MSK- bone and joint disorders

Question 1

what is osteoarthritis

Answer 1

wear and tear of articular (hyaline) cartilage

Question 2

is osteoarthritis pain worse/improved with movement

Answer 2

worse

Question 3

how long is morning stiffness with osteoarthritis

Answer 3

< 30 mins

Question 4

XRAY osteoarthritis LOSS

Answer 4

Loss of joint space
marginal Osteophytes
Sclerosis
Subchondral cysts

Question 5

what is subchondral sclerosis

Answer 5

increased bone density

Question 6

which types of nodes are only found in osteoarthritis (not RA)

Answer 6

heberdens nodes (DIP joints)

Question 7

what are osteophytes

Answer 7

bony spurs

Question 8

first line treatment for osteoarthritis of the knee

Answer 8

topical NSAIDs

Question 9

score for investigating hyper mobility syndrome

Answer 9

Beighton score

Question 10

what its osteoporosis

Answer 10

reduced bone mineral density

Question 11

type 1 osteoporosis

Answer 11

post-menopausal period

Question 12

type ii osteoporosis

Answer 12

osteoporosis of old age

Question 13

risk factors for osteoporosis

Answer 13

early menopause
white caucasian
smoking
alcohol abuse
little exercise
poor diet
chronic disease
< vitamin D

Question 14

secondary osteoporosis causes

Answer 14

drugs- steroids, breast cancer drugs
malnutrition
alcohol abuse
GI disorders
chronic disease
immobilisation
endocrine disorders

Question 15

what is DEXA scanning

Answer 15

measure of bone mineral density- predicts fracture risk

Question 16

lifestyle advice for patients with osteoporosis

Answer 16

> calcium intake
high intensity strength training
avoid alcohol/smoking

Question 17

first line medical management for majority of patients with osteoporosis

Answer 17

oral bisphosphonates

Question 18

consider treatment of oral bisphosphonates in patients with OA when T score is

Answer 18

</= -2.5

Question 19

what is osteomalacia

Answer 19

abnormal softening of bone due to < osteoid secondary to < calcium and phosphorus

Question 20

what is rickets

Answer 20

same as osteomalacia but in children

Question 21

osteomalacia symptoms of hypocalcaemia

Answer 21

paraesthesiae, muscle cramps, irritability, fatigue, seizures, brittle nails

Question 22

what is avascular necrosis

Answer 22

failure of blood supply to the end of the bone, resulting in ischaemic necrosis of bone and marrow

Question 23

where does avascular necrosis most commonly affect

Answer 23

head of the femur

Question 24

risk factors for avascular necrosis

Answer 24

APS
pregnancy
sickle cell disease
trauma
alcohol and steroid abuse

Question 25

blood results in pages disease of bone

Answer 25

raised alkaline phosphate

Question 26

what is pagets disease of bone

Answer 26

chronic condition involving cellular remodelling and deformity of one or more bones

Question 27

pagets disease commonly affects what bones

Answer 27

long bones, pelvis, lumbar spine, skull

Question 28

pathophysiology of pagets disease of bone

Answer 28

abnormal osteoclastic activity followed by increased osteoblastic activity- abnormal bone structure with decreased strength and increased fracture risk

Question 29

treatment of pagets disease of bone

Answer 29

treat with bisphosphonates if pain not responding to analgesia