Upper Limb Arthritis Flashcards
What are some of the symptoms of arthritis
Pain Swelling Stiffness Deformity Loss of function
What are some of the causes of arthritis
Degenerate (OA)
Inflammatory (RA, psoriasis, gout)
Post-traumatic
Septic
What are the basic treatment principles of Arthritis
Nothing Rest / analgesia/ splintage Steroid injections Replace Fuse Excise
What joint is arthritis more common in? Acromioclavicular or sternoclavicular
Acromioclavicular
What might glenohumeral joint arthritis be due to
Cuff tear
Instbaility
Previous surgery
Idipathic
What does glenohumeral joint OA present with
Pain
Crepitus (grinding)
Loss of mvovement (esp. external rotation)
What are soe of the complications of a shoulder replacement
Infection Instability Stiffness - too much scar tissue Nerve damage Loosening
What is the function of the rotator cuff
To stabilise the humeral head
What happens if the rotator cuff is torn
The deltoid pulls the head upwards
What might be an indication of a cuff tear on XRay
A step up along the scapula as it runs laterally
What does a reverse geometry shoulder replacement do?
It increases the lever arm of the deltoid lengthens the deltoid
prevents upward migration
Moves the centre of rotation medially
When might a fusion be useful
When pain is unbearable and patient is not bothered about the movement
What types of arthritis can the ebow be affected by
RA
OA
ulnohumeral
Radiocapitellar
What can be seen on XRay of RA in the elbow
Erosin
Instability
What does a patient complain of when presenting with OA in the elbow
Pain
restriction of movement
What can we do for radopcapitellar OA
Excise
Replace
Why can we do a radiocapitellar replacement or excision
Because the ligaments are more important than the radial head
What can be done for osteophyte impingement
Surgery = make a hole in the back of the elbow and remove all of the osteophytes present - remove all of this and make a hole in it that will give you access to the front of the elbow
What is the main problem with an elbow replacement
Patient is limited to lifting 5kg
Loosen quite rapidly
No good for young /active
What types of arthritis can affectt the wrist
RA
OA
Post traumatic
Instability
What joints does OA affect in the hand
Base of thumb, PIP and DIP joints
What joints does RA affect in the hand
MCP joint and carpus
What is a SLAC wrist
Scapholunate advanced collapse
What happens in a SLAC wrist
The capitate starts to migrate into the space between the lunate and scaphoid
What can result due to base of thumb OA
Subluxation of CMC joint
What is the treatment for Thumb CMC joint OA
Rest Anaglesia Splints Capsacin gel Steroid injection Surgery - trapazectomy
