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Musculoskeletal > Pathology > Flashcards

Pathology Flashcards

1
Q

What surrounds the entire skeletal muscle?

A

epimysium

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2
Q

What surrounds the bundles of skeletal muscle fibres?

A

perimysium

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3
Q

What surrounds the individual muscle fibres?

A

endomysium

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4
Q

What are the 3 main indications for muscle biopsy?

A
  • evidence of muscle disease (eg weakness, muscle symptoms, elevated CK)
  • presence of neuropathy
  • presence of vascular disorder (vasculitis)
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5
Q

what is fasciculation?

A

uncontrolled twitching of muscle

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6
Q

When CK level is higher than normal, in the ‘low’ classification, what type of disorder does this indicate?

A

neurogenic disorder

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7
Q

when CK level is higher than normal, in the ‘intermediate’ classification, what type of disorder does this indicate?

A

inflammatory myopathy

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8
Q

when CK level is higher than normal, in the ‘high’ classification, what type of disorder does this mean?

A

muscular dystrophy

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9
Q

what are the 5 main groups of myopathies?

A
  • muscular dystrophies
  • inflammatory myopathies
  • congenital myopathies
  • secondary myopathies
  • metabolic myopathies
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10
Q

Why are ring fibres sometimes formed during muscle dystrophy?

A

condensation of the cytoplasm

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11
Q

Why can there be enlarged nuclei and increased number of nuclei during muscle dystrophy?

A

due to attempted regeneration co-existing with the atrophy

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12
Q

What type of inheritance is Duchenne’s Muscular Dystrophy (DMD)?

A

x-linked

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13
Q

What muscles does Duchenne’s Muscular Dystrophy (DMD) mainly affect?

A

muscles of the pelvic girdle

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14
Q

What type of inheritance is Becker’s Muscular Dystrophy (BMD)?

A

x-linked

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15
Q

What muscles does Becker’s Muscular Dystrophy (BMD) mainly affect?

A

muscles of the pelvic girdle

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16
Q

When is the onset of Duchenne’s Muscular Dystrophy (DMD)?

A

2 - 4 years old

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17
Q

What is the life expectancy of someone with Duchenne’s Muscular Dystrophy (DMD)?

A

20

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18
Q

What happens to the calves of patients with Duchenne’s Muscular Dystrophy (DMD)?

A

pseudohypertrophy

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19
Q

What mutation causes Duchenne’s Muscular Dystrophy (DMD)?

A

Mutations in dystrophin gene on long arm of chromosome X

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20
Q

What causes the different severities of Duchenne’s Muscular Dystrophy (DMD)?

A

mutations resulting in frame shift- severe
mutations resulting in altered binding- moderate to severe
mutations in middle rod- mild (Beckers)

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21
Q

What does the mutation in the dystrophin gene in Duchenne’s Muscular Dystrophy cause? (in terms of basement membrane and actin and Ca++ entry)

A

changes anchorage of actin cytoskeleton to basement membrane

uncontrolled Ca++ entry into cells

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22
Q

What does the change in anchorage of actin cytoskeleton to basement membrane in Duchenne’s Muscular Dystrophy do to the muscle fibres?

A

makes them more liable to tear

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23
Q

What gene is mutated in Becker’s Muscular Dystrophy (BMD)?

A

dystrophin

variant of DMD

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24
Q

compare disease progress of Beckers to Duchennes?

A

Beckers progression is much slower

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25
Q

What is myotonia?

A

inability to relax voluntary muscles after vigorous effort

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26
Q

What are inflammatory myopathies?

A

primary inflammation of muscle

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27
Q

What is polymyositis?

A

a chronic inflammatory myopathy

autoimmune

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28
Q

compare inflammatory myopathies to muscular dystrophies in terms of pain?

A

no pain in dystrophies, pain is present in inflammatory myopahties

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29
Q

What autoimmune proteins are found in polymyositis?

A

antibodies to muscle antigens

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30
Q

what type of lymphocytes are mainly involved in polymyositis?

A

cytotoxic lympocytes

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31
Q

what is dermatomyositis?

A

polymyositis with skin changes
a chronic inflammatory myopathy
autoimmune

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32
Q

What type of skin changes are present in dermatomyositis?

A

upper body erythema

swelling of eyelids with purple discolouration

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33
Q

what is the aetiology of polymyositis?

A

unknown

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34
Q

what is the aetiology of dermatomyositis?

A

unknown

but 10% associated with underlying malignancy

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35
Q

what type of lymphocytes are mainly involved in dermatomyositis?

A

helper T cells

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36
Q

compare the histology of polymyositis and dermatomyositis?

A

no histological differences, need to use other tests eg fluorescent staining

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37
Q

What are neurogenic disorders of muscle?

A

stereotyped changes after nerve damage with subsequent re-innervation
(pathology in motor neuron not muscle)

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38
Q

What is motor neurone disease?

A

progressive degeneration of anterior horn cells causing denervation atrophy, fasciculation and weakness

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39
Q

What type of inheritance is spinal muscular atrophy?

A

autosomal recessive

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40
Q

compare motor neurone disease to spinal muscular atrophy?

A

same pathology but different aetiology
MND is sporadic
spinal muscular atrophy is inherited

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41
Q

What is myasthenia gravis?

A

an autoimmune disease causing weakness, proptosis, fatigue and dysphagia

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42
Q

What is proptosis?

A

bulging of the eye

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43
Q

who commonly gets myasthenia gravis?

A

women between 20 and 40

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44
Q

what are the main causes of myasthenia gravis?

A

thymoma or thymic hyperplasia

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45
Q

What antibodies are produces in myasthenia gravis?

A

antibodies to ACh recepto in post-synaptic cleft

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46
Q

What is rhabdomyolysis?

A

breakdown of skeletal muscle

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47
Q

what are the 4 major side effects of rhabdomyolysis?

A
  • myoglobinuria (which causes acute renal failure)
  • hyperkalaemia
  • necrosis
  • shock
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48
Q

what are the main causes of rhabdomyolysis?

A

massive trauma
pressure induced
mushroom poisoning
drug side effects

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49
Q

What is the main management of connective tissue disorders?

A

anti-inflammatory/immunosuppression therapy

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50
Q

what antibodies are produces in SLE?

A

antinuclear antibodies (ANAs), anti-ds DNA, anti- Ro, anti-RNP

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51
Q

what skin effects of SLE can be seen?

A

butterly rash

discoid lupus erythematosus

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52
Q

what are the effects of SLE on the joints?

A

arthralgia

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53
Q

what are the effects of SLE on the kidneys?

A

glomerulonephritis

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54
Q

what are the effects of SLE on the central nervous system?

A

psychiatric symptoms

focal neurological symptoms

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55
Q

what are the effects of SLE on the cardiovascular system?

A

pericarditis
myocarditis
necrotising vasculitis

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56
Q

what are the effects of SLE on the immune system?

A

lymphadenopathy

splenomegaly

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57
Q

what are the effects of SLE on the lungs?

A

pleuritis

pleural effusions

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58
Q

what are the effects of SLE on haematological system?

A

anaemia
leukopenia
thrombophilia

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59
Q

what hypersensitivity reaction is SLE?

A 
type 3 (visceral lesions)- deposition of IgG
type 2 (haematological effects)- lysis of RBCs
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60
Q

What is polyarteritis nodosa?

A

inflammation and fibrinoid necrosis of small/medium arteries

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61
Q

what is the aetiology of polyarteritis nodosa?

A

unknown

small association with Hep B carriage

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62
Q

where is the pain and stiffness most present in polymyalgia rheumatica?

A

shoulder and pelvid girdle

no muscle weakness

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63
Q

what is the treatment for polymyalgia rheumatica?

A

steroids

prednisolone 15mg for 18 months

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64
Q

who are the people most likely to get polymyalgia rheumatica?

A

elderly women

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65
Q

when is pain and stiffness usually at its worst in polymyalgia rheumatica?

A

morning

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66
Q

what is termporal arteritis?

A

giant cell arteritis of the temporal artery (vasculitis)

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67
Q

what is scleroderma?

A

excessive fibrosis of organs and tissues due to excessive collagen production

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68
Q

scleroderma is associated with CREST syndrome, what is this?

A 
calcinosis
raynauds
oesophageal dysfunction
sclerodactyly
telangectasia
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69
Q

what is sclerodactyly?

A

thickening of skin on fingers and toes

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70
Q

what is telangectasia?

A

dilation of small capillaries so they appear like red or purple clusters on teh skin

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71
Q

what are the 4 main causes of death for patients with scleroderma?

A
  • renal failure (secondary to malignant hypertension)
  • severe respiratory compromise
  • cor pulmonale
  • cardiac failure/arrhymias (secondary to myocardial fibrosis)
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72
Q

What is the name of a cartilage capped bony projection arising on the external surface of the bone which contains a marrow cavity continuous with that of the underlying bone?

A

osteochondroma

exostosis

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73
Q

who tends to develop osteochondroma?

A

males and females under 20

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74
Q

where do osteochondromas tend to develop?

A

epiphyses of long bones

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75
Q

what is the presumed cell of origin of osteochondromas?

A

chondrocytes

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76
Q

are osteochondromas benign or malignant?

A

benign

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77
Q

why can osteochondromas be surgically removed even if they are benign?

A

can sometimes cause pain or irritation

or if it’s growing in size (may become malignant)

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78
Q

what is a chondroma?

A

benign hyaline cartilage tumour

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79
Q

where do chondromas arise?

A

medullary cavity of bones of hands and feet

usually at metaphysis

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80
Q

who tends to get chondromas?

A

young adults

men > women

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81
Q

What is Mafucci’s syndrome?

A

multiple enchondromas associated with multiple haemangiomas

premalignant

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82
Q

What is Ollier’s Disease?

A

a rare developmental disorder involving multiple enchodromas of one extremity (usually unilateral)
(premalignant)

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83
Q

what type of inheritance is Ollier’s disease

A

not hereditary or familial

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84
Q

compare maffucci’s syndome to ollier’s disease in terms of malignant transformation risk?

A

Maffucci’s syndrome has a greater malignant transformation risk than Ollier’s disease

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85
Q

What is the name of a benign osteoblastic tumour composed of a central core of vascular osteoid tissue (immature) and peripheral zone of sclerotic bone?

A

osteoid osteoma

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86
Q

who tends to get osteoid osteomas?

A

children and young adults

M > F

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87
Q

where are osteoid osteomas found?

A

poximal femur,
diaphysis of long bones,
vertebrae

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88
Q

what is the distinct clinical picture of a person with an osteoid osteoma?

A

dull pain which is worse at night

pain relieved by aspirin or NSAIDs

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89
Q

what is the name of a benign cartilage tumour arising in bone?

A

chondroblastoma

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90
Q

where are chondroblastomas found?

A

epiphysis of long bones

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91
Q

who tends to get chondroblastomas?

A

20 -30 year olds

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92
Q

what is the treatment for a chondroblastoma?

A

biopsy and curettage

plus adjuvant liquid nitrogen

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93
Q

who tends to get giant cell tumours?

A

25-40 year olds

F > M

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94
Q

where is the site of giant cell tumours?

A

metaphsis and epiphysis long bones, often around the knee and distal radius
can occur in pelvis and spine
can involve subchondral bone and joint

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95
Q

what is the presumed cell of origin of a giant cell tumour?

A

osteoclast

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96
Q

is a giant cell tumour benign or malignant?

A

benign

but locally aggressve

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97
Q

what is the treatment for a giant cell tumour?

A

intralesional excision

very aggressive lesions may need joint replacement

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98
Q

what happens to giant cell tumours when they are radiated?

A

undergo malignant transformation

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99
Q

what is the name of a benign, self-limited tumour that produces osteoid and bone?

A

osteoblastoma

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100
Q

are osteoblastomas benign or malignant?

A

benign

but locally aggressive

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101
Q

where are osteoblastomas found?

A

metaphysis or diaphysis of long bones

102
Q

what is the treatment for an osteoblastoma?

A

surgical resection by:
curettage
intralesional excition
en bloc resection

103
Q

what is the name of a very rare tumour arising from notochord remnants?

A

chordoma

104
Q

where are chordomas usually found?

A

midline

often in sacral region or base of skull

105
Q

who tends to get chordomas?

A

40+

F > M

106
Q

are chordomas benign or malignant?

A

benign

but locally aggressive

107
Q

what is the treatment for chordomas?

A

generally difficult to resect
radiation may be helpful
chemotherapy for late stage disease

108
Q

what is the name of a malignant tumour of osteoblasts which form osteoid?

A

osteosarcoma

109
Q

who tends to get osteosarcomas?

A

young adults
older patients with predisposing conditions (eg Pagets)
M > F

110
Q

where are osteosarcomas usually found?

A

bones around the knee,ie particularly distal femur, proximal tibia
also proximal femur, proximal humerous and pelvis

111
Q

what needs to be produced by an osteosarcoma for diagnosis?

A

osteoid producion is essential for diagnosis

112
Q

what are the 3 histological variants of conventional osteosarcoma?

A

osteoblastic
chondroblastic
fibroblastic

113
Q

what is the treatment of an osteosarcoma?

A

biopsy, CT, bone scan
pre-op chemo
surgical resection
post-op chemo

114
Q

what tumour is composed of malignant chondrocytes?

A

chondrosarcoma

115
Q

which is the most common primary malignant tumour of bone?

A

osteosarcoma

116
Q

what is the treatment of a chondrosarcoma?

A

wide surgical excision

117
Q

what are the 3 main types of malignant bone cancer?

A

osteosarcoma
chondrosarcoma
Ewing’s Sarcoma

118
Q

who tends to get Ewing’s Sarcoma?

A

10 - 20 year olds

M > F

119
Q

what is Ewing’s Sarcoma?

A

a primary malignant tumour of the primitive cells in the bone marrw

120
Q

where does Ewing’s Sarcoma occur?

A

metpahysis and diaphysis of:

  1. femur
  2. tibia
  3. humerous
121
Q

what is the treatment of Ewing’s Sarcoma?

A

surgery
radiation therapy
chemotherapy
post-op adjuvant chemo

122
Q

what is the name of the tumour caused by malignant proliferation of plasma cells in bone marrow?

A

multiple myeloma

123
Q

who tends to get multiple myeloma?

A

elderly

124
Q

what is the usual result of multiple myeloma?

A

bone destruction of axial skeleton

125
Q

what is more common: primary bone tumours or secondary bone tumours?

A

secondary mets

126
Q

what is the most common benign bone tumour?

A

osteochondroma

127
Q

what type of inheritance is the hereditary disorder which causes multiple osteochondromas?

A

autosomal dominant

128
Q

what are enchondromas caused by?

A

failure of normal endochondral ossification at the growth plate

129
Q

why can enchondromas lead to pathological fractures?

A

because even though they are usually asymptomatic, they weaken the bone

130
Q

what is the treatment for an enchondroma which has caused a fracture or is threatening to cause a fracture?

A

curettage (once one has healed)

+ filled with bone graft to strengthen bone

131
Q

what is a simple bone cyst?

A

a single cavity, fluid filled, benign cyst in a bone

132
Q

where are simple bone cysts generally found?

A

metaphysis of long bones particularly proximal femur and humerous
can be found in talus or calcaneous

133
Q

why can simple bone cysts lead to pathological fractures?

A

because they weaken the bone

134
Q

what is the treatment for a simple bone cyst?

A

curettage

+ filled with bone graft to strengthen

135
Q

what is the probable cause of a simple bone cyst?

A

developmental defect

136
Q

what is an aneurysmal bone cyst?

A

multiple fluid-filled chambers within a bone which contain blood or serum

137
Q

what is the probable cause of an aneurysmal bone cyst?

A

small arteriovenous malformation

138
Q

where do aneurysmal bone cysts occur?

A

metaphyses of long bones, flat bones and vertebral bodies

139
Q

why do aneurysmal bone cysts cause pain?

A

because they are locally aggressive so cause cortical expansion and destruction

140
Q

what is the treatment of an aneurysmal bone cyst?

A

curettage

+ filled with bone graft to strengthen

141
Q

why are giant cell tumours of the bone painful?

A

destruction of cortex

142
Q

despite being classified as benign, what typically malignant feature do they have?

A

can metastasise

usually causing benign pulmonary giant cell tumours

143
Q

what is the characteristic sign of a giant cell tumour of the bone on an x-ray?

A

soap bubble appearance

144
Q

what is the name of the genetic condition which results in lesions of fibrous tissue within bone and immature bone?

A

fibrous dysplasia

145
Q

when does fibrous dysplasia tend to occur?

A

adolescence

146
Q

compare monostatic fibrous dysplasia to polystatic fibrous dysplasia?

A

monostatic fibrous dysplasia- affects only one bone

polystatic fibrous dysplasia- affects more than one bone

147
Q

what deformity is typical of fibrous dysplasia if there is extensive involvement of the proximal femur?

A

shepherd’s crook deformity

148
Q

what can be used to reduce pain in fibrous dysplasia?

A

biphosphates

149
Q

what should be done to treat pathological fractures caused by fibrous dysplasia?

A

internal fixation (for stability) and cortical bone graphs (for strength)

150
Q

how do you treat osteoid osteomas?

A

many resolve spontaneously

others require CT guided radio-frequency alation or en bloc resection

151
Q

what are the red flag symptoms for bone cancer?

A 
constant pain
worse at night
systemic symptoms (eg weight loss, loss of appetite, fatigue)
152
Q

are osteosarcomas radiosensitive?

A

no

153
Q

where are chondrosarcomas likely to be found?

A

pelvis

proximal femur

154
Q

compare osteosarcoma and chondrosarcoma in terms of mets rate??

A

osteosarcoma metastasizes faster than chondrosarcoma

155
Q

are osteosarcomas responsive to adjuvant chemotherapy?

A

yes

156
Q

are chondrosarcomas radiosensitive?

A

no

157
Q

are chondrosarcomas responsive to adjuvant chemotherapy?

A

no

158
Q

what are fibrosarcomas and malignant fibrous histiocytma?

A

fibrous malignant primary bone tumours which tend to occur in abnormal bone (eg bone infarcts, fibrous dysplasia and pagets disease)

159
Q

which malignant bone cancer has the poorest prognosis?

A

Ewing’s Sarcoma

160
Q

are Ewing’s Sarcomas radiosensitive?

A

yes

161
Q

are Ewing’s Sarcomas responsive to chemotherapy adjuvants?

A

yes

162
Q

what is neo-adjuvant chemotherapy?

A

chemotherapy given before surgery

163
Q

What are the 5 most common primary malignant tumours which commonly metastasize to bone?

A
  1. breast carcinoma
  2. prostate carcinoma
  3. lung carcinoma
  4. renal cell carcinoma
  5. thyroid adenocarcinoma
164
Q

what is the most common benign soft tissue tumour?

A

lipoma

165
Q

what is a lipoma?

A

a neoplastic proliferation of fat

166
Q

where do lipomas occur?

A

usually in the subcutaneous tissue,

can occur in the muscle

167
Q

what is an angiosarcoma?

A

malignant tumour that arises from blood vessels

168
Q

what is a liposarcoma?

A

malignant tumour that arises from fat

169
Q

what is a rhabdomyosarcoma?

A

a malignant tumour that arises from skeletal muscle

170
Q

what is a synovial sarcoma?

A

a malignant tumout that arises from the synovial lining of joints or tendons

171
Q

what is a ganglion cyst?

A

a synovial-fluid-filled swelling that occurs around a synovial joint or synovial tendon sheath
(outpouching of synovium lining)

172
Q

why do ganglion cysts form?

A

as a result of herniation or out-pouching of a weak portion of joint capsule of tendon sheath

173
Q

what is a juvenile Baker’s cyst?

A

a ganglion cyst caused by a developmental weakness

174
Q

what is an adults Baker’s cyst?

A

a ganglion cyst caused by a build up of pressure within the joint capsule

175
Q

what is a bursa?

A

a small fluid filled sac lined by synovium around a joint which prevents friction between tendons, bones, muscles and skin

176
Q

what can cause bursitis?

A

repeated pressure/trauma
bacterial infection
gout

177
Q

how do you treat an abscess?

A

incision and drainage

will not resolve with antibiotics alone

178
Q

what similar end result to osteochondritis and avascular necrosis share?

A

an area of bone undergoes localised necrosis

179
Q

what is avascular necrosis?

A

ischaemic necrosis of bone

predominantly in adults

180
Q

why can alcoholism, steroid abuse and primary hyperlipidaemia lead to avascular necrosis?

A

alcoholism and steroid abuse alter fat metabolism and can result in mobilisation of fat into the circulation which can cause ischaemia
primary hyperlipidaemia causes fat to be in circulation as well

181
Q

what is the treatment of early avascular necrosis? (ie before articular surface has collapse)

A

drilling under fluoroscopy to decompress bone

prevents further necrosis and helps healing

182
Q

what is the treatmend of late stage avascular necrosis? (ie articular surface has collapsed)

A

joint replacement

183
Q

what does the modified beighton score clinically assess?

A

if the patient has joint hypermobility syndrome

184
Q

what do patients with joint hypermobility syndrome usually present with? (if no underlying genetic syndrome)

A

arthralgia

premature osteoarthritis

185
Q

what are the 5 signs of inflammation?

A 
rubor (red)
calor (hot)
dolor (pain)
tumor (swelling)
functio laesa (loss of function)
186
Q

what is sequestrium?

A

dead and dying bone separated from normal bone

a complication of osteomyelitis

187
Q

what is involucrum?

A

new bone forming on the outside, just deep to the periosteum

a complication of osteomyslitis

188
Q

why is pus within a joint an emergency?

A

pus destroys articular cartilage

189
Q

why is needle aspiration of a ganglion cyst not recommended?

A

recurrence is common

190
Q

what is usually the first clinical sign of hp patholgoy?

A

loss of internal rotation

191
Q

what do patients with avascular necrosis of the femoral head present with?

A

groin pain

192
Q

what are the late signs of avascular necrosis of the femoral head on radiography?

A

sclerotic changes
hanging rope sign
irregularity of articular surface

193
Q

why does a lytic zone form at the neck of a femoral head damaged by avascular necrosis?

A

lytic zone formed by granulation tissue (attempted repair)

194
Q

what sign on x-ray suggest avascular necrosis and is due to the lytic zone?

A

hanging rope sign

195
Q

what is morton’s neuroma?

A

irritation of the plantar interdigital nerves (due to repeated trauma) causing neuromas to form

196
Q

what are neuromas?

A

swollen and inflamed nerves

197
Q

what do patients with morton’s neuroma present with?

A

burning pain and tingling radiating into affected toes

198
Q

who is more likely to get morton’s neuroma- M or F?

A

females

199
Q

which nerves are most commonly affected by morton’s neuroma?

A

3rd interspace nerve is the most common followed by the 2nd interspace nerve

200
Q

what test assesses for morton’s neuroma?

A

mulders test

201
Q

what is mudlers test?

A

squeezing the forefoot with your hand

in a positive test symptoms may be reproduced or there will be a characteristic click

202
Q

what is used for diagnosis of morton’s neuroma?

A

Ultrasound

203
Q

what is the conservative management of morton’s neuroma?

A

metatarsal pad or insole

steroid and local anaethetic injections

204
Q

what is myositis ossificans?

A

ossification within a muscle after injury (can be after surgery)

205
Q

what is pes planus?

A

loss of the medial longitudinal arch of the foot- flat foot

206
Q

what is the ligament in the ankle which is most commonly sprained?

A

ATFL

anterior talofibular ligament

207
Q

what test assesses whether flat footedness is flexible or stiff?

A

jacks test- push big toe up

208
Q

what tendon dysfunction is the most common cause of acquired flatfoot deformity?

A

tendon of posterior tibialis

209
Q

what is the primary dynamic stabiliser of the medial longitudinal arch?

A

tibialis posterior tendon

210
Q

who tends to get tibialis posterior dysfunction?

A

obese middle aged females

211
Q

what pain and swelling is very typical to tibialis posterior dysfunction?

A

pain/swelling posterior to medial malleolus

212
Q

what can happen to the big toes in tibialis posterior dysfunction?

A

can move laterally (hallux valgus)

213
Q

what type of surfaces do patients with tibialis posteiror dysfunction not life?

A

uneven surfaces

214
Q

what can happen to the heel of the foot in tibialis posterior dysfunction?

A

heel goes into valgus

215
Q

what can happen to the heel of the foot of a patient with pes cavus?

A

moves into varus

216
Q

what are the 4 main causes of plantar fasciitis?

A
  • physical overload (excessive exercise or weight)
  • seronegative arthropathy
  • diabetes
  • abnormal foot shape
217
Q

what is the main treatment of plantar fasciitis?

A 
conservative:
NSAIDs
night splint + taping
physio
steroid injections
218
Q

how long does plantar fasciitis take to self-limit?

A

18-24 months

219
Q

how does the incidence of hallux valgus change with age?

A

increases with age

220
Q

is hallux valgus mainly unilateral or bilateral?

A

bilateral

221
Q

what are the 5 main problems of hallux valgus?

A 
transfer metatarsalgia
lesser toe impingement
pain
cosmesis of deformity
shoe difficulties
222
Q

why does hallux valgus cause transfer metatarsalgia?

A

loss of function of big toe
lesser toes are used for power
these toes eventually become sore

223
Q

what is hallux rigisus?

A

OA of 1st MTP joint

224
Q

what is the commonest area for morton’s neuroma and why?

A

between 3rd and 4th digit (because these are very mobile so are constantly rubbing against each other)

225
Q

what is the first line treatment for morton’s neuroma?

A

steroid injections

226
Q

what type of condition is curly toes?

A

paediatric condition

227
Q

if a swelling is ‘fluctuant’, what type of material is within it?

A

semi-solid material

228
Q

what is an abscess?

A

a discreet collectin og pus

229
Q

what is the management of bursitis? (which hasn’t become secondarily affected)

A

NSAIDs

analgesia

230
Q

what is the management of bursitis that has become secondarily affected?

A

incision and drainage

antibiotics

231
Q

how many bursae are around the knee?

A

4 bursae

232
Q

what actually is the bunion on the medial side of the foot formed by hallux valgus?

A

an inflamed bursa

233
Q

why do bouchards and heberdens nodes occur?

A

chronic trauma

234
Q

what arthritis are bouchards nodes present in?

A

OA or RA

235
Q

what arthritis are heberdens nodes present in?

A

OA

236
Q

what is myositis ossificans?

A

ossificaiton (calcification) of a muscle haematoma

outside the bone, in a muscle

237
Q

what usually happens before myositis ossificans?

A

large trauma (haematoma occurs)

238
Q

when can you intervene with myositis ossificans?

A

only if symptoms demand

and only once the ossification has matured (otherwise risk of recurrence)

239
Q

what joints are most commonly affected by OA?

A

DIP joints

240
Q

what are mucous cysts?

A

outpouching of synovial fluid from DIP joints

241
Q

what condition are mucous cysts associated with?

A

osteoarthrtis

242
Q

what is DeQuervain’s tendonitis?

A

tendonitis of the tendons which control the thumb

243
Q

when is ficklesteins test positive?

A

in Dequervain’s tendonitis

244
Q

in dupuytren’s contractures what do the fibroblasts change in to?

A

myofibroblasts

245
Q

what simple test is a way to determine if the dupuytren’s contractures are severe enough to require surgery?

A

table top test

246
Q

what is paronychia?

A

infection within the nail fold (essentially an abscess)

247
Q

wat is tendinopathy?

A

disease of a tendon

248
Q

what is tendonitis?

A

acute tendon injury accompanied by inflammation

249
Q

what is tendonosis?

A

chronic tendon injury with damage to tendon at cellular level

250
Q

what is tenosynovitis?

A

inflammation of the tendon sheath

251
Q

what is enthesopathy?

A

inflammation of the tendon origin or the insertion

Musculoskeletal (16 decks)

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