Osteonecrosis and Osteochondritis Quiz

Osteonecrosis, Osteochondritis, and Their Management

• Osteonecrosis is classified into six stages, ranging from normal radiographs to advanced degenerative changes.
• The Ficat and Arlet classification stages avascular necrosis of the femoral head based on radiographs, MRI, and clinical symptoms.
• Osteonecrosis most commonly affects weight-bearing joints like hips and knees, but can also affect non-weight-bearing joints like shoulders, hands, and feet, and rarely the jaw.
• Common causes of osteonecrosis include trauma, corticosteroid medications, excess alcohol consumption, and various medical conditions and treatments.
• Around 10,000 to 20,000 Americans aged 20-50 develop osteonecrosis each year, often due to a history of trauma, corticosteroid use, or other risk factors.
• Diagnosis of osteonecrosis involves X-rays, bone scans, and MRI, with bone pain being a key symptom.
• Management of osteonecrosis includes pain management, limiting weight-bearing, and, in advanced cases, surgical procedures such as core decompression, osteotomy, or joint replacement.
• There is no proven medical therapy for osteonecrosis, though short-term bisphosphonate treatment may slow or prevent bone collapse in the hip and knee.
• Prevention strategies for osteonecrosis include avoiding excessive alcohol consumption, tobacco use, and prolonged corticosteroid use.
• Living with osteonecrosis may involve developing osteoarthritis, and physical therapy and partial weight exercises can help manage pain and stiffness.
• Osteochondritis is an inflammatory condition affecting the cartilage and bone in joints, while osteochondritis dissecans involves the creation of a flap of cartilage that detaches from its underlying attachments.
• Osteochondritis dissecans can occur in various joints, such as the capitular head of the femur or the spinal vertebrae, in conditions like Scheuermann's disease.

Joint Conditions: Osteochondritis dissecans, Septic arthritis, Prosthetic joint infections, and HIV Surveillance

• Osteochondritis dissecans (OCD) is a condition where bone under joint cartilage dies due to lack of blood flow, causing pain and hindering joint motion, commonly affecting children and adolescents.
• Symptoms of OCD depend on the size of the injury and whether the fragment is detached, leading to pain, swelling, joint effusion, and decreased range of motion.
• The cause of OCD is unknown, but it may be related to reduced blood flow and genetic components, with high activity in sports being a risk factor.
• Septic arthritis involves joint inflammation due to an infectious agent, with symptoms including redness, heat, pain, fever, weakness, and headache, and it can occur due to bacteria, viruses, fungi, or parasites.
• Risk factors for septic arthritis include artificial joints, prior arthritis, diabetes, and poor immune function, and it can occur via blood, trauma, or infection around the joint.
• Septic arthritis is diagnosed through joint aspiration and culture, and initial treatment involves antibiotics and, in some cases, surgery to clean out the joint.
• Without early treatment, long-term joint problems may occur, and septic arthritis is more common in older people.
• Prosthetic joint infections occur in about 0.86-1.1% in knee joints and 0.3-1.7% in hip joints, with early, delayed, and late phases, and common bacteria involved are Staphylococcus aureus and others.
• The mode of infection for prosthetic joint infections can be through the bloodstream or direct penetration into the joint, and risk factors include age, diabetes, osteoarthritis, rheumatoid arthritis, immunosuppressive medication, and recent joint surgery.
• HIV surveillance in Hong Kong in 2016 reported 692 HIV cases and 111 AIDS cases, with 86.1% male, 73.0% Chinese, and a median age of 35, and common risk factors included homosexual/bisexual contact and heterosexual contact.
• The common HIV-1 subtypes were CRF01_AE and B, and the commonest primary AIDS defining illnesses were PCP (Angel Dust) and TB.
• HIV prevalence among blood donors was also mentioned.

Joint Conditions: Osteochondritis dissecans, Septic arthritis, Prosthetic joint infections, and HIV Surveillance

• Osteochondritis dissecans (OCD) is a condition where bone under joint cartilage dies due to lack of blood flow, causing pain and hindering joint motion, commonly affecting children and adolescents.
• Symptoms of OCD depend on the size of the injury and whether the fragment is detached, leading to pain, swelling, joint effusion, and decreased range of motion.
• The cause of OCD is unknown, but it may be related to reduced blood flow and genetic components, with high activity in sports being a risk factor.
• Septic arthritis involves joint inflammation due to an infectious agent, with symptoms including redness, heat, pain, fever, weakness, and headache, and it can occur due to bacteria, viruses, fungi, or parasites.
• Risk factors for septic arthritis include artificial joints, prior arthritis, diabetes, and poor immune function, and it can occur via blood, trauma, or infection around the joint.
• Septic arthritis is diagnosed through joint aspiration and culture, and initial treatment involves antibiotics and, in some cases, surgery to clean out the joint.
• Without early treatment, long-term joint problems may occur, and septic arthritis is more common in older people.
• Prosthetic joint infections occur in about 0.86-1.1% in knee joints and 0.3-1.7% in hip joints, with early, delayed, and late phases, and common bacteria involved are Staphylococcus aureus and others.
• The mode of infection for prosthetic joint infections can be through the bloodstream or direct penetration into the joint, and risk factors include age, diabetes, osteoarthritis, rheumatoid arthritis, immunosuppressive medication, and recent joint surgery.
• HIV surveillance in Hong Kong in 2016 reported 692 HIV cases and 111 AIDS cases, with 86.1% male, 73.0% Chinese, and a median age of 35, and common risk factors included homosexual/bisexual contact and heterosexual contact.
• The common HIV-1 subtypes were CRF01_AE and B, and the commonest primary AIDS defining illnesses were PCP (Angel Dust) and TB.
• HIV prevalence among blood donors was also mentioned.