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psoriatic arthritis
5types,treatment ↑more common

oligoarticular(less than 5 joints)
polyarticular(more than 5 joints)
spondyloarthritis
distal interphalangeal predominant (affects joints at the end of the fingers and toes→dactylitis)
arthritis multilans

NSAIDs,(for more severe)sulfasalazine,methotrexate(disease modifying anti-rheumatic drugs,DMARDs)

↓if these fail
biological response modifiers(which blocks TNF-alpha)
rheumatology musculoskeletal   HirotoShishido

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findings diffuse idiopathic skeletal hyperosteosis
広汎性特発性骨増殖症

骨折、骨がもろくなる
musculoskeletal   HirotoShishido

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reactive arthritis

①when does it appear ②which types of HLA ③other diseases associated with(②) ④what does (②)gene code for ①2-3weeks after sexually transmitted infection or gastroenteritis
②HLA-B27
③psoriasis,ankylosing spondylitis
④MHC1
musculoskeletal rheumatology   HirotoShishido

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rotator cuff tear
①muscles ②acute and chronic ③diagnosis ④treatment ①SITS muscles(supraspinatus,infraspinatus,teres minor(小円筋),subscapularis)

②acute→tendons violently stretched
chronic→cumulative tear(usually elderly)

③pain and weakness with abduction or rotation

④rest,ice&pain control
arthroscopic surgery(more severe case)
musculoskeletal   HirotoShishido

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microorganisms that cause osteomyelitis staphylococcus aureus (the most common)
→invade the skin and spread contiguously to the bone

salmonella→particularly affects indivisuals w/ sickle cell

pasteurella multocida→spread from cat or dog bite/scratch
microbiology musculoskeletal   HirotoShishido

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chronic osteomyelitis sequestrum(腐骨) and involucrum(骨柩=new bone) is formed

sequestrum has to be removed by surgery
musculoskeletal   HirotoShishido

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septic arthritis diagnosis joint aspirate,imaging
musculoskeletal   HirotoShishido

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parathyroid hormone, calcitonin effects PTH low conc→stimulates osteoblast→promotes bone formation
PTH high conc→increase bone resorption

calcitonin→supress osteoclasts→decrease bone resorption
pharmacology musculoskeletal   HirotoShishido

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①simple, non-nitrogenous bisphosphonates
②potent, nitrogenous bisphosphonates ①ATP is built up in osteoclast→apoptosis→less bone resorption
e.g.etidronate

②inhibit osteoclast's mevalonate passway→disrupts synthesis of cholesterol→osteoclast becomes nonfunctional
e.g.☆alendronate
pharmacology musculoskeletal   HirotoShishido

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paget's disease of bone
①phases ②symptoms ③treatment ①lytic phase,mixed phase,sclerotic phase

②usually asymptomatic, but can result in weak or misshapen bone which can lead to fracture,nerve compression

③osteoporosis medication(except for teriparatide which can increase the risk of osteosarcoma)as antiresorptive drug

surgery(for deformities,fractures,impinged nerve)
musculoskeletal   HirotoShishido

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