Pagets, myositis ossificans , reactive arthritis Flashcards
pagets disease
abnormal osteoclastic activity followed by increased osteoblastic activity resulting in abnormal bone structure and reduced strength and increased fractures
Risk factors for pagets
Age >50
English, Scottish and central European
Male predominance in age group 45–74
Family history of Paget’s disease
Certain viral infections e.g. respiratory syncitial virus
complications of pagets
Deafness
Osteoarthritis
Nerve compression
Fractures
Limb length discrepancy
Osteosarcoma
management of pagets
Observation and prevention of complications
Bisphosphonate therapy (IV or oral)
Physiotherapy
Surgery if indicated
what is raised in pagets
ALP
Common sites for pagets
long bones, pelvis, lumbar spine and skull
xray of pagets
- Initial lytic phase results in well defined lucency
- Later sclerotic phase with enlarged bone, increased density and coarse trabecular pattern
myositis ossificans
abnormal formation of bone or bone-like tissue (heterotopic ossification) within large muscle groups
when does myositis ossificans present
2-4 weeks ppost trauma
key signs and symptoms of myositis ossificans
may mimic osteal malignancy, including pain, stiffness, and a palpable mass
management of myositis ossificans
Conservative management is the primary approach, although surgical excision may be considered in severe cases.
common places for myositis ossificans to occur
elbow
thigh
who does myositis ossificans commonly present in
young adults who are active in sports, particularly those involving heavy contact, which predisposes them to trauma
reactive arthritis
inflammatory response to infection
reiters syndrome
conjunctibvits, urethritis, arthritis
when does reactive arthrisi commonly presetn
1-4 weeks post infection
common infections invoolved in reactive arthritis
GI/ sexually
chlamydia, neisseria
campylobacter, salmonella
symptoms in reactive arthritis
fever
fatigue
malaise
what is raised in reactive arthritis
inflammatory markers
culture in reactive arthritis
none
sterile
no viable organisms or its septic
signs in reactive arthritis
- Mucocutaneous lesions
- Keratodema blenorrhagica
- Circinate balanitis
- Painless oral ulcers
- Hyperkeratotic nails
- Ocular lesions (uni or bilateral) - conjuntivitis, iritis
- Vissceral manifestations - mild renal disease, carditis
