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Orthopaedics Notes

This is a sample of our (approximately) 16 page long Orthopaedics notes, which we sell as part of the Medicine and Surgery Notes collection, a === Other === package written at Peninsula Medical School in 2011 that contains (approximately) 121 pages of notes across 6 different documents.

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ORTHOPAEDICS Contents:

Gout Psoriatic arthritis Psuedogout Rheumatoid arthritis

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GOUT Summary Points


Gout is caused by the deposition of monosodium urate crystals in a joint


Patients present with acute, severely painful, swollen joint


Confirm with synovial fluid aspiration, as gout crystals are negatively birefringent under polarised light


Manage acute attacks with NSAIDs, and allopurinol for prophylaxis from future attacks Aetiology and Pathophysiology Gout is a condition whereby there is deposition of monosodium urate monohydrate crystals in joints causing inflammation and eventual tissue damage. It is one of the most acutely painful conditions known. They affect the joints of the upper and lower limbs. Types:

Primary 95% - acute attacks, genetic influence due to overproduction or underexcretion of uric acid Secondary 5% - usually due to chronic diuretic therapy/changes in uric acid metabolism

Further subdivided into:


Asymptomatic


Hyperuricaemic


Acute


Intercritical/chronic tophaceous Most patients with hyperuricaemia never develop gout and patients with gout do not need to have hyperuricaemia at the time of presentation. Crystals deposited in and around joint and can be found in synovial fluid Most cases are due to the undersecretion of uric acid.

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