Rheumatology and musculoskeletal Flashcards
What is Reiter’s syndrome?
urethritis + conjunctivitis + arthritis
young males usually
buttock/sacroiliac pain worse in the morning, relieved by exercise
syndesmophytes, bamboo spine
ankylosing spondylitis
What conditions are associated with ankylosing spondylitis?
4 A’s
arthritis
anterior uveitis
apical lung fibrosis
aortic regurgitation
arthritis in IBD patients
enteropathic arthropathy
usually asymmetrical, mainly affectes lower limbs
features of systemic sclerosis
Calcinosis (nodules)
Raynaud’s phenomenon
Oesophageal dysmotility
Sclerodactyly
Telangiectasia
What is polymyositis?
proximal muscle weakness, pain and tenderness
elevated serum CK
if purple rash -> dermatomyositis
Churg-Strauss syndrome features
middle aged men
asthma + rhinitis + systemic vasculitis
+++ eosinophils
What disease is anti-dsDNA antibodies associated with?
SLE
What disease is anti-Jo 1 antibodies associated with?
polymyositis
What disease is anti-centromere antibodies associated with?
limited systemic sclerosis
What disease is anti-topoisomerase antibodies associated with?
diffuse systemic sclerosis
What disease is cANCA and anti-PR3 antibodies associated with?
wegener’s granulomatosis
What disease is anti-mitochondrial antibodies associated with?
primary biliary cirrhosis
What disease is alpha-endomysial antibodies associated with?
coeliac disease
What are the radiological findings of osteoarthritis?
loss of joint space
subchondral sclerosis
sybchondral cysts
osteophytes
What are the radiological findings of rheumatoid arthritis?
loss of joint space
juxta-articular osteoporosis
erosions, subluxation joints
What are the radiological findings of ankylosing spondylitis?
syndesmophytes
bamboo spine appearance
malignant bone disease
malignant
- osteosarcoma
- Ewing sarcoma
- chrondrosarcoma
- metastatic disease (secondary)
- haematopoietic
what abnormal bone growth response very well to aspirin to relieve pain?
osteoid osteoma (benign)
features of osteosarcoma
- RF: Paget’s, radiation
- most sporadic
- around knee, proximal humerus, femur
- sclerosis/lytic areas, cortical destruction, Codman triangle (elevation of periosteum), sunray spicules (calcification within tumour but outside of bone)
features of osteosarcoma
- RF: Paget’s, radiation
- most sporadic
- around knee, proximal humerus, femur
- sclerosis/lytic areas, cortical destruction, Codman triangle (elevation of periosteum), sunray spicules (calcification within tumour but outside of bone)
features of chondrosarcoma
- lytic lesion with cortical destruction and central calcification
- growth in pelvis and hip commonly
Ewing sarcoma
- small cell sarcoma
- flat bones (long, femur or tibia, pelvis or vertebra)
- unwell, swelling, fever, warm area
- lytic lesion with laminated periosteal reaction
- onion skinning
pseudogout aspirate features
- calcium pyrophosphate crystals
- positive birefringent
- rhomboid crystals
what is this:
- calcium pyrophosphate crystals
- positive birefringent
- rhomboid crystals
pseudogout
features of gout on aspirate
- monosodium urate crystals
- need shaped
- negatively birefringent
what is this:
- monosodium urate crystals
- need shaped
- negatively birefringent
gout
Musculocutaneous nerve:
- origin
- sensory
- motor
Musculocutaneous nerve:
- origin - C5, C6, C7
- sensory - lateral forearm
- motor - BBC (biceps brachii, brachialis, coracobrachilis)
Axillary nerve:
- origin
- sensory
- motor
Axillary nerve:
- origin - C5/C6
- sensory - sergeant’s patch over lower deloit
- motor - deltoid, teres minor
muscles of the rotator cuff
supraspinatus
infraspinatus
teres minor
subscapularis
Radial nerve:
- origin
- sensory
- motor
Radial nerve:
- origin - C5, C6, C7, C8, T1
-
sensory
- lower posterior arm
- posterior forearm
- lateral ⅔ dorsum (back)
- proximal dorsal aspect of lateral 3 ½ fingers
-
motor
- triceps brachii (posterior compartment arm)
- posterior compartment of forearm
- wrist + finger extensors
- brachioradialis
- supinator
Median nerve:
- origin
- sensory
- motor
Median nerve:
- origin - C5-8, T1
-
sensory
- thenar eminance
- lateral ⅔ of palm of the hand
- palmar aspect of lateral 3 ½ fingers
- distal dorsal aspect of lateral 3 ½ fingers
-
motor
- all muscles in anterior compartment except flexor carpi ulnaris and medial 2 parts of flexor digitorum profundus
- wrist + finger flexers
- pronator teres and quadratus
- LOAF muscles of hand
- lateral 2 lumbrical
- opponens pollicis
- abductor pollicis brevis
- flexor pollicis brevis
- all muscles in anterior compartment except flexor carpi ulnaris and medial 2 parts of flexor digitorum profundus
Ulnar nerve:
- origin
- sensory
- motor
Ulnar nerve:
- origin - C8, T1
- sensory
- hypothenar eminence
- medial ⅓ of palm of hand
- palmar aspect of medial 1 ½ fingers
- whole dorsal aspect of medial 1 ½ fingers
- medial ⅓ dorsum of hand
- motor
- anterior arm - flexor carpi ulnaris, medial 2 parts of flexor digitorum profundus
- HILA hand mucles
- hypothenar eminence
- interossei
- lumbricals (medial 2)
- adductor pollicis
Median nerve:
- common injuries
- results of injury
Median nerve:
- common injuries
- rare
- stab to upper arm
- results of injury
- S - numb lateral fore arm
- M - weak elbow flexion + supination, absent biceps reflex
- wasting of biceps