Upper Limb Arthritis

Question 1

What are some of the symptoms of arthritis

Answer 1

Pain
Swelling 
Stiffness 
Deformity 
Loss of function

Question 2

What are some of the causes of arthritis

Answer 2

Degenerate (OA)
Inflammatory (RA, psoriasis, gout)
Post-traumatic
Septic

Question 3

What are the basic treatment principles of Arthritis

Answer 3

Nothing 
Rest / analgesia/ splintage 
Steroid injections 
Replace
Fuse 
Excise

Question 4

What joint is arthritis more common in? Acromioclavicular or sternoclavicular

Answer 4

Acromioclavicular

Question 5

What might glenohumeral joint arthritis be due to

Answer 5

Cuff tear
Instbaility
Previous surgery
Idipathic

Question 6

What does glenohumeral joint OA present with

Answer 6

Pain
Crepitus (grinding)
Loss of mvovement (esp. external rotation)

Question 7

What are soe of the complications of a shoulder replacement

Answer 7

Infection 
Instability 
Stiffness - too much scar tissue 
Nerve damage
Loosening

Question 8

What is the function of the rotator cuff

Answer 8

To stabilise the humeral head

Question 9

What happens if the rotator cuff is torn

Answer 9

The deltoid pulls the head upwards

Question 10

What might be an indication of a cuff tear on XRay

Answer 10

A step up along the scapula as it runs laterally

Question 11

What does a reverse geometry shoulder replacement do?

Answer 11

It increases the lever arm of the deltoid lengthens the deltoid
prevents upward migration
Moves the centre of rotation medially

Question 12

When might a fusion be useful

Answer 12

When pain is unbearable and patient is not bothered about the movement

Question 13

What types of arthritis can the ebow be affected by

Answer 13

RA
OA
ulnohumeral
Radiocapitellar

Question 14

What can be seen on XRay of RA in the elbow

Answer 14

Erosin

Instability

Question 15

What does a patient complain of when presenting with OA in the elbow

Answer 15

Pain

restriction of movement

Question 16

What can we do for radopcapitellar OA

Answer 16

Excise

Replace

Question 17

Why can we do a radiocapitellar replacement or excision

Answer 17

Because the ligaments are more important than the radial head

Question 18

What can be done for osteophyte impingement

Answer 18

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

Question 19

What is the main problem with an elbow replacement

Answer 19

Patient is limited to lifting 5kg
Loosen quite rapidly
No good for young /active

Question 20

What types of arthritis can affectt the wrist

Answer 20

RA
OA
Post traumatic
Instability

Question 21

What joints does OA affect in the hand

Answer 21

Base of thumb, PIP and DIP joints

Question 22

What joints does RA affect in the hand

Answer 22

MCP joint and carpus

Question 23

What is a SLAC wrist

Answer 23

Scapholunate advanced collapse

Question 24

What happens in a SLAC wrist

Answer 24

The capitate starts to migrate into the space between the lunate and scaphoid

Question 25

What can result due to base of thumb OA

Answer 25

Subluxation of CMC joint

Question 26

What is the treatment for Thumb CMC joint OA

Answer 26

Rest 
Anaglesia 
Splints 
Capsacin 
gel 
Steroid injection 
Surgery - trapazectomy