Nonneoplastic Disorders of MSK (clinical) - Edwards

Question 1

bone makeup

Answer 1

• 70% hydroxyapatite

- 30% collagen fibers

Question 2

articular cartilage

Answer 2

• inflexible and no blood supply –> long healing time
• do not divide
• aneural (don’t feel)
• hypocellular –> tissue repair poorly restored

Question 3

tendons

Answer 3

• connect muscle to bone
• provide flexibility
• avascular and hypo cellular
• contain fibroblasts and tenocytes

Question 4

osteomalacia

Answer 4

• inadequate bone mineralization –> soft bones
• rickets in children –> bone bending
• low levels of phosphate, Vit. D, and Ca2+

Question 5

osteoporosis

Answer 5

• risk factors: post-menopause (low estrogen), low bone density, Ca2+, phosphate, and Vit. D, tobacco, EtOH, genetic, no exercise, PPI, steroids, thyrotoxicosis, high PTH etc.
• osteoclasts (resorption) working faster than osteoblasts (formation) –> trabecular/cancellous bone
• high risk of fractures
• diagnosed with DEXA scan –> BMD <=2.5 SD
• treatment: bisphosphonates, Ca2+/Vit.D/estrogen supplementation, PTH, exercise

Question 6

osteoarthritis

Answer 6

• most common arthritis
• degrade cartilage –> bone on bone and lose function (degenerative joint disease)
• risk factors: women, age, joint injury, obese, genetics
• check ESR (sedimentation rate) and CRP
• treat: NSAIDs, steroids, surgery, stem cells

Question 7

degenerative disc disease

Answer 7

narrowing of intervertebral disc space

Question 8

spondylosis

Answer 8

• degeneration of vertebral column

- presence of arthritis

Question 9

spondylolysis

Answer 9

-defect or stress fracture in the pars interarticularis of vertebral arch

Question 10

spondylolithesis

Answer 10

-displacement of one vertebrae compared to another

Question 11

gouty arthritis

Answer 11

• only treatable arthritis
• treat: remove purines, allopurinol, and lower uric acid
• cause: trauma, no exercise, EtOH
• usually seen in 1st MTP joint
• staph and strep can cause septic arthritis –> infection

Question 12

Ankylosing Spondylitis aka bamboo spine

Answer 12

• fusion of vertebrae
• no pain, chronic inflammation
• impeded respiratory function if worsens
• HLA-B27 positive

Question 13

facet syndrome

Answer 13

• fused facets, lose ROM, have pain

- “Scotty Dog”**

Question 14

rheumatoid arthritis

Answer 14

• autoimmune –> attack joint synovium –> joint erosion/deformity, nodules, loss of function
• more common in women
• can lead to systemic diseases –> lungs, pericardium, vasculitis, eyes (Sjogren’s)
• check ESR, CRP, and X ray
• treat: ANSAIDS, steroids, methotrexate

Question 15

Paget’s disease

Answer 15

• punched out holes in bone

- bone bending in one leg** (rickets if both legs)

Question 16

march fracture

Answer 16

• trauma, walking too much

- metatarsals affected (usually 5th)

Question 17

chronic osteomyelitis

Answer 17

• infected toe or gangrene foot
• diabetic foot –> ulcers
• signs: exposed bone, sinus tract, necrosis of tissue over bone, chronic wound overlying hardware or fracture
• high CRS and ESR

Question 18

Colle’s fracture

Answer 18

• dinner fork abnormality

- fall on outstretched hand with forearm pronation –> distal radius fracture

Question 19

Salter fractures

Answer 19

• type I –> through growth plate
• type II –> through growth plate and metaphysis
• type III –> through growth plate and epiphysis
• type IV –> through all 3 planes
• type V –> crush injury on growth plate