MSK Emergencies Flashcards
What is the most common MSK emergency in elderly patients?
Fractures —> hip
- may require surgery —> fixation of hip
What is osteoporosis?
Weakened bones due to low bone density
- signs —> fractures
—> stooped back
- develops slowly (years)
- women —> higher risk
- post-menopause —> less oestrogen (inc
bone loss and dec Ca retention)
What are the 5 causes of osteoporosis?
- Corticosteroids - long term, high dose
- Medications for inflammatory, endocrine,
malabsorption - Family history
- Low BMI
- Drinking/smoking
How is osteoporosis diagnosed? (2)
- Risk assessment —> see likelihood of fracture —>
decide if caused by osteoporosis - DEXA scan —> bone density
- over -1 = normal
- -1 to -2.5 = osteomalacia
- under -2.5 = osteoporosis
How is osteoporosis treated? (5)
- Bisphosphonates —> dec bone resorption
- Ca/Vit D supplements
- PTH —> inc bone turnover
- SERMs = Selective oEstrogen Receptor Modulators
- eg. raloxifebe - HRT = Hormone Replacement Therapy
—> replace oestrogen loss
- risks —> breast cancer, strokes, CVD
What is osteomalacia?
Softened bones due to inadequate mineralisation
- low Ca/Vit D
- inc renal loss —> phosphate deficiency
What are the 7 causes of osteomalacia?
- Insufficient dietary intake
- VitD metabolism issues
- Renal tubular acidosis
- Chronic renal failure
- Malnutrition during pregnancy
- Bone tumour
- Coeliac disease
How is osteomalacia diagnosed? (3)
- Low Vit D levels
- X-rays —> pseudo fractures
—> protrusion acetabula (femur protrude
into pelvis) - DEXA scan (-1 to -2.5)
How is osteomalacia treated? (3)
- Nutritional (Vit D) —> inc dietary intake
—> inc sun exposure
—> supplements - Malabsorption (Vit D) —> injection
—> oral (daily) - Secondary —> treat other conditions
What are 2 common MSK emergency in paediatric patients?
- Transient Synovitis
- Septic Arthritis
What are the 4 causes of limping in children?
- Inflammation
- Infection
- Trauma
- Other eg. cancers
What are the 5 common causes of hip pain in children under 4?
- Transient synovitis
- Osteomyelitis/ septic arthritis
- Juvenile idiopathic arthritis
- Injury (non-accidental —> abuse)
- Limb pain
+ Leukaemia
Eosinophilic granuloma
Metastases neuroblastoma
What are the 3 common causes of hip pain in children between 4 and 10?
- Transient synovitis
- Perthes disease (dec blood to femur head)
- Osteomyelitis/ septic arthritis
+ Leukaemia
Ewing sarcoma
What are the 3 common causes of hip pain in children over 10?
- Slipped femoral epiphysis
- Avulsion fractures
- Osteomyelitis/ septic arthritis
+ Leukaemia
Osteoid osteoma
Ewing sarcoma
Osteosarcoma
What is transient synovitis and how is it treated?
Swelling of hip joint following a viral infection
- Rest
NSAIDs (Non-Steroidal Anti-Inflammatory Drugs)
- most common cause of limping in children
