Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

MSK > Upper Limb Arthritis Management > Flashcards

Upper Limb Arthritis Management Flashcards

1
Q

how do upper and lower limb differ in terms of function?

A 
lower = large weight bearing forces, only mobility
upper = large range of movement, fine control
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

symptoms of upper limb arthritis?

A 
pain (not always)
swelling
stiffness
deformity
loss of function
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what can cause upper limb arthritis?

A

degeneration (OA)
inflammation (RA, psoriasis, gout)
post-traumatic
septic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what are the basic treatments principles for arthritis?

A 
nothing
rest/analgesia
splinting (occasionally in thumb)
steroid injections (only for around 3 months)
replacement
fusion
excise
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

how does sternoclavicular joint arthritis present?

A

rare

swelling and pain at SC joint

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

how is sternoclavicular joint arthritis treated?

A

physio
injections
excision (rarely)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what can cause acromioclavicular joint arthritis?

A

trauma
often overlaps with impingement
very common

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

how is acromioclavicular joint arthritis managed?

A

injection

excision

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

where is fusion used for arthritis?

A

wrist

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what can cause glenohumeral joint arthritis?

A

cuff tear
instability
previous surgery
idiopathic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

how does glenohumeral joint arthritis present?

A

pain
crepitus
loss of movement (esp. external rotation)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

how does AC joint arthritis present?

A

painful scarf test

very well localised pain at AC joint

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what are the risks with shoulder replacement?

A 
infection
instability
stiffness
nerve damage
loosening
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

how does rotator cuff tear affect the glenohumeral joint? what are the implications of this?

A

if torn, the deltoid pulls the humeral head upwards
abnormal forces on glenoid fossa leads to OA
anatomical shoulder replacement will fail until tear is fixed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

describe a reverse geometry shoulder replacement

A 
reverses ball-socket
increases lever arm of deltoid
lengthens deltoid
resurfaces joint
prevents upward migration
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what are the risks with reverse geometry shoulder replacement?

A

high complication rate

deltoid may fatigue after around 7 years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

when is a reverse geometry shoulder replacement used?

A

only if rotator cuff is not repairable

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what may be used if a reverse geometry shoulder replacement fails?

A

excision fusion

19
Q

what is the elbow susceptible to?

A

RA

OA

20
Q

what are the 2 joints at the elbow?

A

ulnohumeral

radiocapitellar

21
Q

what does RA cause at the elbow?

A

erosion

instability

22
Q

what does OA cause at the elbow?

A 
pain
restriction of movement
osteophytes
may be radiocapitellar
can have restriction of movement without pain
23
Q

how is radial capitellar OA managed?

A

can be excised as radial head is only a secondary stabiliser so not vital
can also be replaced

24
Q

what procedure can be used to remove osteophytes?

A

OK procedure

25
Q

how successful are elbow replacements?

A

limited life span

not good for young/active as limited capabilities and usage possible

26
Q

displacement of RA vs OA?

A 
RA = polyarticular, systemic, MCP involvement
OA = monoarticular, localised, PIP and DIP involvement
27
Q

features of RA?

A

erosions
later joint space narrowing than OA
synovitis
tendon rupture

28
Q

RA medications?

A

DMARDs (+ short term steroids)

..

29
Q

what surgeries can be used for RA?

A 
synovectomy
tendon realignment
replacement
fusion
"a la carte"
30
Q

what is the Terry Thomas sign?

A

gap?/loss of gap? in carpal bones indicating scapholunate advanced collapse (SLAC)

31
Q

what is SNAC wrist?

A

scaphoid non-union advanced collapse

32
Q

how is SNAC or SLAC wrist treated?

A

arthrodesis?

33
Q

how does small joint OA present?

A

most commonly in DIPs
pain
deformity
heberdens or ostlers nodes

34
Q

how is small joint OA treated?

A 
NSAIDs
activity modification
capsaicin gel
injections
fusion
35
Q

what is the 1st and second most common site of OA in the body?

A 
1 = DIPs
2 = base of thumb
36
Q

what does base of thumb OA cause?

A

subluxations of CMC joints

pain (esp. in pinch movement)

37
Q

how is thumb CMC joint OA managed?

A

rest, analgesia, splints, capsaicin gel
steroid injection
surgery

38
Q

what are the features of psoriatic arthritis?

A

inflammatory arthritis
skin, nails, hair, hips, knees and hands/wrists affected
sausage fingers (dactylitis)
pencil in cup X ray features

39
Q

what are the standard general principles of arthritis management for all types?

A

rest, analgesia, activity modification, splintage
injections
fusion, replacement, excision surgery

40
Q

name 2 tendon complications of RA

A

swan neck deformity

boutonniere

41
Q

what is swan neck deformity?

A

volar plate of PIP joint becomes attenuated
small ligaments + lumbrical tendons fall more dorsal to joint centre
PIP hyperextension with DIP hyperflexion

42
Q

what is boutonniere?

A

“buttonhole”
extensor hood of PIP joint becomes attenuated
hyperflexion of PIP with hyperextension of DIP

43
Q

how are tendon complications of RA managed?

A 
splintage
surgery (tendon reposition)

MSK (66 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions