Limb pain/swelling Flashcards
(21 cards)
What are the differentials for an acute hot, swollen, and red leg?
DVT Cellulitis Nec fasciitis Septic arthritis Contact dermatitis Drug reaction
Treatment for moderate cellulitis in patient?
IV fluclox 2g 6 hrly
Which antibiotic is recommended for moderate cellulitis and penicillin allergy?
IV vancomycin
What is the difference between cellulitis and erysipelas?
cellulitis= acute infection of deep subcutaneous tissue and dermis
Erysipelas= more superficial dermal and upper subcutaneous tissue infection, often affecting the face
Which is the most useful imaging modality in necrotising fasciitis?
MRI
What is the most common organism to cause nec fasciitis?
strep pyogenes
What are the risk factors for nec fasciitis?
recent wound or bite diabetes immunocompromised IVDU Alcohol excess CKD NSAIDs
What are the investigations for nec fasc?
gram stain exudate
MRI/CT to delineate extent of NF
rapid strep diagnostic kit and PCR
What is the management of NF?
ICU
R/V infectious disease, surgery, orthopaedics
Broad spectrum abx
Debridement
Name five categories for the causes of limb pain
- MSK
- Joint pain
- Inflammatory
- Infective
- Vascular
- Neurological
- Malignant
Examples of MSK causes of limb pain?
bruising, soft tissue trauma, fractures
Examples of joint pain resulting in limb pain?
OA, meniscal injury
Inflammatory limb pain causes?
RA, polymyalgia rheumatica, dermatomyostitis
Infective causes of limb pain?
cellulitis, osteomyelitis
Vascular causes of limb pain?
arterial ischaemia, venous thrombosis
Neurological cause of limb pain?
radiculopathy
Examples of conditions causing bilateral limb pain?
OA, RA, fibromyalgia, polymyalgia rheumatica
Examples of causes of unilateral limb pain?
fracture, sarcoma, radiculopathy, cellulitis, venous thrombosis, osteomyelitis
What are characteristic symptoms/signs of polymyalgia rheumatica?
Bilateral shoulder and/or pelvic girdle pain
Stiffness lasting for >45 mins after walking or periods of rest
Raised CRP and ESR
What is the management for polymyalgia rheumatica?
prednisolone
A patient has temporal arteritis. Who should you refer them to?
rheumatology
