Osteoarticular System Flashcards
Which are the articular structures?
Include joint capsule and articular cartilage, synovium and synovial fluid, intra-articular ligaments, and juxta-articular
bone.
Which are the extra articular structures?
Include periarticular ligaments, tendons, bursae, muscle, fascia, bone, nerve, and overlying skin
Ligaments: ropelike bundles of collagen fibrils that connect bone to bone –
Tendons: collagen fibers connecting muscle to bone – Cartilage: collagen matrix overlying bony surfaces –
Bursae: pouches of synovial fluid that cushion the movement of tendons and muscles over bone or other joint structures.
Joint types?
Synovial, cartilaginous, fibrous.
Synovial joint?
Joint is freely movable, bones are covered by articular
cartilage, bones are separated by synovial cavity, synovial membrane secretes synovial fluid that lubricates joint movement.
Cartilaginous joint?
Joint is slightly movable, bones separated by discs, discs contain nucleus pulposus that cushions bony movement.
Fibrous joint?
No movement, separated by fibrous tissue or cartilage.
Inflammatory athralgia?
Pain and stiffness at rest.
Worse at morning.
Pain improves with movement.
No improvement with rest
Not restorative sleep Morning stifness >30 min Local signs of inflammation (tumor=swelling, calor=heat e rubor=redness)
Mechanic athralgia?
No pain at rest
Worse at the end of the day (“after work”)
Pain starts with movement
Improvement with rest
Worsening with movement Morning stiffness <30 min Absence of local signs of inflammation (is it really true? )
Examination for wrist and hand for osteo arthritis?
Passive wrist stretch. Finkelstein test, grab thumb and ulnar and pull hand. Palpate the radiocarpal joint and ulnar styloid.
Squeeze test at MCP 2 to 5th, if pain early arthritis. Look for Bouchard node in fingers, heberdens node in thumb. Fusiform swelling on joints.
Rheumatoid arthritis?
Boutonnière deformity, Ulnar deviation of MCP joints and swan neck deformity in fingers.
Psoriatic Arthropathy?
dactylitis, lifting and splitting of nails, and nail pitting.
Gout in hands?
Tophi lumps.
Elbow pain examination?
Tennis elbow aka lateral epicondylitis causes pain on the outside of elbow. Golfers elbow aka medial epicondylitis causes pain inside the elbow.
Can find rheumatoid nodules and TOFUS of gout.
Muscles of the rotator cuff? Examination?
Supraspinatous ( arms straight, thumb down and push palms out), Teres minor, Infraspinatous ( riscaldamento pale) and subscapularis. Hawkins test for subcromial impingement.
Hip examination?
Faber or Patrick test, flexion + abduction + external rotation. SI pain is sacroiliitis, groin pain is hip disease.
