MSK Flashcards
(38 cards)
Most common organisms in septic arthritis
Staphylococcus aureus
Pseudomonas aeruginosa
E coli
Gonnorhoea
Most common joints affected by septic arthritis
Knee > Hip > Shoulder > Ankle > Wrists
Which organism commonly causes Sternoclavicular/ Sacro-iliac septic arthritis?
Group B streptococcus
Can present with chest wall pain
XR changes seen in septic arthritis
Non-specific
MRI and CT are most sensitive
Joint space narrowing
Fat pad displacement
Risk factors for GCA/ Temporal Arteritis
- Female (3X)
- Age 60-80 years
- European ethnicity
- Family history of GCA or PMR
Kocher Criteria for Septic Arthritis
Non-Weight Bearing
Raised ESR (>40)
WCC (>12000)
Temp 38.5+
ACR criteria for GCA
3/5 of:
Age 50+ New onset headache Abnormal biopsy Elevated ESR Temporal artery abnormality (e.g. tenderness, pulsation)
NICE diagnostic criteria of osteoarthritis
Aged 45+
Activity-related joint pain
No/ under 30 minutes morning joint stiffness
Most commonly affected joint in OA?
Knee
Bouchard’s and Heberden’s Nodes- which is which?
Bouchard’s - Proximal IP
Heberden’s - Distal IP
What is Lhermitte’s Sign?
Seen in spinal cord compression
Neck flexion causes an electric-shock type pain down neck and into back
How do tendon reflexes change with Spinal cord compression
o Increased below the lesion level
o Absent at the lesion level
o Normal above
Brown Sequard Syndrome
Ipsilateral Weakness and loss of proprioception/ vibration sensation; contralateral loss of pain and temperature sensation
Treatment of osteoporosis based on FRAX score
- Green (under 10%) Lifestyle advice, re-assurance
- Amber (around 10%) Measure BMD using DXA then recalculate need for treatment
- Red (over 10%) Treat for osteoporosis
Systemic features of RA
- Malaise, weight loss, fever, night-sweats
- Nodules (elbows and lungs)
- Sjogren’s Syndrome
- Leg Ulcers
- Pulmonary Fibrosis and pleural involvement
- Increased CV risk (and pericarditis, myocardial fibrosis)
- Thyroid disorders
- Osteoporosis
- Lymphadenopathy
- Vasculitis
Antibodies for RA
o RF : 60-70% patients, but low specificity
o Anti-CCP : More specific than RF; around 80%
ACR criteria for RA diagnosis- what is included
Joint involvement (5)
Serology (3)
Duration of symptoms 6 months+ (1)
Acute-phase reactants (ESR/CRP) (1)
Need 6+ for diagnosis
Poor prognostic factors for RA
rheumatoid factor positive poor functional status at presentation HLA DR4 X-ray: early erosions (e.g. after < 2 years) extra articular features e.g. nodules insidious onset anti-CCP antibodies
What is the cause of pseudogout
Calcium Pyrophosphate deposition in synovium
Common organisms associated with Reactive Arthritis infection
Chlamydia trachomatis Chlamydia pneumoniae HIV Campylobacter Salmonella Shigella
Reiter’s Syndrome
Presenting feature of reactive arthritis
- Conjunctivits
- Urethritis
- Arthritis
Examples of Small vessel vasculitis
- Rheumatoid Vasculitis
- Wegener’s Granulomatosis (GPA)
- ANCA +ve Vasculitis
- Goodpasture’s Syndrome
Common features of small vessel vasculitis
Palpable purpura 1-3mm/ papule formation Splinter Haemorrhages Urticaria Vesicles Livedo reticularis
Wegener’s Granulomatosis- key facts
cANCA positive in 90%
Granulomatous vasculitis affecting respiratory tract and the kidneys- formation of cavitating lesions
Epistaxis/ haemoptysis common
