Erb-Duchenne Palsy (“Waiter’s Tip”)
Def’n, Pres?
Superior Trunk (C5-C6) Brachial Plexus injury.
PRES:
- “Neonate with ARM PARALYSIS following difficult birth”
“Fall on an outstretched hand”
Bone + Nerve damaged?
Hook of Hamate -> Ulnar nerve
Bone Disease
Enzyme↑?
Alkaline phosphatase
Skeletal Muscle Injury / Damage
Enzymes↑(2)?
- LD4 + LD5 (damage)
Carpal Tunnel Sx
Def’n, Pres (3)?
Entrapment of Median nerve in carpal tunnel -> nerve compression.
PRES:
Acute Carpal Tunnel Sx
Cause?
CAUSE = Dislocation of Lunate
Guyon Canal Sx
Def’n, Pres (Epi)?
Compression of Ulnar nerve at wrist / hand.
PRES: Cyclists
Tetany
Mech, Causes (Electrolytic)?
Activation of all nerve cells in body -> muscle overstimulation ->
muscle spasms + cramps.
CAUSES:
Muscular Dystrophy
Inher, Def’n, Pres?
XR.
XR deletion of dystrophin gene.
PRES:
- Calf pseudohypertrophy
Duchenne Muscular Dystrophy
Def’n, Inher, Genetics, Pres (2)?
Deletion of dystrophin gene.
XR.
Frameshift DNA mutation.
PRES:
Becker Muscular Dystrophy
** LESS severe than Duchenne **
Def’n, Inher, Pres (Epi + 1)?
Missense mutation in dystrophin gene.
XR.
PRES: Boys
- Slow, progressive muscle weakness
McArdle Disease
Def’n, Pres (5), Urine?
Muscle Glycogen Phosphorylase deficiency.
PRES:
URINE:
- Myoglobinuria
Achondroplasia
Mech (2 steps), Inher (2), Genetics, Pres (2)?
MECH:
Impaired chondrocyte / cartilage prolif in growth plate ->
Failure of Endochondral Ossification = longitudinal bone growth.
INHER:
FGFR3 Activating Mutation (-> overexpression -> growth inhib).
PRES:
McCune-Albright Sx (form of Polyostotic Fibrous Dyplasia)
Def’n, Assoc, Pres (2)?
Bone is replaced by fibroblasts, collagen and irregular bony trabeculae.
ASSOC:
- Precocious Puberty
PRES:
Osteoporosis
Def’n / Mech (3 steps), 2 Types, Comp (2), Prev (2), Rx (3), CI?
↓TRABECULAR bone mass / density / interconnections ->
Porous bone ->
↑risk of fracture + thin cartilage between vert.
COMP:
PREV:
RX:
CI:
- Glucocorticoids
Vertebral Crush Fractures
Def’n / Seen In, Pres (4: 3 + 1 sign)?
Possible comp of Osteoporosis.
PRES:
Paget’s Disease of Bone
Pres (6, incl Epi), Labs, Biopsy Finding, Comp (2)?
PRES: Avg age > 60
LABS:
- ALP ↑
FINDING:
- “Mosaic” / “Woven” pattern of lamellar bone
COMP:
Osteomyelitis
Pres (2)?
PRES:
Osteitis Fibrosa Cystica
Cause, Pres?
CAUSE = Hyperparathyroidism
PRES = “Brown tumors” (due to deposited hemosiderin from hem)
Giant Cell Tumor of Bone (Osteoclastoma)
Location, XR Finding?
Long bones (epiphysis): KNEE region- distal femur / proximal tibia.
XR FINDING:
- “Soap bubble” appearance on XR (lytic expansile lesion)
Ewing Sarcoma
Def’n, Locations (4), Genetics, Pres (Epi)?
Anaplastic malignant (aggressive with early metastases) small round / blue-cell tumor.
Long bones (diaphysis), Scapula, Ribs, Pelvis.
11;22 translocation.
PRES: Boys
Osteosarcoma
Assoc (6), Location, Pres (Epi), XR Findings (2 possible)?
ASSOC: (Predisposing factors)
Long bones (metaphysis). ** Often around KNEE **
PRES: Men 10-20
XR FINDING:
- “Codman’s Triangle” or “sunburst pattern”
Infectious Arthritis
2 Types?
- Chronic
Septic Infectious Arthritis
Causative Agents (3)?