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Musculoskeletal > swellings > Flashcards

swellings Flashcards

1
Q

what kind of lump would be seen in cellulitis?

A

a generalised swelling rather than a discreet lump

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2
Q

what kind of presentation would be seen with cellulitis?

A

pain, swelling, erythema

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3
Q

what organisms could it be in cellulitis?

A

beta-haemolytic streps

staph

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4
Q

what is the management of cellulitis?

A

Rest, elevation, analgesia, splint Antibiotics; oral vs IV; penicillin NOT SURGERY

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5
Q

what is an abscess?

A

discreet collection of pus

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6
Q

how would an abscess present?

A

Defined and fluctuant swelling
Erythema, pain
History of trauma (eg. bite, IVDU)

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7
Q

what’s the management of an abscess?

A

surgical incision & drainage
rest, elevation, analgesia, splint
antibiotics

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8
Q

what is the management of septic arthritis?

A

Urgent orthopaedic review
Aspiration
Urgent Open/arthoscopic washout + debridement

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9
Q

what presentation is usually seen in septic arthritis?

A

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

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10
Q

what are ganglia?

A

Outpouchings of the synovium lining of joints and filled with synovial fluid

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11
Q

describe the appearance of ganglia?

A

discreet, round swellings

Non-tender

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12
Q

what is a baker’s cyst?

A

cyst/ganglion of the popliteal fossa

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13
Q

what is the normal 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

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14
Q

what is the management of a baker’s cyst?

A

non-operative

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15
Q

what is bursitis?

A

inflammation of the synovium lined sacs that protect bony prominence & joints

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16
Q

what can happen to the bursa in bursitis?

A

Can become secondarily infected and form an abscess

17
Q

what is the management of bursitis?

A

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

18
Q

what are rheumatoid nodules?

A

Appear around joints in rheumatoid patients, again, associated with repetitive trauma

19
Q

describe the normal presentation of rheumatoid nodules?

A

Chronic, more severely affected RA patients, rheumatoid factor +ve

20
Q

what’s seen histologically in rheumatoid nodules?

A

intense inflammatory changes

21
Q

what are bouchard’s & heberden’s nodes?

A

bony swellings of the interphalangeal joints in hands caused by bony spurs due to chronic trauma

22
Q

describe bouchard’s nodes

A

Proximal IPJ

Less common OA or RA

23
Q

describe heberden’s nodes

A

Distal IPJ More common

OA

24
Q

what is dupuytren’s disease

A

Progressive disease resulting in digital flexion contractures

25
Q

describe the pathogenesis of dupuytren’s disease

A

Excessive myofibroblast proliferation and altered collagen matrix composition lead to thickened and contracted palmar fascia, avascular process involving O2 free radicals

26
Q

what type of collagen are the bands commonly in dupuytren’s disease

A

collagen type 3

27
Q

what is the management of dupuytren’s disease?

A 
Needle fasciotomy
Collaginase injection
Limited fasciectomy
Dermofasciectomy + graft
can recur
28
Q

what is an osteochondroma?

A

Benign tumour most commonly occurring near the knee

Distal femur / proximal tibia metaphyseal regions

29
Q

what does an osteochondroma look like macroscopically?

A

Cartilage capped ossified pedicle

30
Q

what is the normal presentation of an osteochondroma?

A

Painless, hard lump
Symptoms with activity
(pain from tendons; numbness from nerve compression)

31
Q

what is the management of an osteochondroma?

A

Close observation

Surgical excision

32
Q

what is Ewings sarcoma?

A

Malignant primary bone tumour of the endothelial cells in the marrow

33
Q

describe the normal presentation of ewings sarcoma

A

The great mimic: Hot, swollen, tender joint or limb with raised inflammatory markers
Can mimic infection
Be suspicious; ask about night pain and duration of symptoms; investigate early

34
Q

describe the management of wings sarcoma

A

Poor prognosis
Surgical excision problematic
Often radio- and chemo-sensitive

35
Q

what is a lipoma

A

Benign neoplastic proliferation of fat

Often subcutaneous

36
Q

describe the normal 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
37
Q

describe the management of a lipoma

A

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

38
Q

what is myositis ossificans

A

Abnormal calcification of a muscle haematoma

Musculoskeletal (22 decks)

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