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msk > swelling > Flashcards

swelling Flashcards

1
Q

name some general causes of swelling

A

Infection
Cellulitis
Abscess
Septic Arthritis

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2
Q

name some swellings related to joints

A 
Ganglion
Bakers Cyst 
Bursitis 
Gout
Rheumatoid nodules
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3
Q

what are some swellings relating to hand nodes

A

Bouchards Nodes

Heberden’s Nodes

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4
Q

what are the history features of swelling

A

Systemic upset
Pyrexia
Trauma (break in skin)
Association with medical co-morbities

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5
Q

what is cellulitis

A

Inflammation and infection of the soft tissues

A generalised swelling rather than a discreet lump

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6
Q

presentation of cellulitis

A

pain
swelling
erythema

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7
Q

microorganisms for cellulitis

A

β-haemolytic streps, staphylococci

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8
Q

management of cellulitis

A

Rest, elevation, analgesia, splint Antibiotics; oral vs IV; penicillin

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9
Q

management for an abscess

A

SURGICAL INCISION & DRAINAGE
“If there’s pus, let it out” (Mr Clift)
Rest, elevation, analgesia, splint
Antibiotics

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10
Q

organisms for septic arthritis

A

Staph. Aureus / Strep / E.Coli

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11
Q

does septic arthritis cause Irreversible damage to hyaline articular cartilage

A

yes

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12
Q

presentation of septic arthritis

A

Acute monoarthropathy
↓↓ ROM +/- swelling
Systemic upset
Raised WCC + inflammatory markers

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13
Q

management of septic arthritis

A

A-E Assessment
Urgent orthopaedic review
Aspiration; M,C & S
Urgent Open / arthoscopic washout + debridement

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14
Q

describe the appearance of ganglia

A 
Discreet, round swellings
Non-tender
<10mm – several cms
Skin mobile, fixed to underlying structures
Wrists, feet, knees
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15
Q

management of ganglia

A

Nothing

NOT aspiration

Percutaneous rupture

Surgical excision

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16
Q

what is a baker’s cyst

A

cyst/ganglion of the popliteal fossa

17
Q

presentation of a baker’s cyst

A

Can appear as general fullness of the popliteal fossa
Soft and non-tender
Associated with OA
Painful rupture

18
Q

management of baker’s cyst

A

analgesia

19
Q

what is bursitis

A

Inflammation of the synovium lined sacs that protect bony prominences and joints

20
Q

management of bursitis

A 
NSAIDs / Analgesia
Antibiotics
Incision and drainage 
	 (secondary infection)
V. rarely excision
	 (chronic cases)
21
Q

what is gout

A

An inflammatory arthritis most commonly affecting the great toe but can affect other joints, esp the knee

Elevated serum urate causes a deposition of uric acid crystals in joints

Episodes of inflammation result in acute attacks

Will cause chronic progressive joint damage

22
Q

associations of gout

A

Purine rich food, alcohol, dairy

23
Q

presentation of gout

A

Severe pain,
Red, hot, swollen joint
Sometimes mistaken for septic arthritis

24
Q

treatment for gout

A

NSAIDs
Steroids
Allopurinol

25
Q

what are Bouchards and hebredens nodes

A

These are bony swellings of the interphalangeal joints in hands

Caused by bony spurs due to chronic trauma

26
Q

where are bouchards nodes

A

Proximal IPJ
Less common
OA or RA

27
Q

where are heberdens nodes

A

Distal IPJ
More common
OA

28
Q

what is dupuytren’s

A

Progressive disease resulting in digital flexion contractures

Excessive myofibroblast proliferation and altered collagen matrix composition lead to thickened and contracted palmar fascia

29
Q

risk factors for dupuytrens

A

alcohol
diabetes
genetics
trauma

30
Q

management of dupuytren’s

A

Needle fasciotomy (single band)

Limited fasciectomy (removal of the bands)

Dermofasciectomy + graft (removal of the band, adherent/contracted skin and covering graft)

31
Q

what is a lipoma

A

Benign neoplastic proliferation of fat

subcutaneous

32
Q

presentation of a lipoma

A 
Can be discreet or less well defined
Slow growing and painless/non-tender
Can be large (several cms)
Characteristic consistency
No overlying skin changes
33
Q

management of lipoma

A

Based on symptoms
Can be left alone
Surgical excision if causing symptoms

34
Q

what is myositis ossificans

A

Abnormal calcification of a muscle haematoma

35
Q

history of myositis ossificans

A

Trauma, initial soft swelling, hardness develops over several weeks

36
Q

management of myositis ossificans

A

Observation
Intervene only if symptoms demand
Must wait until maturity of ossification, otherwise risk of recurrence (6-12 months)

msk (45 decks)

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