Ortho - general

Question 1

assess acutely swollen joint

Answer 1

hx - fevers, rigors, lethargy, WB tolerance, time frame, onset, precipitating factors
A-E
look, feel, move
?red, ?swollen, ?skin changes, ?scars
compare to contralateral
?focal tenderness, ?joint effusion

Question 2

differentials for acutely swollen joinit

Answer 2

septic arthritis
enteropathic arthritis - GI cause
haemarthrosis
crystal arthropathies
OA
MsK
spondyloarthropathies - ank spond, reactive, psoriatic

Question 3

joint aspirate
- appearance
- WCC
- neutrophils

Answer 3

normal - clear, normal wcc, low neut
non-inflam arthritis - clear/straw, mod wcc, low neut
inflam arthritis - clear/ cloudy yellow, high wcc, mod neut
septic - turbid, v high wcc, high neut

Question 4

gout
- what
- where
- dx
- mx

Answer 4

inflam arthritis of monosodium urate crystals
where - 1st MTPJ, elbow, knee, wrist, fingers
dx - joint asp and microscopy, needle-shaped monosodium urate crystals