musculoskeletal disorders Flashcards
number of joints effected - which words are used?
mono - 1 at a time, oligo - fewer than 5 joints in the first 6 months the child has the disease, poly (5 or more joints are effected)
what is the most common arthritis?
osteoarthritis
what is the cause of the pain in osteoarthritis?
low grade inflammation causes joint pain caused by wearing of the cartilage. Less cart = less protection so pain on weight bearing. Muscle atrophy. Imbalance between cart synthesis n degrading.
key symptom of osteoarthritis.
morning joint stiffness less than 30mins
Radiographic changes in osteoarthritis?
Sclerotic bone, subchondral cysts, osteophytes, narrowing joint spaces
drugs for osteoarthritis
analgesics, NSAIDs, cox2 inhibitors, steroid injections, hyaluronan(hyalauronic acid) injections
difference between rheumatoid and osteoarthritis.
rheumatoid arthritis is usually more deforming and inflaming than osteoarthritis
name the KEY feature of rheumatoid arthritis
symmetrical !!! more than 60mins morning stiffness, RF, onset - genetic/environmental? - HLA DR4,
what Is present in the blood (raised) in RA pts?
erythrocyte sedimentation rate, CRP, anti-cyclic citrulluniated peptide
drugs - management of RA?
NSAIDS, DMARDs (lots of examples in lecture) - reduce symp n prevent further joint damage, painkillers - surgery is less likely as its a multi system disease
what combination treatment is used for RA?
Methotrexate/sulphasalazine/hydroxychloroqiuine or methotrexate/lefluomide
what is the profix of anti TNF drug?
mab
ANTI TNF NEED FULL BLOOD COUNT TO SEE IF THEY ARE FIT FOR TREATMENT
MORE DRUGS IN LECTURE
other than the spine, what other systems are effected in ankylosing spondylitis?
eyes, lungs, anaemia, aortic valve disease (bamboo spine - joint spaces calcify)
When does ankylosing spondylitis onset?
Teens - early twenties
what is the link between psoriasis and arthritis?
most people with psoriasis don’t have arthritis but it is more common in those with nail lesions, rheumatoid factor is usually negative
what is arthrodesis
when joint is fused in a position of function
when does the onset of reactive arthritis peak?
onset peaks 10-14days after distant infection, could be due to GI (campylobacter, salmonella, urogenital (chlamydia)), causative infection often not found
what is reiters syndrome
reactive arthritis plus conjunctivitis or urethritis
reiters syndrome tx ?
self limiting, NSAIDs, DMARD therapy
what antibodies is sjrogens associated with
anti-ro (ss-A) and anti-LA (SS-B), patients at higher risk of lymphoma due to lymphocytic infil of lacrimal/salivary glands.
Clinical features - sjrogens
tired, dry mouth n eyes, arthritis, raynauds, interstitial lung disease, renal tubular acidosis. chronic n incurable!!!- only given steroids for severe systemic issues.
which type of arthritis is mechanical?
osteoarthritis
name 3 connective tissue diseases?
SLE, sjrogens, scleroderma
