Other Codnitions

Question 1

Fibromyalgia clinical findings and diagnosis

Answer 1

Diffuse tenderness and at least 11 of 18 tender trigger points
Normal blood tests and imagining

Clinical diagnosis

Question 2

Fibromyalgia typical presentation

Answer 2

More often women
Peak 40-50 but can be 20-60
Chronic widespread pain longer than 3 months
Pain in back, neck and everywhere

Worsened with cold weather, stress, activities

Morning stiffness , fatigue, sleep problems, anxiety, depression, mood / memory difficulties

Headaches, abdominal pains, urinary frequency and hands + feet paresthesia

Question 3

What is infectious septic arthritis

Answer 3

Spread of bacteremia, periarticular osteomyelitis, infection due to diagnostic or therapeutic procedure or Fromm infection elsewhere

Question 4

Which joints do septic arthritis usually involve

Answer 4

Monoarthitis

Usually knee, hip, shoulder, ankle, wrist

Question 5

Which infections commonly cause septic arthritis

Answer 5

In children - Staph or strep
In sexually active adults - neisseria gonorrhoea

Question 6

Symptoms of septic arthritis

Answer 6

Hot joint, acute swelling/effusion, pain, tender on palpating and restricted ROM

Systemically unwell with fever

Question 7

Diagnosis and treatment for septic arthritis

Answer 7

Aspirate native joint for culture and gram stain to start correct antiobiotic

IV antibiotics (vancomycin) and ortho referral

Question 8

What is osteomyelitis

Answer 8

Inflammatory condition of bone caused by infecting organism usually staphylococcus aureus

Question 9

Presentation of osteomyelitis

Answer 9

Involves single bone

Non specific pain
Fever
Malaise and fatigue
Inflammation
Swelling

Other possible factors:
History of penetrating injuries
Intravenous drug misuse
Diabetes
HIV infection
Surgical contamination
Peridontitis

Question 10

Investigations and treatment for osteomyelitis

Answer 10

WBC, CRP, ESR, x ray (to look for osteopenia and bone destruction)

High dose antibiotics

Can cause dead bone after few weeks if it recurs

Question 11

What is compartment syndrome

Answer 11

EMERGENCY

Elevated interstitial pressure in closed osteofascial compartment that causes restriction of capillary blood flow and if not treated causes tissue death

Question 12

Symptoms and risk factors of compartment syndrome

Answer 12

Pain, pallor, paresthesia, pulseless, poikilothermia, paralysis

RF:
History of trauma, bleeding disorders, thermal injury, IV infusion, venous obstruction and sports

Question 13

Investigations and treatment for compartment disorders

Answer 13

Tissue pressure measurements
CK (creatinine kinase)elevation - muscle breakdown/ damage due to pressure
Urine myoglobin elevated - also muscle damage sign

To: immediate fasciatomy and release pressure