Case study 1

Question 1

Define spondylosis

Answer 1

A descriptive term, not diagnostic. Degenerative changes of the spine that occur with age such as disc dehydration.

Question 2

Define osteoarthritis

Answer 2

Degenerative disease affecting joints within the body. Characterised by the degeneration of articular cartilage

Question 3

How would OA present on an X-ray (4)

Answer 3

1 joint space narrowing
2 sclerosis formation (white density around joint margins)
3 osteophyte formation
4 mineral bone density increases.

Question 4

How is OA classified on X-rays 1-4

Answer 4

Kellgren Lawrence grading system 1-4
1 joint space narrowing 
2 JSN and small osteophyte formation 
3 multiple moderste osteophytes
4 sclerosis, bone deformity, large osteophytes

Question 5

What do red flags indicate

And symptoms

Answer 5

Serious pathology e.g Ca, TB, sepsis,

Night sweats fever weight loss

Question 6

What are the issues with red flags (general)

Answer 6

80% patients present with at least 1 red flag
Cannot identify pathology- not specific.
More helpful for management than screening.Cooke 2017 BJSM

Question 7

Why do we use Greenhalgh 2016

Answer 7

Clear, concise and consistent wording for patients.
Symptoms that pt won’t report without prompts.
Useful for early identification and awareness

Question 8

5 key CES symptoms as per Todd and Dickson 2016

Answer 8

Bilateral leg Radicular pain
Reduced perineal sensation
Altered bladder function
Loss of anal tone 
Loss of sexual function