Musculoskeletal Disorders

Question 1

Fractures: Aetiology and Pathophysiology

Answer 1

a fracture is break in the bone, often from significant bone
pathological fractures are linked to weakened bones from osteoporosis, osteomalacia

Question 2

Fractures: Epidemiology

Answer 2

Women more prone due to osteoporosis; men at risk from accidents
Classification based on injury mechanism, stability

Question 3

Fractures: Clinical Manifestations, Diagnosis and Management

Answer 3

symptoms: pain, swelling, deformities, possibly shock
Diagnosis: imaging
Management: pain relief, immobilization
Bone healing is effective throughout life, but slows as you age

Question 4

Types of Fractures

Answer 4

Types of Fractures:
Facial (e.g. Maxilla, Mandible. leads to airway obstruction due to displaced bone fragments)
Vertebral (anywhere along the spine)
Ribs (singular or multiple ribs may break)
Upper limb (clavicle, proximal humorus)
Pelvic (carry high risks of blood loss, and damage to other abdominal structures)
hip (common in older adults)
lower limb (occur in the femur and tibia)

Question 5

Fracture complications

Answer 5

delayed union (healing), malunion (bone heals in abnormal position), avascular necrosis (death of bone tissue due to lack of blood supply)

Question 6

Osteoporosis: Aetiology and Pathophysiology

Answer 6

reduced bone mineral density and bone microstructure deterioration -> makes bones more brittle
imbalance in bone formation and resorption

Question 7

Osteoporosis: Epidemiology

Answer 7

Risk factors: age, hormonal changes, lifestyle, dietary deficiencies

Question 8

Osteoporosis: Clinical Manifestations, Diagnosis and Management

Answer 8

typically asymptomatic until a fracture
Diagnosis: medical history, DEXA scans
Management: calcium supplementation, specific drugs that inhibit bone resorption

Question 9

Osteomalacia: Aetiology and Pathophysiology

Answer 9

softening of bones from abnormal mineralisation of bone matrix
Causes: Vitamin D and dietary calcium deficiency

Question 10

Osteomalacia: Clinical Manifestations, Diagnosis and Management

Answer 10

Symptoms: bone pain, reduced mobility, muscle weakness
Diagnosis: clinical exam, lab tests, imaging
Management: Vitamin D and dietary calcium supplements, sun exposure education

Question 11

Osteomyelitis: Aetiology and pathophysiology

Answer 11

acute or chronic bone infection often from Staphylocus aureus (bacteria)
Acute osteomyelitis -> triggers inflammatory responses due to pathogen invasion
Chronic osteomyelitis -> results from injuries, diabetes and IV drug use

Question 12

Osteomyelitis: Clinical Manifestations, Diagnosis and Management

Answer 12

Symptoms: pain, swelling, restricted movement, fatigue
Diagnosis: involves medical history, imaging, microbial cultures
Treatment based on antimicrobial agents

Question 13

Osteogenic tumours: Aetiology and Pathophysiology

Answer 13

malignant bone cancer
common in children and adolescents
it is rapid bone growth
Types: osteosarcoma (can occur in any bone)
ewing’s sarcoma (typically in leg bones)

Question 14

Osteogenic tumours: Clinical Manifestations, Diagnosis and Management

Answer 14

Symptoms: pain, tenderness, swelling, mobility issues
Diagnosis: through history, radiological tests, biopsies, treated with chemotherapy, radiotherapy, surgery

Question 15

Osteoarthritis: Aetiology and Pathophysiology

Answer 15

degeneration of synovial joints (most common degenerative disease)
enzymatic breakdown of cartilage
developed due to a complex interaction of factors such as genetics, hormonal effects and injury

Question 16

Osteoarthritis: Clinical Manifestations, Diagnosis and Management

Answer 16

symptoms: joint pain, stiffness, reduced motion
commonly affected area include knees, hips, spine and hands
Joints may become tender, enlarged, misaligned, and may lock due to free floating cartilage fragments
Diagnosis: physical assessment, x-rays, history
Management: pain control, mobility maintenance, NSAIDS, supplements and surgery

Question 17

Rheumatoid Arthritis: Aetiology and Pathophysiology

Answer 17

chronic inflammation affecting synovial joints
Autoimmune disease
risk factors: genetics, environment, smoking

Question 18

Rheumatoid Arthritis: Clinical Manifestations, Diagnosis and Management

Answer 18

Symptoms: joint pain, swelling, and symptom-wide effects
commonly affects joints in hands, feet, ankles, hip and elbows
Diagnosis: health history, physical exam, blood tests
Management: lifestyle changes, disease-modifying anti-rheumatic drugs, and surgery if it becomes severe

Question 19

Compartment Syndrome: Aetiology and Pathophysiology

Answer 19

a serious disorder characterised by elevated pressure in muscle compartments which is encased by fascia (tough membrane holds muscles in place)
causes: inflammation, bleeding, tight bandages

Question 20

Compartment Syndrome: Clinical Manifestations, Diagnosis, Management

Answer 20

symptoms: severe pain, numbness, paralysis
diagnosis: pressure measurement, blood tests immediate treatment critical to prevent limb damage

Question 21

Muscle contractures: Aetiology and Pathophysiology

Answer 21

shortening or tightening muscles
reduces the full range of joint movement
causes: trauma to brain or spinal cord, burns and improper positioning
neurally mediated muscle contractures: excess activity of nerves supplying muscle
non-neurally mediated muscle contractures: skin and connective tissue shortening

Question 22

Muscle contractures: Clinical Manifestations, Diagnosis, Management

Answer 22

Symptoms: reduced joint mobility and muscle atrophy
Diagnosis and prevention: physical assessment (examining joints, ROM, muscle strength and tone, PNS functionality), exercises, splinting

Question 23

Disuse atrophy

Answer 23

Disuse atrophy due to physical inactivity (muscle strength and size reduce)
Assessment: includes examining affected limbs for changes in size and comparing to unaffected limbs
Management: gradual return to activity.

Question 24

Denervation Atrophy: Aetiology and Pathophysiology

Answer 24

Denervation Atrophy is from nerve damage affecting skeletal muscle -> leading to a significant reduction in muscle mass
severity of denervation atrophy depends on severity of nerve damage

Question 25

Denervation Atrophy: Clinical Manifestations, Diagnosis and Management

Answer 25

Symptoms: muscle mass loss and reduced strength, paralysis
Diagnosis: medical history review, physical assessment, electromyography, nerve conduction studies and imaging like CT or MRI
Management: attempts to reinnervate muscles where possible, in cases where it’s lifelong recovery -> transcutaneous electrical nerve stimulation device can be used to send electrical signals to the muscles