MSK Flashcards

(34 cards)

1
Q

what is osteoarthritis?

A

age related reaction of a joint to insult or injury

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2
Q

which inflammatory mediators are seen in osteoarthritis?

A

IL1 and TNF-a

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3
Q

which type of tissue is most affected in osteoarthritis?

A

articular cartilage

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4
Q

what are the radiological features of a joint affected by osteoarthritis?

A
joint space narrowing
osteophyte formation
subchondral sclerosis
subchondral cysts
bone contour abnormalities
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5
Q

what is an osteophyte?

A

a bony projection associated with the degeneration of cartilage in joints

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6
Q

what are heberden’s nodes?

A

swellings of the finger joints specifically at the distal interphalangeal joints (dip)

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7
Q

what are bouchard’s nodes?

A

swellings of the finger joints specifically at the proximal interphalangeal joints (pip)

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8
Q

where does osteoarthritis of the knees begin?

A

medially

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9
Q

where will hip joint pain commonly be felt?

A

groin

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10
Q

what type of joint is affected by osteoarthritis?

A

synovial joint

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11
Q

what are the causes of primary and secondary osteoarthritis?

A

primary-idiopathic

secondary-joint disease, haemochromatosis, obesity, occupational

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12
Q

what are risk factors of OA?

A
age increase
female
diabetes
hypermobility of joints
obesity
occupation
inflammatory arthritis
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13
Q

which joints are most commonly affected in OA?

A
DIP joints
first carpometacarpal joints (base of thumb)
first metatarsophalangeal joint of foot
vertebra
hips
knees
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14
Q

what is crepitus?

A

joint grating/crunching during movement

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15
Q

what is the pattern of joint stiffness and pain in OA?

A

joint pain made worse by movement and relieved by rest

morning stiffness lasts less than 30 mins

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16
Q

what is non medical treatment of OA?

A
weight loss if obese
exercise
heat/ice packs
supportive footwear/joint supports
acupuncture, physiotherapy
17
Q

what are pharmacological managements of OA?

A

paracetamol
nsaids
weak opioids if necessary
corticosteroid injections- short term

18
Q

what are the surgical managements of OA?

A

arthroscopy- removal of loose bodies from joint cavity
arthroplasty- prosthetic joint, knee/hip replacement
osteotomy- cut and realign joint (younger)
fusion- fuse joint to remove pain but also mobility

19
Q

what is rheumatoid arthritis?

A

autoimmune disorder causing symmetrical polyarthritis

20
Q

what is arthritis?

A

joint inflammation causing pain

21
Q

what types of joints does rheumatoid arthritis affect?

A

synovial joints

22
Q

what are the risk factors of RA?

A

women
family history
genetic predisposition
smoking

23
Q

what is the pattern of joint stiffness and pain in RA?

A

morning stiffness lasts more than 30 minutes
worst in the morning and in the cold
pain eased by movement

24
Q

how may an affected joint present in RA?

A

hot, red, swollen, tender

25
what are common hand deformities of RA?
ulna deviation, swan neck, z thumb, boutonniere deformity
26
what does rheumatoid factor show and how useful is it?
not positive in all RA patients, found in other inflammatory conditions too
27
what does anti ccp stand for and how useful is it?
anti cyclic citrullinated peptide | not present in all RA patients but specific for RA and indicates worse form of disease
28
what are the pharmacological managements for RA?
``` nsaids cox inhibitors-aspirin paracetamol +/- opioid corticosteroids- IM, oral, intraarticular DMARDS biological therapies ```
29
what does DMARDS stand for?
disease modifying anti-rheumatic drugs
30
how do dmards work?
inhibit cytokines and supress immune system
31
what are commonly prescribed dmards?
methotrexate, sulfasalazine, leflunomide
32
what are the different types of biological therapies available for RA?
interleukin blockers b cell inhibitors t cell blockers TNF-a blockers
33
what is osteopenia?
a precursor to osteoporosis characterised by low bone density
34
what is osteoporosis?
systemic skeletal disease characterised by low bone mass and deterioration of bone tissue therefore increasing fragility and susceptibility to bone fracture