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Pictorial lesson in MSK
H Lord
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History What will you ask?
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History Acute / chronic
Current symptoms: pain, stiffness, swelling, distribution of jts Other systems involved Impact on pt’s life
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Examination What will you examine and how?
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Examination Introduce
Inspect – symmetry, skin changes, nails, muscle bulk, swelling Feel – temperature, swellings ( boney, fluctuant, tender, rubbery,) Move – actively, passively, ROM Assess jt function – arm raising, eating, gait, etc
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What hand deformities do you know?
OA RA Other arthropathies?
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Heberden’s nodes
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Bouchard’s nodes
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Node?
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X ray appearance
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What type of arthritis?
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RA – list the deformities
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RA
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Arthritis? Psoriatic arthrits
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Psoriatic arthritis
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Describe this knee
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X ray correlation
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Charcot’s arthropathy
Type 1 or 2 DM diabetic neuropathy is always present and quite severe. Typically, the foot suddenly becomes very swollen and warm to touch . The patient can recall no history of trauma or only a very minor episode (eg. twisted the ankle a few weeks ago). The first clue to the diagnosis is the disproportionate lack of pain. The second clue is the slowness of recovery. (i.e the swelling does not go away). X-ray at this stage may be normal or show a minor fracture but may already show quite gross bone destruction.
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What other Dx might this pt have
HPOA – Lung CA
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Otherwise known as?
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