1.8 Medical Imaging & Diseases of the Bones & Joints
Understand the main features of the major diseases that affect the bones and joints and their treatments
Understand the main features of the major diseases that affect the bones and joints and their treatments
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Cartes-fiches
Give three clinical manifestations of CDH.
(Congential Dislocation of the Hip)
- Limited abduction of the flexed hip due to shortening and contracture of hip adductors
- Increase in the depth or asymmetry of thigh skin folds
- Shortening of on leg
- Waddling gait
What factors play a part in influencing the inidence of CDH?
Genetic factors
Briefly explain how CDH should be treated
At birth?
splint or harness hold the hips abducted and flexed worn for 12 weeks
Briefly explain how CDH should be treated
At two months?
traction and plaster immobilisation
Briefly explain how CDH should be treated
At 12-18 months?
series of operations
Briefly explain how CDH should be treated
In later life?
may surgery (total hip arthroplasty) if indicated
How is coxa vara defined?
Femoral neck shaft angle less than 120°
Give an example of how coxa vara may be "acquired"?
- Femoral neck bend, soft or breaks
- tuberculosis or pyogenic infection
- Fractures
Who is most usually affected by SCFE?
Slipped Capital Femoral Epiphysis
Boys often overweight
Why does the osteomyelitis organism usually settle in the metaphysis, particularly of the proimal femur?
arrangement and shape of the blood vessels in this area is particularly suitable to bacterial colonisation
What is rheumatoid arthritis?
Who is more likely to be affected by RA?
three times as common in women as in men
How is RA best described?
Chronic inflammatory joint disease
Which areas are mainly affected by ankylosing spondylitis SA?
mainly in the spine and sacroiliac
What is osteoarthritis?
Who is most likely to be affected by OA?
Women (3:1)
Give three examples of factors that may cause OA.
- Genetic predisposition
- Metabolic and hormonal influences on cartilage
- Patterns of joint usage
- Local mechanical stresses
- Pre-existing joint disease
- Specific incidents of cartilage damage
What is the name given to the bony outgrowths seen at the edges of joints affected by OA?
Osteophytes
which is often thought to be the most distressing symptom of osteoarthritis
Loss of function
Give a common site for avascular/aseptic necrosis.
- Femoral Head / Neck
- Scaphoid (Handknochen)
- Head of Talus (Sprungbein)
When is there an increased likelihood (Wahrscheinlichkeit) of avascular necrosis?
When blood supply to bone is interrupted
What is gout?
Disorder of the metabolism characterised by an excess of copper in the blood. deposition of urate crystals in the synovium of the joints.
(Gicht)
Give three risk factors that render people more susceptible to osteoporosis.
- Family history of osteoporosis
- Premature menopause
- Early hysterectomy
- Cigarette smoking
- Alcohol abuse
What are the main characteristics of Paget's disease?
enlargement and thickening of the bone, but the internal architecture is abnormal and the bone is unusually brittle (spöde).
What is the average age of patients affected with Perthes disease?
4-8 years old
Tumours can be divided into two main categories:
- Benign
- Malignant
What are the two types of chondroma?
- Ecchondroma (outwards the bone)
- Enchondroma (inside the bone)
Which is the most common benign tumour of bone?
Osteochondroma
Occurrence of osteosarcoma in adults is usually a complication of which disease?
disease (osteitis deformans)
Where is myeloma usualy found?
Wherever red marrow occurs:
- trunk bones
- skull
- proximal ends of the humerus
- proximal ends of the femur
Which five carcinomas are most likely to metastasise to bone?
- lungs
- breast
- prostate
- thyroid
- kidney
What are the three causes of fractures?
- single traumatic incident
- repetitive stress
- abnormal weakening of the bone
What are the two classical ways of classifying bone?
- simple fracture
- compound fracture (open wound)
Briefly describe a "greenstick" fracture.
does not snap cleanly but bends so that one cortex buckles while the other remains.
