MSK Introduction - Taxonomies

Question 1

What are the key structures that make up the MSK system?

Answer 1

STRUCTURE / TISSUE:
A. Hyaline cartilage: wear-and-tear
B. Bony structure: Osteophytes
C. Synovial membrane (lines the moveble joint) : inflammation
D. Ligaments: prone to tears, inflammation
E. Tendons: tears inflammation
F. Bursae: sacs filled with fluid, prone to inflammation

MAIN CAUSES: Mechanical injury, inflammation, autoimmunity, congenital, other causes.

Question 2

What can go wrong with MSK systems?

Answer 2

Generally you get :
* Local structural musculoskeletal conditions eg problems with hip, oesteoporosis OR
* Systemic musculoskeletal pathologies such as conditions that affect joints on both sides of the bodies

BUT not all conditions fit into these two groups. I classify using the following groupings:

• Osteoarthritis
• Structural / mechanical conditions eg carpal tunnel synd.
• Seronegative inflammatory pathologies E.g. Ankylosing spondylitis
• Seropositive inflammatory pathologies E.g. RA

Most of the common conditions can go into these buckets

Question 3

Which are inflammatory and non-inflammatory conditions?

Answer 3

Inflammatory conditions - can be Seropositive (with rheumatoid factor) or Seronegative (no rheumatoid factor). When you take blood and test the serum, you can check if there is rheumatoid factor or not

Seropositive conditions include:
Rheumatic diseases:
* Rheumatoid A.
* S.L.E.
* Sjogren’s
* Systemic sclerosis
* Mixed Conn. Tissue disease

Seronegative include:
* Ankylosing spondy.
* Reiter’s disease
* Psoriatic arthritis
* Enteropathic arthritis

Non- inflammatory conditions are quite diverse
* Osteoarthritis
* Joints deformities
* Congenital disorders
* Metabolic bone diseases
* Endocrine disorders
* Degenerative conditions
* Osteoporosis

Question 4

What is the difference between Osteoarthritis and RA?

Answer 4

Osteoarthritis:
“A pathology of articular or hyaline cartilage, eventually affecting joint structure and function” - if you damage the hyaline cartilage you eventually impact structure and fucntion

Rheumatoid arthritis
“A multi-system inflammatory disorder with persistent synovitis eventually affecting joint structure and function” - key words, persistent synovitis, inflammatory etc