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Summary Locomotor Core Conditions
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A condensed summary of the locomotor core conditions for the Leeds MBChB year 3 syllabus
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LOCOMOTOR CORE CONDITIONS SUMMARYCondition Summary Epidemiology Pathophysiology Prognosis Aetiology Risk Factors S/S Investigations DDs Treatment Complications
Deposition of urate Hyperuricaemia
Spontaneous development Pseudo-gout;
crystals within a joint Painful, but Consumption of high- Arthrocentesis with Colchicine (acute);
from hyperuricaemia; urate Rapid-onset severe pain; joint septic arthritis;
(usually the hallux), self-limiting; 90% renal under- purine foods; diuretic use; synovial fluid allopurinol (chronic); Nephrolithiasis; acute
Gout causing attacks of M>F crystals in the joint interact high recurrence excretion and 10% haematological cancer; stiffness/swelling; tophi; analysis; uric acid trauma; RA; corticosteroids; uric acid nephropathy
with phagocytes and trigger erythema; calor reactive arthritis;
acute inflammatory if left untreated renal over-production HTN levels; joint X-ray NSAIDs
acute inflammation psoriatic arthritis
arthritis of urate
PT/OT; simple
Failure in maintenance of Functional decline
Joint pain/stiffness/swelling Bursitis; gout; analgesia; topical
Degenerative balance between cartilage Host of mechanical Obesity; physical/manual and inability to
Incidence increases Chronic, (commonly knees, hips, X-ray (LOSS); CRP;/ pseudo-gout; Diclofenac; NSAID;
Osteoarthritis mechanical and with age/use of joints matrix synthesis and degenerative and biological factors occupation; joint trauma; hands and lower spine); ESR; rheumatoid psoriatic arthritis; gastro-protection; perform ADLs; spinal
(OA) biological deterioration degradation, resulting in that culminate in the high bone mineral density; stenosis (C/L-spine);
M<F disease Heberden’s/Bouchard’s factor; anti-CCP RA; avascular opioids; surgery;
of bony joints reduced bone formation and development of OA low oestrogen status NSAID-related GI
nodes; functional difficulties necrosis intra-articular
increased catabolism bleeding; gout
corticosteroids
Osteoclasts resorb bone and Bone strength Prior fragility fracture;
Complex skeletal Multiple myeloma;
osteoblasts synthesise bone; Fractures determined by bone white; low BMI; alcohol; DEXA scan; X-ray; Bisphosphonates Hip, rib and wrist
disease, characterised White, post- Vertebral fractures (back pain, osteomalacia;
disruption in osteocyte minimised with mineral density, size/ smoking; immobilisation; serum calcium; TFT; (alendronic acid); fractures; jaw
Osteoporosis by low bone density menopausal women function (hormone-controlled) prophylactic shape of bone, bone calcium/vitamin D- kyphosis); pain and swelling creatinine; vitamin D; CKD; PHPT; calcium/vitamin D necrosis associated
and micro-architectural M<F at the fracture site metastatic bone
results in poor bone treatments turnover, micro- deficiency; corticosteroid phosphate; PTH supplementation with bisphosphonates
defects malignancy
remodelling architecture use; hyperthyroidism
Herniation of nucleus Degenerative changes follow Sprain/strain;
pulposus (inner, softer) L-spine most a loss of hydration of the Pain (exacerbated by activity spinal tumour/ Rest (if severe pain);
Prolapsed Degenerative disc
through a weakness in commonly affected, nucleus pulposus and leads Occupation; smoking; and relieved by rest); radicular infection; postural stay active (if non- Surgery-related spinal
Good disease; spinal MRI/CT spine
disc the annulus fibrosus followed by C-spine to a cascade of cellular obesity leg pain; problems bending/ back pain; intra- severe pain); simple cord compression
trauma
(outer, harder) of an M>F events that may result in straightening the back abdominal analgesia; NSAIDs
intervertebral disc prolapse of a disc pathology
Hands (Z-/swan neck/
Inflamed synovium is central Patient education;
Boutonniere deformity, ulnar
to pathogenesis - it shows glucocorticoids;
Rheumatoid Chronic, autoimmune
increased angiogenesis,
Good if patient
Unknown; type II
deviation, Raynaud’s); other
Psoriatic arthritis; DMARDS Work disability; CAD;
type II hypersensitivity Adult on diagnosis is treated Genetic predisposition; (carpal tunnel, rheumatoid ESR/CRP; RF; anti-
arthritis reaction that principally M≤F cellular hyperplasia, and an aggressively hypersensitivity smoking nodules, atherosclerosis, CCP; X-ray infectious arthritis; (methotrexate); increased mortality;
influx of inflammatory cells reaction gout; SLE; OA NSAIDs; joint Carpal tunnel
(RA) affects the joints
and cytokines; high levels of
and early pulmonary fibrosis,
replacement
osteoporosis, morning
metalloproteinases arthroplasty
stiffness, digit subluxation)
Increase incidence in Delayed or OA/RA; gout/
Infection of one or Bacterial virulence factors as Underlying joint disease; Synovial fluid Gram Abx-associated
patients with inadequate Staphylococcus pseudo-gout;
Septic more joint caused by underlying joint well as the immunological treatment can spp.; Streptococcus
joint prosthesis; IVDU; Hot, swollen, tender, stain and culture; haemarthritis; Joint aspiration; allergic reaction;
arthritis haematogenous or host response determines alcohol; DM; previous joint restricted joint with fever blood culture; WCC; IV Abx osteomyelitis; joint
disease/prosthetic lead to joint spp. trauma; bursitis;
direct infection disease development infection; ulceration CRP/ESR destruction
joints destruction cellulitis
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