Week 2 - Tony Sampson Flashcards
What is haemarthrosis?
Blood in the joint causing immediate and very painful swelling
What are the main landmarks of the knee?
Patella, patella tendon ACL, PCL Humerus Fibia and tibia The two collateral ligaments
How would knee movement change with an ACL rupture?
Knee specific movement may not change but you would be able to pull the tibia anteriorly much more than otherwise
How could you adjust your examination technique if a patient was in severe pain?
You could ask them to do the movements themselves (active), as opposed to passive movement
What are some of the effects of intra-articular steroid injection?
Reduction in pain and inflammation
What are some side effects of intra-articular steroid injection?
Infection at injection site (1:3000 - 1:50000)
Skin atrophy if any leaks occur
What are the actions of steroids?
Decrease macrophage expression of cytokines
Limit capillary dilation and permeability of vascular structures
Lowers release of vasoactive kinins
Inhibit release of arachidonic acid from phospholipids, reducing formation of prostaglandins
Where do you infect IACI?
At the anterolateral joint line
What are the steps of clean technique knee joint injection? (8)
- Obtain informed consent
- Explain procedure
- Prepare workspace
- Prepare patient
- Be adequately skilled/obtain supervision
- Have somewhere to dispose of sharps
- Post procedural advice
- Follow-up
What are components of informed consent for IACI?
What we are going to do, why we want to do it, risks, benefits, complications, expected costs, post-procedural care
What are three common biologics and how are they administered?
Etanercept - subcutaneous infection, 2 weekly
Infliximab - every 6 weeks, IV only
Adalimumab - Subcutaneous injection, 1 weekly
All need 2-8 degree storage
What should you do when someone presents with psoriatic arthritis?
Check for other spondyloarthropathies i.e. bowel involvement
Commence simple analgesics and NSAIDs
IACI if a single large joint is involved
