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Questions and Answers
What is the primary component of the cartilage found in joints?
What is the primary component of the cartilage found in joints?
What is NOT a cause of secondary osteoarthritis?
What is NOT a cause of secondary osteoarthritis?
Which of the following is a clinical feature of osteoarthritis?
Which of the following is a clinical feature of osteoarthritis?
What is a common radiographic feature of osteoarthritis?
What is a common radiographic feature of osteoarthritis?
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Which treatment is generally NOT used for osteoarthritis management?
Which treatment is generally NOT used for osteoarthritis management?
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What does the synovium primarily produce?
What does the synovium primarily produce?
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What is a common treatment for rheumatoid arthritis?
What is a common treatment for rheumatoid arthritis?
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Which type of joint is primarily affected by rheumatoid arthritis?
Which type of joint is primarily affected by rheumatoid arthritis?
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Which type of cerebral palsy is characterized by upper motor neuron involvement and increased tone?
Which type of cerebral palsy is characterized by upper motor neuron involvement and increased tone?
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What is a common consequence of muscle imbalance in individuals with cerebral palsy?
What is a common consequence of muscle imbalance in individuals with cerebral palsy?
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Which treatment method involves the use of botulinum A toxin injections?
Which treatment method involves the use of botulinum A toxin injections?
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What is a significant risk associated with hip joint involvement in cerebral palsy?
What is a significant risk associated with hip joint involvement in cerebral palsy?
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Which anatomical structure is primarily associated with osteoarthritis?
Which anatomical structure is primarily associated with osteoarthritis?
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What is the primary function of synovial fluid?
What is the primary function of synovial fluid?
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What characterizes septic arthritis?
What characterizes septic arthritis?
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Which of the following is NOT typically used in the management of gout?
Which of the following is NOT typically used in the management of gout?
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Which condition is characterized by bi-refingent crystals in synovial fluid?
Which condition is characterized by bi-refingent crystals in synovial fluid?
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What is a common cause of bursitis?
What is a common cause of bursitis?
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What is the primary role of ligaments in the joints?
What is the primary role of ligaments in the joints?
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In the context of meniscus and labrum, what is their primary function?
In the context of meniscus and labrum, what is their primary function?
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What is an important distinction when diagnosing gout?
What is an important distinction when diagnosing gout?
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Study Notes
Pathology of Joints
- The aims of this module are to understand the anatomical features of a typical joint, key pathologies at each anatomical part, management principles, and the scope of musculoskeletal medicine.
- A typical joint has cartilage, synovium, synovial fluid, bursa, ligaments/menisci, tendons/muscles, and bone.
- Cartilage is hyaline cartilage, composed of type 2 collagen and chondroitin polysaccharide, with a firm gel-like structure. It lacks blood supply, making it slow to repair. Degeneration leads to osteoarthritis.
- Osteoarthritis can be primary (genetic) or secondary (common sequelae of other joint pathologies, trauma, infection, dysplasia, or inflammation).
- Clinical features of osteoarthritis include post-exercise stiffness, joint pain and tenderness, crepitus, bony swelling, angulation deformities, and functional impairment. Synovial fluid is non-inflammatory.
- Radiographic features of osteoarthritis include osteophytes, joint space narrowing, subchondral cysts and sclerosis, and malalignment.
- Histological features of osteoarthritis show osteophytes, joint space narrowing, subchondral cysts and sclerosis, and an absence of inflammatory tissue.
- OA management usually involves slow and irreversible treatments, including analgesics, NSAIDs, activity modification, mobility aids, and glucosamine sulphate. Possible further treatment includes arthroplasty.
- Arthroplasty, such as low frictional-torque arthoplasty, involves joint replacement with metal/ceramic/polyethylene/PMMA components.
- Synovium, the innermost part of the joint capsule, is highly vascular and lacks connective tissue. It produces synovial fluid that nourishes avascular cartilage.
- Excessive synovial fluid, known as effusion, is easily visible in subcutaneous joints.
- Septic arthritis is a medical emergency with risk of post-infective arthritis. Differential diagnosis includes inflammatory arthritis and gout.
- Investigations include WBC and CRP, with fluid aspiration and analysis.
- Management includes urgent gram stain (usually gram-positive cocci), IV antibiotics, and arthroscopic washout.
- Gout is characterized by abrupt onset of severe joint inflammation, often at night, commonly in the first metatarsophalangeal joint (MTP). It usually subsides in 3-10 days. Urate crystals are present in the synovial fluid and hyperuricemia may be present. Treatment includes excluding infection, NSAIDs, colchicine, and allopurinol.
- Bursitis is inflammation of a bursa, a lubricating cushion around a joint that allows skin/tendons to move freely. Repetitive use can cause bursitis.
- Housemaid's knee (pre-patellar bursitis) and student's elbow (olecranon bursitis) are common examples. Management typically involves activity modification (rest, knee pads), NSAIDs/analgesics, antibiotics if infected, and surgical debridement.
- Ligaments are tough collagen tissues that connect bones to bones, providing dynamic stability to all joints, preventing dislocation/subluxation. More mobile joints rely more on ligaments. Weight-bearing joints are more likely to fail.
- ACL rupture occurs when twisting forces stress the joint, resulting in injuries. Repairs are possible.
- Menisci/Labrum are thickened fibrocartilage, adding stability and distributing load.
- Shoulder dislocation needs closed reduction. Bankart lesion is injury to the lower part of the labrum.
- Muscles and tendons enable joint movement and locomotion. Muscle imbalance causes stiffness, contractures, and subluxation.
- Cerebral palsy is a non-progressive neuromuscular disorder with onset before 2 years of age. Etiology includes perinatal infection, anoxia, prematurity, and head injury. Joint contractures can affect cartilage or cause joint dysplasia. Classifications include spastic (70%), dyskinetic (20%), and ataxic (10%) types.
- Hip joint problems include excessive contractures in the quadriceps and adductors, progressive subluxation, and posterior dislocations. Developmental dysplasia (valgus neck, shallow acetabulum) can affect the hip joint. Management includes bracing, serial casting, physiotherapy to maintain ROM, botulinum Atoxin injection, adductor tendon release, and femoral/acetabulum osteotomy.
- Bones are structural elements in the musculoskeletal system.
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Description
Test your understanding of joint anatomy, pathologies, and management principles in musculoskeletal medicine. This quiz covers key topics like osteoarthritis, its clinical features, and radiographic signs, providing a comprehensive overview of joint pathology. Assess your knowledge and prepare for advanced studies in pathology.
