What disease causes pain over the tibial tuberosity??(Mainly seen in young men)
What is spondylolisthesis, which region of the spine is it likely to occur in?
- It is where 1 vertebra slips anteriorly over the 1 below
- Most likely to occur in the lumbar region of the spine
What are the 4 main classifications of muscle action in a movement?
- Fixator/ Stabiliser
What would you see in a supraspinatous tendonitis (pain doing what)?
- Pain and restriction on active abduction of arm, worsened by resistance
- Normal and pain-free passive movements
What problems can flat footedness cause?
- Increased susceptibility to Achilles' tendon problems
- Hallux valgus
What are the 3 categories of arthritis based on the number of joints?
- Mono-arthritis - 1 joint
- Oligo-arthritis - 2-4 joints
- Poly-arthritis - More than 4 joints
In an arrangement of 2 bones joined by a muscle, what are the 3 components of muscle action?
- Swing - alters angle of joint
- Shunt - compresses bones together
- Spin - twists the mobile bone along its long axis
What are some causes of chronic inflammatory poly-arthritis
- Rheumatoid arthritis
- Connective tissue disorders such as SLE
- Psoriatic arthritis
- Chronic poly-articular gout, often with tophi
What joints are commonly affected by osteoarthritis?
- DIP joints
- PIP joints
- 1st carpo-metacarpal joint
What are the 5 major forces that act on bone?
What is passive insufficiency of a muscle?
The inability of a muscle to lengthen enough to allow movement
What is active insufficiency of a muscle?
The inability of a muscle to contract enough to produce a movement
What are the 3 parts of the stance phase?
- Heel strike - start, when the heel first hits the ground
- Mid-stance -whole foot contact, midway through
- Toe-off - toes push off from floor
Which joints of the back are commonly affected?
Facet joints of the spine
What is the disease called where by the Achilles' tendon avulses a small part of bone off the calcaneous?
What is an important function of tendons (Achilles) in locomotion, apart from transmitting muscle force to the bone?
They act as springs that store energy and release it to complement the muscle action
What are the 4 radiological signs of OA?
- Loss of joint space
- Subchondral sclerosis
- Subchrondral cysts
What is countercurrent movement of a muscle?
A muscle either shortens or lengthens at both ends at the same time
What are the signs and symptoms of peri-articular pain?
- Localised pain to 1 structure
- Pain only in certain directions of movement
- Passive movement less restricted and painful than active
- May have tenderness away from joint line
What are the signs and symptoms of articular pain?
- Pain all around the joint
- Exacerbated by movement in all directions
- Active and passive movements equally restricted & painful
- Joint line tenderness
- May have swelling within capsule
What are the 4 main causes of inflammatory oligo-arthritis?
- Psoriatic arthritis
- Enteropathic arthritis
- Ankylosing spondylosis
- Reactive (post-infection)
What are the signs and symptoms of an inflammatory arthritis?
- Worse with over 30 mins rest, worse at night
- Systemic features - fever malaise etc
- Redness of overlying skin is rare- septic and gout
- Pain, swelling and loss of function
- Joint effusion and synovial thickening
- Joint restriction and pain with both passive and active movements
What is concurrent movement of a muscle?
It is where it lengthens at 1 end while shortening at the other end
Why is a spiral femoral fracture significant in children?
It may fracture across the epiphyseal plate, leading to stunting or acceleration of the bone growth
What problems can cause "flat footedness"
- Subtalar joint hypermobility
- Collapsed medial longitudinal arch
What are the 4 major properties of skeletal muscle?
- Irritability - respond to nervous stimulus
- Contractility - ability to shorten
- Extensibility - ability to lengthen
- Elasticity - ability to return to normal length after stretching
What investigations would be performed for suspected septic arthritis?
- Aspiration of synovial fluid
- Blood cultures
- Urine cultures
- Inspection of skin
- C-reactive protein
What are the 2 main phases of gait?
- Stance phase
- Swing phase
What are the signs and symptoms of non-inflammatory arthritis?
- Better with rest
- No systemic symptoms
- Never see redness of overlying skin
- Pain and loss of function
- May have effusion, but no synovial thickening
- Joint restriction and pain with active and passive movements
What are the 2 main causes of acute inflammatory mono-arthritis?