Disease Profiles: Bone and Joint Disorders Flashcards
(146 cards)
List one way corticosteriods indirectly impact bone density
Inhibition of gonadal and adrenal steroid production
Which forms of malignancy are patients with Paget’s disease of bone at increased risk of?
Osteosarcoma, fibrosarcoma
The following organisms most commonly cause what type of prosthetic joint infection?
Coagulase-negative staph (e.g. Staph. epiderdimis), cutibacterium, corynebacterium, S. aureus
Chronic prosthetic joint infection (3 weeks + after operation)
How does vitamin D deficiency cause osteomalacia/rickets?
Vitamin D deficiency increases calcium absorption, osteoclastic activity, and release of Ca2+ from bone → impairs mineralisation of newly formed osteoid
What are Bouchard’s nodes?
Osteophytes of the PIP joints (can be seen in OA but more commonly seen in RA)

What is osteomyelitis?
Infection of the bone and/or bone marrow
The following organisms most commonly cause what type of
prosthetic joint infection?
Staph. aureus, coagulase-negative staph (e.g. Staph. epiderdimis)
Early prosthetic joint infection (within 2-3 weeks of operation)
Which patient group is most likely to develop primary osteoarthritis?
> 50 years, more common in females
How does chronic osteomyelitis develop?
From an untreated acute osteomyelitis
When would you prescribe an osteoporotic patient oral bisphonates?
Normal patients: T score = -2.5
If ongoing steroid requirement >/= 7.5mg prednisolone for 3 months or more or if there is a prevalent vertebral fracture, consider treatment with T score < -1.5
When would you refer a patient for a DEXA scan?
Anyone with a 10 year risk assessment for any OP fracture of at least 10%
Any patient over 50 years with a low trauma fracture
Which patient group is most likely to develop joint hypermobility syndrome?
Higher incidence in females, usually presents in childhood or 3rd decade
Why does acute osteomyelitis in children commonly localise to the metaphyses of long bones?
The metaphyses of children’s long bones contain abundant tortuous vessels with sluggish flow which can result in accumulation of bacteria
Which patient group is most likely to develop Paget’s disease of bone?
> 50
Describe the clinical presentation of hypocalcaemia
Paraesthesiae, muscle cramps, irritability, fatigue, seizures, brittle nails
The following organisms most commonly cause osteomyelitis in which patient group?
S. aureus, Enterobacter sp., and group A and B Strep
Newborns (<4 months)
What is the diagnostic investigation for osteomyelitis?
Bone biopsy
When should rifampicin be added to patients with a prosthetic joint infection?
If culture is positive for rifampicin-sensitive staphlococci
Define primary osteoarthritis
Osteoarthritis due to normal ‘wear and tear’ of joints as people age
Which type of fractures are common in patients with type II osteoporosis?
Femoral neck fractures and vertebral fractures
What is tertiary hyperparathyroidism?
Seen in patients with chronic secondary hyperparathyroidism (usually CKD) who develop an adenoma which will continue to produce PTH despite biochemical correction
Which patient groups would you assess with a 10-year osteoporotic fracture risk calculator?
Anyone over 50 years with risk factors
Anyone under 50 years with very strong clinical risk factors - early menopause, glucocorticoids
Which organism is associated with septic arthritis in the elderly, IV drug users and the seriously ill?
Escherichia coli
Define diffuse osteomyelitis
Segment of bone is infected resulting in skeletal instibility e.g. infected non-union

