteoarthritis managed?
Lose weight Physio Analgesics No symptoms = no treatment Steroid injections Joint replacement
What is rheumatoid arthritis?
An auto immune disease of unknown aetiology
Joint destruction due to synovial inflammation
Compared to osteoarthritis, rheumatoid arthritis is…?
More localised
How common is rheumatoid arthritis and who does it affect more?
1-3% of population
3x more women
What is the peak onset for rheumatoid arthritis?
30-50
What are the signs and symptoms of rheumatoid arthritis?
Joint pain initially with hands and feet Later cervical spine, knees, ankles, elbows and shoulders Acute = Hot, swollen and tender Established = Deformity, and restriction Heart disease Lung problems Kidney failure Sjogrens syndrome Systemic inflammation
What do 1/4 of cases of rheumatoid arthritis show?
Symmetrical onset
What effects can rheumatoid arthritis have on the nervous system?
Peripheral neuropathy
Cervical cord compression - paralysis
How is rheumatoid arthritis diagnosed?
Clinical exam
Blood tests - full blood count
Anti CCP test
How is the disease severity established with rheumatoid arthritis?
Radiographically
What makes the prognosis of rheumatoid arthritis worse?
If pt is a woman
If they are diagnosed as anaemic within 3 months of diagnosis of rheumatoid arthritis
How is rheumatoid arthritis managed?
Analgesia Disease modifying anti rheumatic drugs Corticosteroids Surgery - joint replacement Physic Occupational therapy
Why patients with rheumatoid tend to have better dexterity than patients with osteo?
Rheumatoid progresses slowly over time so give pts a change to get used to it
What is systemic sclerosis?
An auto immune disease that affects mainly the skin - thickened skin that is bound to underlying structures
Does systemic sclerosis occur more in men or women?
3-5x more in women
What age does systemic sclerosis present?
Middle age
What are the signs and symptoms of systemic sclerosis?
Sclerodactyly
Telangiectasis
Characterised appearance - beaked nose, fixed expression, radial furrowing of lips and limitation in mouth movement
How is systemic sclerosis diagnosed?
Clinical exams
Blood tests
What is systemic lupus erythematous?
A multi system auto immune disease
What % of the population does systemic lupus erythematous affect and is it more common in men or women?
0.1%
9x more common in women
What is the average age onset for systemic lupus erythematous?
20-40 years
What are the symptoms of systemic lupus erythematous?
Photosensitivity of skin Butterfly rash on face Small joint arthritis Raynaulds disease Heart problems Lung problems Kidney failure Nervous system problems
How is systemic lupus erythematous diagnosed?
Clinical exam
Test for specific ago antibodies
How is systemic lupus erythematous managed?
Analgesia Disease modifying anti rheumatic drugs Corticosteroids Surgery - joint replacement Physic Occupational therapy Psychological practical support
What is gout?
Accumulation of rate crystals in joints
Who is gout most common in?
Older men
What is psonatic arthritis associated with?
Psoriasis
What is hyperparathyroidism?
Excess of parathyroid hormone
What are the symptoms of hyperparathyroidism?
Hypercalcaemia - malaise - depression - constipation - abdominal pains - kidney stones Bone pain
How is hyperparathyroidism diagnosed and managed?
Diagnosed - blood tests and X-rays
Management - Parathyroidectomy or drugs
What does hyperparathyroidism affect dentally?
Bone resorption
Loss of lamina dura around roots
What is pagets disease?
Abnormal bone remodelling and abundant new bone formation
What are patients with pagets disease prone to?
Fractures
In pagets disease, what is the bone resorption initially replaced with?
Fibro-vascular tissue
What eventually happens to the bone remodelling and bone resorption?
They level off
What are the signs and symptoms of pagets?
Most completely asymptomatic Bone deformities - enlargement of skull - nerve compression - fractures
How is pagets diagnosed?
Clinical exam
Xrays
Hypercementosis of roots of teeth
How is pagets managed?
With bisphosphonates
What is osteomalacia?
Vitamin D deficiency
What are the symptoms of osteomalacia?
Diffuse bone pain
Proximal muscle
How is osteomalacia diagnosed?
Xrays and blood tests
What does osteomalacia affect in children?
Development of teeth
What is osteoporosis?
Loss of bone mass
What are patients who suffer osteoporosis prone to?
Fractures
What are the risk factors for developing osteoporosis?
Female Alcohol Thin White Lack of exercise Short menstrual cycle history Malabsorption Hyperthyroidism Hyopgonadism
How is osteoporosis managed?
Diagnosis with a DEXA scan
Pharmacological
Calcium and vitamin D
