Musculoskeletal System Disorders Quiz

Bones & Joints - Learning Objectives

• Disorders of bones, cartilage, and joints are a significant clinical and socioeconomic problem, impacting all ages, especially with increasing age and obesity.
• Connective tissues are defined and classified.
• The cells of connective tissues are described.
• Components of the extracellular matrix (ECM) are described, along with their cellular functions and interplay in forming tissues.

Disorders of the Musculoskeletal System

• Rheumatic diseases cover a broad spectrum, affecting connective tissues, bones, and joints.

  • "Arthritis" is used broadly, often encompassing all joint issues, including inflammation.
  • "Rheumatism" is a less precise term, often used for muscle, bone, or joint pain.
  • "-itis" denotes inflammation; not all joint conditions are inflammatory (e.g., -osis, like osteoporosis).

• Disorders span all life stages:

  • Young: growth disorders
  • Middle age: injury/trauma
  • Older age: osteoarthritis (OA), rheumatoid arthritis (RA), osteoporosis (OP)

• Developmental deformities: Issues like bowlegs might arise from asymmetrical growth.

• Septic arthritis: Infection of the joint is a condition, sometimes occurring in the elbow.

• Leg-length discrepancy: A difference in the length of legs that might require attention.

• Important medical conditions: Increasing data indicates a higher incidence of certain issues, like rickets in children, similar to historical epidemics like 17th century England.

• Arthritis Risk Factor: Middle-aged "exercise addicts" might encounter higher risk for arthritis with running or jumping, potentially more than swimming or cycling.

• High Heels and Arthritis: A correlation exists between wearing high heels and an increased risk of arthritis.

• Treatment Cost: The cost of treating musculoskeletal problems to the NHS is significant (e.g. £1.7B annually for hip fractures).

• Multi-morbidity Issues: About one in five working-age adults have a musculoskeletal condition making them more susceptible to multiple co-occurring disorders.

Long-Term Drug Treatment and Problems

• Many musculoskeletal disorders are chronic and typically treated with long-term medications like NSAIDs.
• NSAIDs (e.g., VIOXX) reduce inflammation and pain but might increase the risk of heart issues.
• Long-term use of NSAIDs and corticosteroids can lead to bone loss and complications with treatments like bisphosphonates.
• The efficacy of current treatments is compromised and needs improvement.

Population Aging and Arthritis

• Population aging on a global scale is a critical issue and a major concern, specifically for the NHS.
• The number of people over 65 and 85 is dramatically increasing.
• Healthcare costs will dramatically increase due to this issue.
• A significant portion of those affected may not be able to afford proper care.
• Public awareness for health maintenance needs improvement.

Frightening UK Statistics

• Arthritis is a leading cause for chronic pain and physical disability. High multi-morbidity often coincides with a higher risk of death.
• A substantial number of individuals consult GPs yearly for arthritis issues, representing a major health concern.
• A significant portion of those affected lose employment due to chronic illness.
• Pain and associated difficulties are substantial concerns.
• Many are unaware of support resources and the extent of healthcare support they are eligible for.

Cost to the Nation (UK)

• Musculoskeletal (MSK) conditions account for a large portion of the NHS budget, including:
  • Costs associated with sickness absence and worklessness.
  • Drug treatment.
  • Consultations with GPs.
  • Hospitalizations.

Co-morbidity and Multimorbidity

• Co-occurring conditions (e.g., diabetes, heart disease) are increasingly common with musculoskeletal issues impacting quality of life and health span.
• Musculoskeletal (MSK) conditions are frequently associated with other conditions and problems.
• Musculoskeletal conditions are a significant cause of lost healthy years.
• Chronic pain or restricted mobility can impact various body systems (e.g., respiratory or cardiovascular).

Osteoarthritis (OA)

• One of the most common sources of debilitating pain.
• Significant pain and difficulty in performing daily tasks is often the result.
• It is mostly seen among the elderly population.
• Several factors are involved (e.g., genetics, injury).
• A high prevalence in women (2:1 ratio). X-rays reveal cartilage loss, a common symptom in older individuals.

Direct, Indirect, and Intangible OA Costs

• Direct costs encompass things like surgery and medical treatment.
• Indirect costs include loss of productivity.
• Intangible costs include pain and suffering, and decreased quality of life.

Bone Development - Endochondral Ossification

• Bone forms as cartilage first.
• Blood vessels invade the cartilage.
• Cartilage remains in the growth plate during development.

Cell Biology of the Growth Plate

• This provides details on cartilage and bone development through the growth plate and the cellular mechanisms.

Model of Growth Plate Hypertrophy

• Programmed cell death (apoptosis) is crucial for proper bone growth.

Leg Length Discrepancy in Children

• Differences in leg lengths are a medical condition that needs to be addressed.

Epiphyseodesis

• This is a treatment method to address growth plate problems.

Harris Growth Arrest Lines

• Lines appearing on x-rays indicate growth plate interruption arising from factors including nutritional deficiencies.

Idiopathic Scoliosis

• A condition involving abnormal curvature of the spine often occurring in the back, affecting posture and overall health.

The Ilizarov Technique

• A surgical treatment for specific bone conditions, particularly Paget's disease.

Meniscal Injuries

• Damage to the meniscus in the knee joint often necessitates treatment.

Osteoporosis

• A condition affecting bone density, increasing the risk of fractures due to falls.

Rheumatoid Arthritis

• Inflammatory autoimmune disease, involving immune system attack on synovial cells.
  • Affects joints, potentially impacting other organ systems (e.g., heart and lungs).

Dry Eye and RA

• This demonstrates the systemic impact of diseases by explaining the correlation between rheumatoid arthritis and dry eyes.

Connective Tissue Properties

• Discusses the composition of connective tissues, specifically focusing on various components and factors involved in their repair or functional properties/processes.