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SMC
Osteomyelitis
Cause/Mechanism
Bone Infection
Assessment
Warmth
Edema
Constant Bone Pain
Fever
Interventions
IV Antibiotics
Implanted Beads
Hyperbaric Oxygen
Surgical Removal of Ischemic Tissue
Considerations
Elevated ESR
3 mins
Paget's Disease of Bone
Pathophysiology
Men > Age 40
Increased Osteoblast and Osteoclast activity
Mosaic Pattern
Signs and Symptoms
Increased Skull Diameter
Hearing Loss
Fractures
Bone Ache and Joint Pain
High Output Heart Failure
Diagnosis
Bone Scan
Normal Parathyroid hormone (PTH) and Calcium
Elevated ALP
Treatment
Bisphosphonate
Calcitonin
2 mins
Osteoporosis Interventions
Increased Calcium Intake
Vitamin D Supplements
Bisphosphonates
Raloxifene
Denosumab
Calcitonin
Teriparatide
Bone Densitometry (DEXA) Scan
Weight Bearing Exercises
2 mins
Osteoporosis Assessment
Highest Risk
Postmenopausal Women
Long Term Corticosteroids
Assessment
Kyphosis
Dowager's Hump
Loss of Height
Back Pain
Pathologic Fractures
Spinal Compression Fracture
1 min
Osteopetrosis (Marble Bone Disease)
Pathophysiology
Defective Osteoclast Resorption
Carbonic Anhydrase II Mutation
Lack of Acidic Environment
Symptoms
Fractures
Nerve Palsies
Diagnosis
Myelophthisic Anemia
Erlenmeyer Flask Bones
Normal ALP and PTH
Normal Calcium and Phosphorus
Bone-in-bone Appearance
Treatment
Bone Marrow Transplant
2 mins
Osteogenesis Imperfecta
Pathophysiology
Autosomal Dominant
Decreased Type I Collagen Production
Symptoms
Phenotypically Diverse
Brittle Bone Disease
Fractures from Minimal Trauma
Confused with Child Abuse
Hearing Loss
Dental Imperfections
Blue Sclera
1 min
Achondroplasia
Mechanism
Autosomal Dominant
Advanced Paternal Age
Most Common Cause of Dwarfism
Mutation of FGFR3 (Fibroblast Growth Factor Receptor 3)
Defective Endochondral Ossification
Symptoms
Delayed Motor Milestones
Shortened Limbs with Normal Axial Skeleton Size
May Develop Hydrocephalus
Symptoms of Spinal Stenosis
Normal Life Span and Fertility
2 mins
Ehlers-Danlos Syndrome Types
Types
Types 1 and 2 - Classical
Type V Collagen Mutation
Joints and Skin
Type 3 - Hypermobility
Most Common
Tenascin X Deficiency
Joint Instability
Type 4 - Vascular
Type III Collagen Mutation
Vascular and Organ Rupture
2 mins
Marfan Syndrome
Mechanism
Fibrillin-1 Mutation
Symptoms
Autosomal Dominant
Tall
Arachnodactyly
Pectus Excavatum
Hypermobile Joints
Aortic Aneurysm And Dissection
Mitral Valve Prolapse (MVP)
Subluxation of Lens (Superior)
2 mins
Osteoarthritis
Mechanism
Articular Cartilage Destruction
Biomechanical Stress
Aging
Signs and Symptoms
Asymmetric
Pain Decreases with Rest
Morning Stiffness Under 30 Minutes
Crepitus
DIP and PIP Joints
Treatment
Lifestyle Changes
Acetaminophen or NSAIDs
2 mins
Compartment Syndrome Assessment
Mechanism
Trauma
Increased Pressure
Compressed Nerves and Blood Vessels
Assessment
1 or more of 6 P's
Ankle-Brachial Index (ABI)
Considerations
May take Days to develop
Early Detection
Ischemia
Damage often Irreversible
2 mins
Herniated Disc (Nucleus Pulposus)
Cause/Mechanism
Spine Trauma
Natural Degeneration
Spinal Stenosis
Assessment
Pain
Weakness
Urinary and Fecal Incontinence
Interventions
Brace
Medications
Outpatient Procedures
Surgery
2 mins
Pseudogout
Pathophysiology
> 50 Years Old
Arthritis of Large Joints (Classically the Knee)
Calcium Pyrophosphate Crystals
Diagnosis
Positively Birefringent
Chondrocalcinosis (On X-ray)
Treatment
NSAIDs
Colchicine
Steroids
1 min
Gout Disease
Acute Inflammatory Monoarthritis
Epidemiology
Primarily in Males
Pathophysiology
Precipitation of Monosodium Urate Crystals
Underexcretion of Uric Acid
Overproduction of Uric Acid
Negatively Birefringent, Needle-Shaped
Symptoms
Swollen, Red, Painful Joint
Asymmetric Joint Distribution
Podagra
Tophus
After Large Meal or Alcohol
2 mins
Gout Treatment
Acute (Acute-angle)
NSAIDs
Glucocorticoids
Colchicine
Impairs Leukocyte Chemotaxis
Chronic Gout (Crone Goat)
Inhibit Xanthine Oxidase
Allopurinol
Febuxostat
Inhibit Reabsorption of Uric Acid
Probenecid
1 min
Myasthenia Gravis
Mechanism
Antibodies to Acetylcholine Receptor
Symptoms
Ptosis
Diplopia
Weakness with Muscle Use
Respiratory Death
Thymus Associated
Treatment
Acetylcholinesterase Inhibitors
Plasmapheresis
Thymectomy
1 min
Ankylosing Spondylitis
Chronic Inflammatory Arthritis
"Bamboo Spine"
HLA-B27
Uveitis
Aortic Regurgitation
1 min
HLA-B27 Associations
Associations
PAIR Acronym
Psoriatic Arthritis
Ankylosing Spondylitis
Inflammatory Bowel Disease
Reactive Arthritis
1 min
Acetylcholinesterase Inhibitor Poisoning
DUMBBELSS
Diarrhea
Urination
Miosis
Bronchospasm
Bradycardia
Emesis
Lacrimation
Salivation
Sweating
2 mins
Infectious Arthritis
Staphylococcus Aureus
Streptococcus
Neisseria gonorrhea
Gonococcal presents with migratory arthritis
Asymmetric
Tenosynovitis
Synovitis
Dermatitis
Tumor, rubor, calor, dolor
WBC>50,000
Glucose<50%
Complication: osteomyelitis
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