Is this a Male or Female hip?

After making a mistake earlier today, I thought it’d be a good time to review some basics.

Before we begin – is this a male or female pelvis?

Normal pelvis of an adult Case courtesy of Dr Ian Bickle, Radiopaedia.org, rID: 37956

Normal pelvis of an adult
Case courtesy of Dr Ian Bickle, Radiopaedia.org, rID: 37956

Read on if you don’t know!

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MSK 22 – What is Osteoarthritis?

Osteoarthritis of the hip joint. Right side worse than the left with a loss of joint space + subchondral sclerosis and geodes. Remodelling is also present in the hip joint.

Osteoarthritis of the hip joint. Right side worse than the left with a loss of joint space + subchondral sclerosis and geodes.
Remodelling is also present in the hip joint.

Case courtesy of Dr Frank Gaillard, Radiopaedia.org. From the case rID: 35875

so, What is osteoarthritis?

OA is characterised by the loss of cartilage in synovial joints leading to changes in the periarticular bone.¹ Interestingly there’s more evidence of an inflammatory component to it’s pathology rather than just purely wear-and-tear.

Interesting and important fact:

Only advanced damaged from OA show up on X-rays.¹ Other investigations such as arthroscopy and MRI may be able to show damage in earlier stages.

For more information Listen to the episode:

 

 

References:

  1. Kumar P, Clark M (eds.) Clinical medicine. 7th ed. Edinburgh: Elsevier Saunders; 2009. p.518-521.

Additional Reading:

MSK14-Systemic Lupus Erythematosus

Typical 'malar' or butterfly rash in SLE showing across the nasal and cheeks

Typical ‘malar’ or butterfly rash in SLE showing across the nasal and cheeks

Systemic Lupus Erythematosus is an autoimmune disease involving multiple organs. Antibody testing include Antinuclear antibodies (ANA), antiphospholipid antibodies, antibodies to double stranded DNA (dsDNA) and anti-Smith (Sm) antibodies.  

Note: ANA is highly sensitive, but not specific. A positive anti-dsDNA and anti-Sm are highly specific antibodies for Lupus.

Find out the pathophysiology and the diagnostic criteria from this episode!

MSK 11 – 6 Steps you MUST know in fracture healing

Types of fractures Top row (Left to right): Transverse, Oblique, Segmental Bottom row (left to right) Angulated, Shifted, Comminuted

Types of fractures
Top row (Left to right):
Transverse, Oblique, Segmental
Bottom row (left to right)
Angulated, Shifted, Comminuted

What are the 6 steps of healing a bone fracture?

  1. Haematoma formation
  2. Granulation Tissue formation
  3. Soft Callus formation
  4. Hard callus conversion
  5. Ossification
  6. Remodelling

Find out more on the Common Rounds on how bone fractures can be described and what factors affect its healing.

MSK10 – When the bone gets inflammed – Osteomyelitis

diabetic-osteomyelitis

Diabetic Osteomyelitis; Case courtesy of Dr Frank Gaillard, Radiopaedia.org. From the case rID: 7663

Ever wonder what osteomyelitis was? What is the most likely cause of it? Find out on the Common Rounds.

Answer to FB question:

Osteomyelitis is an inflammation of bone and marrow, virtually always secondary to infection. Common organisms are pyogenic bacteria and mycobacteriaThese organisms may reach the bone by (1) hematogenous spread, (2) extension from a contiguous site, and (3) direct implantation

MSK 7 – Simplifying Calcium and Phosphate Regulation

Calcium and Phosphate regulation is complicated as it ties the GI, kidneys and bones together.
Join us as we go through how PTH, Calcitriol regulate calcium and phosphate.

Calcium and Phosphate regulation

Calcium and Phosphate regulation

In short:

PTH: increases [calcium], decreases [phosphate]
Calcitriol: increases [calcium], increases [phosphate]

FOUR actions of Parathyroid Hormone(PTH):

1. Increase bone resorption leading to rise in calcium and phosphate.
2. Phosphate is filtered in the kidney and it’s resorption is blocked by PTH. This leads to an overall drop in phosphate levels.
3. Calcium is filtered in the kidneys but the resorption is increased by PTH. This leads to an overall increase in calcium concentration.
4. PTH increases Calcitriol (activated Vit D) production in the kidneys. This indirectly increases calcium absorption from the intestines.

FOUR actions of Calcitriol (activated vitamin D)

1. Increases bone resorption causing a rise in calcium and phosphate levels.
2. Calcitriol INCREASES the reabsorption of phosphate in the kidneys.
3. Calcitriol increases the reabsorption of calcium in the kidneys.
4. Calcitriol acts DIRECTLY on the intestines to increase calcium absorption from diet.