ALL

(Medical Student
Education Series:Core
ABOUT
Orthopaedics)
 Types:
4 basic types

Osteo arthritis
Inflammatory arthritis
OA
Septic arthritis hip Rheumat
oid
hand

Septic hip. Crohn’s

dis.,20 yo,F.
 Causes
INFLAMMATION(WHATEVER CAUSE)
leads to destruction of ligaments,
ligaments and
joint surfaces by the inflammation
from
Infection,blood,gouty crystals,
abnormal loads
Gout
 Osteoarthritis(OA)
OA=loss
 OA is a loss of the articular
articular cartilage. Often cartilage;
the long term result of seen at
damage ( eg trauma).
 It maybe 1° or 2°.
 2° from abnormal cartilage
(e.g. ochronosis),abnormal
bone ( e.g. radionecrosis,AVN) Knee
or abnormal loads( eg replacement
deformity from childhood-
Perthe’s, SUFE, DDH and
Paget’s).
 The XR changes are loss of
joint space, sclerosis and
osteophytes.
 Ochronosis/alkaptonuria
(68F, pain and stiff knee)

2°
OA

Black staining
Black from of knee from xx
colouration
xx homogentisic
homogentisic acid
deposits
acid acid deposits into joint.
RADIONECROSIS. 64m
post- radiotherapy for
testicular Ca.
Needed THR.

SEGMENTALAVN post DERMATOMYOSITIS

sliding screw plate for 43 F with painful
#NOF. 35M. Needed THR. hip. 2° OA. Needed
THR.
 AVN hip
(42F,on steroids for pemphigus, to THR)

LARGE FLAP FLAP IS CARTILAGE &

HIP BONE

COLLAPSE OF
TH
SURFACE
WITH 2° OA R
LARGE HEAD, 2°OA, COARSE BROAD TRABECULAR, ACTIVE
TRABECULATION, OSTEOBLASTS, CEMENT LINES &
OSSIFICATION OF PSOAS. FIBROUS VASC. TISSUE.

Large head, 2°
OA,
TH
coarse trabeculae,
R
ossification psoas
 S
pistol-
UFE
grip
shape

2° OA as
adult.
Needed THR

SUFE, left side, Pin-in-situ; but still

as child went
onto 2°OA as adult
 Treatment
Osteoarthritis- wgt loss, NSAIDs,walking
aids,glucosamine, Surgery(Joint
replacement, other).
Inflammatory arthritis- anti-
inflammatory medication, soft tissue
surgery,joint replacement/fusion
Septic arthritis-antibiotics, wash out,
later joint replacement/fusion
Haemorrhagic arthritis-control of
bleeding, later on or joint
 Small print
JRA
SLE
Psoriasis
Crohn’s,Ulcerative Colitis
Sickle cell disease
See: ALL ABOUT ORTHOPAEDIC
INFECTIONS
&
ALL ABOUT ORTHOPAEDIC