presentation osteogenesis imperfecta
- growth deficiency
- defective tooth formation
- hearing loss
- blue sclera
- scoliosis
- barrel chest
- ligamentous laxity
- hyper mobility
- easy bruising
presentation osteomalacia
- weak
- fall over a lot
- find it difficult to get out of their chair
- small fracture @ ends of long bones
presentation rickets
- bandy legs when a child starts walking
- soft bone bends
treatment of symptomatic pagets disease
IV bisphosphonate therapy
one off zoledronic acid
how do bisphosphonates work
absorbed onto hydroxyapatite crystals in bone, slowing both their rate of growth and dissolution, and therefore reducing the rate of bone turnover
management enteropathic arthritis
- sulfasalazine
- steroids
- methotrexate
- anti-TNF
- bowel resection
acute treatment reactive arthritis
NSAIDs
joint injection
antibiotics if chlamydia primary
bacteria most commonly associated with endocarditis
staph aureus
strep viridians
what is juvenile idiopathic arthritis
group of systemic inflammatory disorders affecting children <16 years
presentation cavovarus foot
- shoe problems
- clawing of toes
- ankle instability
- altered gait
- stress fractures of lateral metatarsals
- upward and inward curving of foot
what is tarsal coalitions
abnormal connecting bridge between 2 normally separate tarsal bones
fibrous or osseus tissue
if ulnar nerve is not working properly, what will a patient do to compensate
use flexor pollicis longs (median) instead of adductor pollicus (ulnar)
presentation ulnar claw hand
MCPJ in hyper extension
IPJs in flexion
which nerve(S) supplies elbow joint
median, musculocutaneous and radial nerves anteriorly, and the ulnar nerve posteriorly
origin musculocutaneous nerve
C5,6,7
presentation Klumpkes palsy
affects small muscles of hand causing claw hand
presentation:
- shoulder adducted and internally rotated
- elbow extended and pronated
- wrist is flexed
Erbs palsy
loss of sensation in hand after being in handcuffs
radial nerve palsy @ wrist
what area of skin does the axillary nerve supply
regimental badge areas on lateral arm
typical presentation osteoporosis
- vertebral compression fractures
- kyphosis
- wrist fractures
medications which can cause osteoporosis
- steroids
- PPI
- enzyme inducing antiepileptic
- aromatase inhibitors
- GnRH inhibitors
- warfarin
GI causes osteoporosis
- coeliac
- IBD
- alcoholic cirrhosis
- chronic pancreatitis
- whipples disease
- short gut syndrome
- ischaemic bowel
