Orthopaedics Flashcards
risk factors for OA?
- obesity
- ageing
- occupation
- trauma
- female sex
- FHx
which joints are commonly affected in OA?
- hips
- knees
- sacro-iliac joints
- DIPs
- CMC (base of thumb)
- wrist
- cervical spine (gives spondylosis)
LOSS: X-ray changes seen in OA?
- loss of joint space
- osteophytes
- subarticular sclerosis
- subchondral cysts
presentation of OA?
- joint pain and stiffness
- worse after use / end of the day
- bulky enlargement of joints
- reduced ROM
- crepitus on passive movement
- effusion around joint
hand signs seen in OA?
- bouchard’s nodes (PIPs)
- heberden’s nodes (DIPs)
- squaring of base of thumb
- weak grip
- reduced ROM
how is OA diagnosed?
does not require investigations if:
- age >45
- typical pain w/ activity
- no morning stiffness (or <30 mins of morning stiffness)
management of OA?
- weight loss
- physiotherapy
- OT
- orthotics (e.g. knee braces)
- analgesia
- joint replacement if severe
analgesic ladder in OA?
- PO paracetamol + topical NSAIDs
- add PO NSAIDs (+PPI)
- weak opioids (codeine)
other options:
- topical capsaicin
- intra-articular steroids
what is a compound fracture?
when skin is broken and the broken bone is exposed to air
what is a stable fracture?
when sections of the bone remain in alignment at the fracture
what is a pathological fracture?
when a bone breaks due to underlying bone abnormalities
give some causes of pathological fractures
- bony mets
- osteoporosis
- paget’s disease of the bone
which cancers commonly metastasise to the bone?
- prostate
- renal cell carcinomas
- thyroid
- breast
- lung
what is a colle’s fracture?
transverse fracture of the distal radius
which fractures are commonly caused by falling onto an outstretched hand (FOOSH)?
- colle’s fracture
- scaphoid fracture
main complication of a pelvic fracture?
intra-abdominal bleeding, which can then cause shock / death
common sites for pathological fractures?
- femur
- vertebral bodies
what is a fragility fracture? commonest cause?
- fracture due to weakness of bone
- osteoporosis
what is the FRAX score?
risk of fragility fracture within the next 10 years
how can bone mineral density be calculated?
using a DEXA scan
which T-score range means there is osteopenia?
-1 to -2.5
which T-score range means BMD is normal?
more than -1
T-score range indicating osteoporosis?
less than -2.5
WHO criteria for severe osteoporosis?
T-score < -2.5 AND a fracture