Musculoskeletal

Question 1

What is fibromyalgia?

Answer 1

syndrome characterised by widespread pain throughout the body with tender points at specific anatomical sites - aetiology unknown

Question 2

Who is most likely to be affected by fibromyalgia?

Answer 2

women (5x more), 30-50yrs

Question 3

What sx are associated with fibromyalgia (other than pain)? (5)

Answer 3

• chronic fatigue
• cognitive impairment (“fibro fog”)
• sleep disturbances
• headaches
• dizziness

Question 4

How is fibromyalgia diagnosed?

Answer 4

clinically - sometimes refers to ACR classification criteria (if pt is tender in at least 11 of 18 tender points, dx is likely)

Question 5

3 components of fibromyalgia mx?

Answer 5

1. aerobic exercise (strongest evidence base so far)
2. CBT
3. pregabalin, duloxetine, amitriptyline

Question 6

What are bursae?

Answer 6

small, fluid-filled sacs that cushion the bones, tendons and muscles near joints (when these become inflamed = bursitis)

Question 7

What is the treatment for bursitis?

Answer 7

conservative - resting the affected joint, ice, analgesia

if persists possible abx, PT, exercises or injections

Question 8

What type of inflammation does reactive arthritis cause in the joints?

Answer 8

synovitis - it is a seronegative spondyloarthropathy

Question 9

What is the key difference between reactive arthritis and septic arthritis?

Answer 9

septic = infection inside the joint, majority will have fever

Question 10

What most often causes septic arthritis?

Answer 10

gastroenteritis or STIs (usually chlamydia)

Question 11

What is the classic triad associated with reactive arthritis?

Answer 11

conjunctivitis, urethritis, arthritis

can’t see, can’t pee, can’t climb a tree

Question 12

How is reactive arthritis managed?

Answer 12

there will be a local hot joint policy
- exclude septic arthritis !! abx can be given until septic arthritis is excluded
- joint aspiration
- treat triggering infection
- NSAIDs
- steroid injections