Msk- Red Flags, Common Orthopaedic Procedures Flashcards
(46 cards)
What are the red flag pathologies related to MSK focus?
- Myelopathy
- Cervical arterial dysfunction (CAD)
- Malignancy
- Systemic inflammatory disorders
- Deep vein thrombosis
- Infections
- Fractures
- Cauda equina syndrome (CES)
These conditions require urgent attention due to their serious nature.
Define myelopathy
A term used to describe any neurological deficit related to the spinal cord.
Usually due to compression of the spinal cord.
What are common symptoms of myelopathy?
- Muscle weakness
- Altered muscle tones
- Sensory loss (in trunk and legs)
- Spasticity
- Impaired coordination
- Gait disturbances
- Spinal pain
- Urinary disturbances
Symptoms can vary based on the level of spinal cord involvement.
What is cervical artery dysfunction (CAD)?
An umbrella term covering a range of vascular pathologies that may lead to cervico-cranial ischaemia.
It includes all known vascular pathologies and anatomical structures that may be compromised by movement or manual therapy.
List some risk factors for cervical artery dysfunction (CAD).
- Previous trauma to Cx spine
- Migraine type headaches
- Hypertension (HTN)
- High cholesterol
- Cardiac disease / vascular disease
- Diabetes
- Blood clotting disorders
- Anti-coagulant therapy
- Long term use of steroids
- History of smoking
- Recent infection
- Immediately post-partum
- Absence of plausible mechanical explanation of symptoms
These factors can increase the risk of CAD.
What characterizes malignancy?
Cancer occurs when normal cells change to divide and grow uncontrollably, forming malignant tumors.
Most cancers start as a primary tumor and can spread to other parts of the body.
What is metastatic spinal cord compression (MSCC)?
An oncological emergency requiring precise assessment of symptoms, urgent investigation, and immediate treatment.
If not caught early, MSCC can lead to permanent paralysis.
What are some general signs and symptoms of MSCC?
- Non-mechanical pain
- Constant pain
- Unexplained weight loss
- General fatigue or feeling unwell
- Previous history of cancer
- Night sweats
- Unusual lumps/bumps/swelling
These symptoms warrant immediate medical evaluation.
What is deep vein thrombosis (DVT)?
A type of venous thrombosis involving the formation of a blood clot in deep veins, most commonly in the legs or pelvis.
DVT can lead to serious complications if not treated.
Define inflammation.
A biological response to stimuli interpreted by the body as potentially harmful, often resulting in chronic pain, redness, swelling, and stiffness.
Inflammation can be a normal response or an abnormal one as seen in inflammatory disorders.
What is rheumatoid arthritis (RA)?
A systemic autoimmune disease characterized by inflammatory arthritis with extra-articular involvement.
The synovium is infiltrated by immune cells leading to joint damage.
List some clinical presentations of rheumatoid arthritis.
- Polyarthritis of small joints of hands (PIP, MCP, RCJ)
- Insidious onset over months
- Joint stiffness in the morning
- Fatigue
- Deformity, pain, weakness, and restricted mobility in affected joints
If the cervical spine is involved, it can lead to cervical instability.
What are the management goals for rheumatoid arthritis?
- Symptom management
- Pharmacological management (DMARDs)
- Nutrition
- Physiotherapy
Early intervention can improve quality of life.
What constitutes an infection?
When a foreign organism enters the body or multiplies in a harmful way, leading to illness.
Bacteria, viruses, fungi, and parasites can all cause infections.
List some risk factors for infections.
- Taking steroids or immune-suppressing medications
- Having HIV or AIDS
- Certain types of cancer
- Open surgery
- Poor nutrition, stress, or lack of sleep
These factors can compromise immune function, increasing susceptibility to infections.
What are common signs and symptoms of infection?
- Fatigue
- Loss of appetite
- Weight loss
- Fevers
- Night sweats
- Chills
- Swelling
- Pus formation
- Increased temperature
Symptoms may vary based on the type of infection.
What are the risk factors for fractures?
- Age and gender
- Smoking
- Diabetes
- Alcohol
- Trauma
- Steroid use
These factors can significantly increase the likelihood of sustaining fractures.
What are some management options for fractures?
- None (e.g., most rib fractures)
- Sling (e.g., many clavicular fractures)
- Cast (many forearm fractures)
- Internal fixation (most hip fractures)
- External fixation
- Physiotherapy for rehabilitation
Treatment varies depending on the type and location of the fracture.
What is cauda equina syndrome (CES)?
A condition where the spinal cord terminates between the L1 and L2 vertebrae, leading to dysfunction of the cauda equina nerves.
These nerves are crucial for sphincter function and sensation in the lower limbs.
List some common causes of cauda equina syndrome.
- Herniated lumbar intervertebral disc
- Epidural abscess
- Spinal epidural hematoma
- Diskitis
- Tumors (either metastatic or primary)
- Trauma
Prompt diagnosis and treatment are essential to prevent permanent damage.
What are red flag signs and symptoms of cauda equina syndrome?
- Saddle anaesthesia
- Severe lower back pain with weakness or loss of sensation in legs
- Urinary retention or incontinence
- Faecal incontinence
These symptoms require immediate medical evaluation.
What is an elective procedure in orthopaedics?
A planned surgery that does not need to be performed immediately, such as joint replacements or ligament reconstructions.
Elective procedures are typically scheduled in advance.
What is a total hip replacement (THR)?
An orthopaedic surgery procedure that replaces an arthritic or dysfunctional hip joint surface with a prosthesis.
It is commonly performed under spinal anaesthetic.
What is hemarthroplasty?
A surgical procedure that involves replacing half of the hip joint, specifically the femoral head portion.
This procedure is less invasive than a total hip replacement.
