Upper limb arthritis Flashcards

1
Q

What are the different causes of upper limb arthrtiis?

A

Degenerate
Inflammatory (RA, psoriasis, gout)
Post-traumatic
Septic

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2
Q

How can steronoclavicular joint arthritis be treatead?

A

PT
Steroid injections
Exicion - very rare, dont do in tayside bc need CT surgeon

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3
Q

What movements are sore in ACJ arthritis?

A

Full abduction when arms are by ears

Scarf test

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4
Q

What is the treatemtn of ACJ arthritis?

A

Steroid injections

Excision - mumford procedure

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5
Q

What pathologies can occur around the glenohumeral joint?

A

Cuff tear
Instability
Previous surgery
Idiopathic

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6
Q

How will glenohumeral joint OA present?

A

Pain
Crepitus (grinding)
Loss of movement esp/ external rotation

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7
Q

What shoulder pathologies cause a loss of external rotation?

A

Locked posterior dislocation
OA
Frozen shoulder

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8
Q

What are the x-ray changes in glenohumeral OA?

A

Inferior osteophyte is very classical

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9
Q

What complications can arise due to a shoulder replacement?

A
Infection
Instability
Stiffness
Nerve damage (neuropraxia) 
Loosening
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10
Q

What will happen to the humerus if the rotator cuff tears?

A

Rotator cuff centres humeral head on glenoid so if torn the deltoid will pull the head upwards

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11
Q

What is a reverse geometry shoulder replacement?

A

Reverses ball and socket
Increases lever arm of deltoid and therefore lengthens deltoid
Resurfaces joint
Prevents upward migration

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12
Q

How does RA affect the elbow?

A

Erosion

Instability

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13
Q

How will OA affect the elbow joint?

A

Pain
Restriction of movement
Osteophytes
Can be radiocapitellar only

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14
Q

What can be done to treat radiocapitellar OA?

A

Excise

Replace

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15
Q

Compare OA to RA

A

OA: monoarticular, localised, osteophytes, early jt space narrowing, base of thumb, PIP + DIPs
RA: polyarticular, systemic, erosions, later joint space narrowing, synovitis, tendon rupture, MCP, carpus

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16
Q

What surgery can be done to help with RA?

A

Synovectomy
Tendon realingment
Replacement
Fusion

17
Q

What joint does well with arthrodesis?

A

Wrist

MCP

18
Q

What is the terry thomas sign?

A

Space between the scaphoid and lunate bones

19
Q

What pathology will show a terry thomas sign?

A

SLAC (scapholouante advanced collapse) wrist

20
Q

What is SNAC wrist?

A

Sacphoid nonunion advanced collapse

21
Q

How will OA affect the small joints of the hands?

A

DIPs common
Pain
Deformity
Heberden’s nodes

22
Q

How will OA affect the thumbs?

A

Trade-off of opposable thumbs and results in subluxation of CMCJ
Pain in pinch

23
Q

How will OA of the thumb look on examination?

A

Squaring of the hand

Compensatory hyperextension of the MCP joint

24
Q

How will psoriatic arthrtis present?

A

Inflammatory arthrtiis
Systemic symtpoms in skin, hair, nails
Affects hips, knees, hands and wrisits
Causes dactylitis

25
Q

What will psoriatic arthrtis look like on x-ray?

A

Pencil in cup

26
Q

What is a swan neck deformity?

A

Volar plate of PIP becomes attenuated
Hyperextension at PIP
Flexion at DIP

27
Q

What is a boutonniere deformity?

A

Extensor hood of PIP becomes attenuated

Flexion at PIP and hyperextension at DIP