MSK Medicine Flashcards

(31 cards)

1
Q

What is a screening assessment used for MSK presentation?

A

GALS screen
-Gait
-Arms
-Legs
-Spine

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2
Q

What is synovitis?

A

Inflammation of a synovial membrane

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3
Q

What are some common causes of synovitis?

A

RA
Gout
Sometimes OA when degeneration causes inflammation

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4
Q

How does synovitis present?

A

Swelling
Pain
Warmth

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5
Q

Define stiffness

A

Slowness or difficulty moving one or more joints

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6
Q

What conditions feature early morning stiffness?

A

Inflammatory arthritis:
-RA
-Psoriatic Arthritis
-Ankylosing spondylitis
-Gout and pseudogout

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7
Q

What problem is indicated when active movement is painful/limited but has full range of passive movement?

A

Problem with the muscles and tendons as they are functioning in active but not passive movement

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8
Q

What is the WHO pain ladder?

A

For acute pain
Stepwise approach to analgesia, NSAIDs and stronger analgesia

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9
Q

What is the problem with using WHO ladder for chronic MSK pain?

A

Risk of side effects with prolonged use
Risk of addiction
Risk of neglecting non-pharmacological options e.g. physiotherapy

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10
Q

What are ‘mechanical’ symptoms of the knee?

A

Locking or catching of the knee on movement

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11
Q

What is bursitis?

A

Inflammation of bursa (fluid filled sacs that surround joints to reduce friction)

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12
Q

What is a joint effusion?

A

Swelling due to excess synovial fluid in joint capsule

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13
Q

How can you differentiate between bursitis and a joint effusion?

A

In an effusion, fluid can be moved across joint but bursitis the swelling is localised to bursa affected

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14
Q

What is lateral hip pain suggestive of?

A

Trochanteric bursitis

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15
Q

What is anterior hip pain suggestive of?

A

‘true’ hip pain e.g. osteoarthritis

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16
Q

What is posterior/posterolateral hip pain suggestive of?

A

Lumbosacral spine or gluteal muscle issue

17
Q

What are some clinical features of plantar fasciitis?

A

-pain at insertion of plantar fascia into calcaneum
-occurs in people who spend lots of time on feet
-pain is marked with first few steps on getting out of bed
-worsens again at end of day

18
Q

What is metatarsalgia?

A

Pain in mid foot

One cause is Mortons neuroma - tenderness in inter-digital space where neuroma is located

19
Q

What is gout?

A

Form of inflammatory arthritis due to Uric acids crystal deposition in joint

20
Q

What joint is most commonly affected by gout?

21
Q

How does gout present?

A

Rapid onset of severe pain, swelling and joint inflammation (warm)

22
Q

What treatment is used to prevent gout?

A

Allopurinol - lowers urate levels in blood

23
Q

How is acute gout managed?

A

-Analgesia
-NSAIDs
-Steriods if NSAIDs aren’t working
-rest

24
Q

What is radicular back pain?

A

Pain caused by irritation or impingement of a nerve root
Felt in a dermatomal pattern

Pain described as shooting or numb
May be other neurological symptoms e.g. weakness

25
What is painful arc?
Pain in mid range (45-120degrees) of abduction of shoulder Eases at greater range of abduction
26
What does painful arc indicate?
Impingement do the shoulder in the sub-acromial space with movement E.g. catching of rotator cuff tendons or shoulder bursae Pain more pronounced on active movement
27
What other conditions can present with shoulder pain?
-Referred pain from neck -Cardiac -MI, angina -Lung -Pancoast tumour -Diaphragmatic pain - right shoulder pain from liver enlargement -Polymyalgia rheumatica (bilateral)
28
How does the appearance of OA and RA differ in the hands?
OA- heberdens nodes (distal IP joints), Bouchards nodes (proximal IP joints) RA: acute- proximal IP, MCP and wrist affected Chronic- ulnar deviation, swan neck and boutonnière deformity
29
What is tennis Elbow?
Lateral epicondylitis Pain in lateral elbow Tenderness over common extensor origin
30
What is golfers elbow?
Medial epicondylitis Pain in medial elbow Tenderness over common flexor origin
31
What is olecranon bursitis?
Inflammation of olecranon bursae Non painful swelling over olecranon process of elbow