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MSK > R: Degenerative Bone Disease > Flashcards

R: Degenerative Bone Disease Flashcards

1
Q

firstly, what are the 4 main pathophysiological causes of joint pathology?

A
  1. cartilage/ synovial composition and function deteriorates
  2. synovial cell proliferation/ inflammation
  3. deposition of crystals
  4. injury and inflammation to periarticular structures
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2
Q

epi of osteoarthritis (OA)?

A

1/3rd of >45s, w

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3
Q

what is OA?

A

articular thinning or loss

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4
Q

aetiology of OA?

A

age, sex, obesity
lifestyle
genetic
prv injuries

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5
Q

pathogenesis of OA?

A

degradation of cartilage & disordered repair
injury to chondrocytes and matrix
inflammatory changes to subchondral bone

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6
Q

types of OA>

A

1y: idiopathic
2y: previous injury, gout, RA, perthes, SUFE

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7
Q

common sites of OA?

A

hip knee, MTPs, cervical spine, lumbar spine, SC, GH, AC jts, elbow, wrist, carpus thumb

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8
Q

s/s of OA?

A

pain worse on activity, stiffness (<30mins in morning)

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9
Q

what are some exam findings of OA?

A

crepitus, jt swelling, tenderness, effusion

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10
Q

T/F: Bouchard’s are bony swellings in the distal IPJs due to repeated trauma

A

F: Bouchard’s= proximal IPJs

Hebreden’s= distal IPJs

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11
Q

dx of OA and common imaging findings?

A

clinical, imaging

- imaging: LOSS (loss of jt space, subchondral sclerosis, subchondral cyst, osteophytes)

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12
Q

what is the grading scale used for OA?

A

Kellgren-Lawrence Grading Scale: grade 0= no signs, grade 4= all signs

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13
Q

mx for OA?

A

physio, wt loss

  • Rx: analgesia, pain modulators, steroids, mild opiates
  • surgical: arthroscopic washout, loose body removal, jt replacement
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14
Q

s/s of hip OA?

A

groin pain*, referred down knee, pain at night, worse on activity/standing, restricted hip movement

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15
Q

mx of hip OA?

A

conservative- steroid injection

surgery- THR (cement hemiarthroplasty indicated for elderly)

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16
Q

which exercises commonly cause knee OA?

A

running and football

17
Q

s/s of knee OA?

A

pain from within knee, stiffness, weakness of surrounding muscles, feeling of instability
flare ups common!

18
Q

surgical mx of knee OA?

A

TKR, osteotomy, washout

19
Q

aetiology of glenohumeral (GH) OA

A

cuff tear, instability, idiopathic, post-traumatic arthritis

20
Q

s/s of GH OA?

A

gradual onset w intermittent exacerbations, reduced ROM- especially external rotation

21
Q

surgical mx of GH OA?

A

shoulder replacement (arthroplasty), resurfacing, reverse-polarity arthroplasty

22
Q

types of arthroplasty?

A

surface replacement (only head)
TSA (head & stem)
Rotator cuff arthroplasty

23
Q

what is cervical spondylosis

A

disc degeneration causing OA of facet joints

24
Q

s/s of cervical spondylosis

A

stiffness/pain in neck which may radiate to shoulders

25
Q

which joint OA is often associated with nerve impingement due to osteophytes requiring surgical decompression?

A

acromioclavicular (AMC) jt

26
Q

which are the 2 sites for elbow OA?

A

ulna-humeral, radio-capitellar sites

27
Q

how to differentiate between wrist OA and RA?

A 
OA= monoarticular and localised
RA= polyarticular and systemic
28
Q

s/s of wrist OA?

A

instability due to SLAC and SNAC

29
Q

which hand joint is the no1 site for OA?

A

Distal inter pharyngeal joints (DIPs)

30
Q

s/s of hand OA (small joints)?

A

pain, deformity, heberden’s/osler’s nodes

31
Q

the base of the thumb is the number ___ site for OA

A

2

32
Q

what are the 2 tendinopathies associated with OA of phalanxes?

A

swan neck deformity, boutonniere

33
Q

why does swan neck deformity occur?

A

PIP jt becomes attenuated and ligaments/ tendons fall more dorsal to jt centre

34
Q

hyperextension of DIP jt is….

A

boutonniere tendinopathy

35
Q

mx of swan neck/ boutonniere deformities?

A

splintage or surgery- tendon reposition

MSK (26 decks)

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