Medical Malpractice Insurance for orthopaedic surgeons

Rheumatoid Arthritis

Discussion ARA criteria for RA pathogenesis differential diagnosis: spondyloarthropathies & related chronic seroneg arthritides; systemic lupus erythematosus; scleroderma; dermatomyositis; juvenile rheumatoid arthritis Clinical Aspects » Laboratory Aspects » Radiographic Aspects » Treatment of RA Medical Management of RA » Surgical Treatment cervical spine hand wrist elbow and shoulder: frequently there is concomitant shoulder and elbow … Read more

Psoriatic Arthritis

(see also: Spondyloarthropathies) Discussion psoriasis affects 1-2 % of U.S. population & typically presents w/ well-defined erythematous scaly plaques; only a minority of pts with psoriasis develop arthritis; when arthritis develops, it most often is an asymmetrical oligoarthritis, which at times may be quite destructive; some patients may develop spondylitis (usually will have HLA-B27 antigen); … Read more

Joint Friction and Lubrication

Discussion (see also synovial fluid) coefficient of friction for two surfaces can be thought of as degree of roughness that exists between two surfaces; where as solid friction is relatively independent of velocity of motion, fluid friction forces are sensitive to velocity & to lubricant film thickness; increase in joint velocity is not accompanied by … Read more

Pseudogout and Chondrocalcinosis

Discussion acute arthritis caused by CPPD crystal-induced inflammation; almost as common as gout & may perfectly mimic gout during acute flare; pseudogout attacks occurring before age 50 are uncommon; see: pseudogout occurence after joint replacement references: A histological study of calcium pyrophosphate dihydrate crystal-deposition disease. Clinical features of pseudogout attack. A survey of 50 cases. … Read more

Polyarthralgia in the Child

(See also: synovial fluid exam:) Def: child w/ 2 to 4 swollen, warm, & moderately painful or tender joints; Symmetric Involvement Polyarticular JRA. Asymmetry suggests JRA: Polyarticular/Pauciarticular Trauma Leukemia Tuberculosis Fungal infections Hemophilia Lyme Disease Acute Rheumatic Fever Septic Arthritis Child Abuse

Osteoarthritis

Discussion OA is defined as a chronic irreversible degenerative disease of articular cartilage predisposing conditions pathology and histology clinical features laboratory aspects Osteoarthritis of the Knee » Hip Osteoarthritis clinical features pain on wt-bearing felt in the groin, buttock, or medial thigh; trendelenburg gait will decrease mechanical stress on joint and thereby lessen pain (see … Read more

Juvenile Rheumatoid Arthritis

Discussion JRA is a persistent non infectious arthritis lasting more than 6 wks to 3 months after other possible etiologies have bee ruled out; most common chronic childhood rheumatoid dz; affects girls more than boys; synovial proliferation leads to joint destruction (chondrolysis) & soft tissue destruction; severe joint destruction is seen in only 5% of … Read more

Cranio Facial

Management of Head Injury (see also: Trauma; Spine / C-spine; Orders for the Spine Injured Patient:) Anesthesia in the Spinal Cord Injured Patient: Fluids in the Head Injured Pt: Hyperventilation Glasgow Coma Scale Head Injury in the Child: Neuro Exam Menu Stroke Seizure ‘phylaxis Urologic Management of the Spinal Cord Injured Patient: Timing of Surgery … Read more

Childhood Arthritic Conditions

Considerations for the Child with Joint Swelling, Limited Motion, and Pain synovial fluid exam polyarthralgia: polyarticular JRA (symmetric polyarthralgia); pauciarticular leukemia hemophilia lyme disease acute rheumatic fever septic arthritis incidious / chronic presentation of joint arthralgias: periarticular tumor oseoid osteoma pauciarticular JRA polyarticular JRA seronegative arthritides osteochondroses (LCP, osgood-schlatter dz) slipped capital femoral epiphysis lyme … Read more

Bone Topics

Bone Healing Bone Circulation Bone Bridge Formation Bone multicellular units Bone Tumors Cancellous Bone Circumferential Grouth Development of Bone from a Cartilage Model Epiphyseal Plate Bone Grafts Haversian System Hydroxyapatite crystals Inorganic Constituents of Bone Longitudinal Growth Microscopic structure Mineralization of Bone Non Union Remodeling of Bone Renal Disease: effects on bone Resorption Steroid induced … Read more