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musculo-skeletal systems > All MSK and Arthritis > Flashcards

All MSK and Arthritis Flashcards

1
Q

DIP

PIP

MCP

MTP

A

Distal Interphalangeal Joint

Proximal Interphagangeal Joint

MCP (knuckle) MetoCarpoPhalangeal

MTP (foot) MetaTarsoPhalangeal

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2
Q

Small bony nodules (osteophytes) at the DIP and PIP joints are characteristic of what?

A

OA

DIP - Herberden’s nodes

PIP - Bouchard’s nodes

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3
Q

Where do you find Rhematoid nodules on the hands?

A

MCP

(knuckles)

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4
Q

Deformities of the finger in RhA

(diagram)

A
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5
Q

Diagram of Tophi (white subcutaneous nodes)

in Gout

  • uric acid crystals
A
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6
Q

Two main features of carpal tunnel syndrome

A

Median nerve compression

Thenar muscle wasting

rem. flexor retinaculum

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7
Q

Subluxation in the hand and ulnar deviation of the the MCP joints are characteristic of what?

A

RhA

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8
Q

What is a pannus?

A

hypertrophied synovium,

containing inflammatory cells that release collagenolytic enzymes

causing loss of bone and cartilage (chronic RhA)

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9
Q

General facts about RhA

Men or Women?

Geographically areas

A

Low incidence in Afria, high incidence in North America.

3:1 ratio (females >>)

Can disappear in pregnancy due to immune system adaptations to foreign matter.

symmetrical

HLA-DR4 antigen identified.

Hormonal & viral links

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10
Q

RhA nodules characteristics

A

Made from fibroblasts.

Pinky colour.

Blood supply on the outside only; can become necrotic.

Locations; extensor surfaces of elbows, forearms and hands

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11
Q

RhA on XR - characteristics

A

White sclerotic changes - spongy bone looks whiter.

Subluxation of MCP

Wrist/ hand displacement

Thumb - Z deformity

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12
Q

RhA diagnostic criteria

A

morning stiffness >> 60 mins

stiffness after rest

>> six weeks duration

DIP joints spared

Volar subluxation

Swan neck/ boutonniere, guttering between bones

RhA attacks connective tissue (therefore tendinous sheaths); fingers stay in flexion/ extension

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13
Q

Felty’s syndrome (important)

A

Rare autoimmune disease

Splenomegaly

neutropenia

RhA

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14
Q

Early sign of RhA?

A

boggy metacarpal joints

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15
Q

Learn the Gold star slide (differences between RhA, OA, and gout)

A

need image

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16
Q

Tx of gout

A

Acute; NSAIDs, (+PPIs) or if can’t tolerate then colchicine or steroids.

Chronic; allopurinol or if not tolerated, try febuxostat

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17
Q

Diagram showing MTP joint

A
18
Q

What does DAS28 measure?

A

Disease Activity Scores for RhA

19
Q

MKD pain of the hip needs to be distinguished from:

A

lumbar nerve roor irritation

spinal or arterial claudication

abdominal causes, e.g. hernias

20
Q

What is the classical appearance of a hip fracture?

A

affected side; shortened leg, externally rotated.

NB> fracture of the hip in the elderly can occur with minimum trauma and present atypically, px even may be able to weight bear.

21
Q

What is a subcapital fracture, and it’s treatment?

A

A subcapital fracture is the commonest type of intracapsular fracture of the proximal femur.

hemiarthroplasty

22
Q

Local knee joint line tenderness could indicate….?

A

Meniscal tears

23
Q

Meniscal provocation test

A
24
Q
A
25
Q

Trendelenberg sign

A
26
Q
A
27
Q

varus and valgus knees

A
29
Q

ankle anatomy diagram

A
34
Q

What tests are useful for checking knee stability?

A
  • Collateral test (knee fully extended between body and elbow and varus/ valgus forces applied). Feel the joint margin. Repeat with knee at 30 degrees.
  • Anterior drawer test (NB. check no posterior subluxation of tibia on femur)
  • Posterior drawer test
  • Patellar apprehension test (for patellar dislocation/ instability)
  • medial/ lateral meniscus tests
  • Squat test (menisci)
35
Q

Which shoulder dislocation is most common?

A

Anterior - 95%

Usually caused by a direct blow to, or fall on, an outstretched arm.

The patient typically holds his/her arm externally rotated and slightly abducted.

36
Q

Dermatome to little finger?

A
37
Q

Dermatome to middle finger

A
38
Q

Dermatome to the thumb

A
39
Q

Dermatome to Inner Forearm

A
40
Q

Dermatome to Upper inner arm

A
41
Q

Dermatome to knee

A
42
Q

Dermatome to medial malleolus

A
43
Q

Dermatome to dorsum of foot

A
44
Q

Dermatome to Toes 1-3

A
45
Q

Dermatome to Toes 4 and 5; lateral malleolus

A
46
Q

Footpain after walking, often in the 2nd metatarsal, can suggest what?

A

Forefoot pain, often localised to the second metatarsal, after excessive activity such as trekking, marching or dancing, suggests a stress fracture. Symptoms are relieved by rest and aggravated by weight bearing.

47
Q

Pain between the 3rd and 4th toes in a middle-aged woman wearing tight shoes is suggestive of?

A

Spontaneous lancinating pain in the forefoot radiating to contiguous sides of adjacent toes occurs with Morton’s neuroma. A common site is between the third and fourth toes.

musculo-skeletal systems (1 decks)

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