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MSK > Upper Limb Arthritis > Flashcards

Upper Limb Arthritis Flashcards

1
Q

what are the general symptoms of arthritis

A

pain, swelling, stiffness, deformity, loss of function

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2
Q

where does cartilage gets its nutrients from

A

the synovial fluid

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3
Q

what is the basic treatment for arthritis at the sternoclavicular joint

A

physio, injection, excision (rare)

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4
Q

what does the scarf test show

A

acromioclavicular joint pathology/ injury

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5
Q

what can cause glenohumeral joint pain

A

cuff tear, instability, previous surgery, idiopathic

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6
Q

what can cause acromioclavicular joint pain

A

may be due to trauma, often overlaps with impingement

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7
Q

how do you treat acromioclavicular arthritis

A

injection, excision

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8
Q

what are the signs of glenohumeral joint OA

A

pain, crepitus (grinding), loss of movement (esp external rotation)

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9
Q

what osteophytes are often seen in glenohumeral OA

A

inferior (on humeral head)

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10
Q

what are the complications of shoulder replacement complications

A

infection, instability, stiffness, nerve damage, loosening

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11
Q

what is neuropraxia

A

stretching but not rupture of a nerve

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12
Q

how does a cuff tear lead to OA

A

deltoid pulls head upwards, abnormal forces on gleaned leads to OA

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13
Q

describe reverse geometry shoulder replacement

A 
reverses the ball and socket (ball in glenoid cavity)
increases level arm of deltoid 
lengthens deltoid 
resurfaces joint 
prevents upward migration
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14
Q

what can RA cause in the elbow

A

erosion and instability

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15
Q

what are the features of OA in the elbow

A

pain, restriction of movements, osteophytes, may be radiocapitellar only

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16
Q

what is the treatment for radiocapitellar OA

A

radial head only secondary stabiliser (not vital) so can excise or replace

17
Q

what are the downfalls of elbow replacements

A

limited life span
no good for young/ active
limited to 5kg/ 1kg repeatedly

18
Q

what joint in hand does OA usually affect

A

PIPs and DIPs

spares MCPs

19
Q

what are features of RA

A 
polyarticular, 
systemic,
erosions,
later joint space narrowing,
synovitis,
tendon rupture (due to synovitis)
20
Q

what are the options for rheumatoid surgery

A

synovectomy,
tendon realignment,
replacement,
fusion

21
Q

what is the terry thomas sign

A

injury into outstretched hand can cause scapholunate advanced collapse (SLAC wrist)

22
Q

What is a SNAC wrist

A

scaphoid non union advanced collapse

23
Q

what movements can a fused wrist do

A

twist but not flex

24
Q

what joints in the hands in commonly affected by OA

A

DIP (#1 in body)

base of thumb (1st CMC (carpometacarpal) (#2 in body)

25
Q

what are the signs of small joint OA

A

pain, deformity, heberden’s or oster’s nodes

26
Q

what is the treatment for small joint OA

A

NSAIDs, activity modification, capsaicin gel, injections, fusion

27
Q

what is the main sign of base of thumb OA

A

subluxation of CMCjt causing squaring of hand, pain- esp in pinch movement

28
Q

what is the treatment for thumb CMCjt OA

A

rest, analgesia, splints, capsaicin gel, steroid injection, surgery

29
Q

what is seen on x ray of psoriatic arthritis

A

similar to RA- pencil in cup

30
Q

what is seen in the fingers in psoriatic arthritis

A

dactylitis, skin and nail changes

31
Q

what is the treatment options for all joints with arthritis

A

rest/ analgesia/ activity modification/ splintage
injections may provide temporary relief
surgery- fusion, replacement, excision

32
Q

what are the tendon complications of RA

A

swan neck deformity,

boutonniere,

33
Q

describe what causes a swan nwck deformity

A

volar plate of PIP jt becomes attenuated. small ligaments + lumbrical tendons fall more dorsal to joint centre

34
Q

describe what causes a boutonniere deformity

A

extensor hood of PIPjt becomes attenuated
slips of extensor tendon move from dorsal to volar to centre of rotation

causes flexion of PIPjt
middle phalangeal head buttonholes through the extensor hood

lateral slips of extensor tendon stretched around PIPjt causes hyperextension of DIPjts

35
Q

what is the treatment for swan neck or boutonniere defomities

A

splintage, surgery (tendon reposition)

MSK (71 decks)

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