MUSCULOSKELETAL CONDITIONS
High-Yield Rheumatology & Orthopaedics Notes for Exams, OSCEs &
Clinical Revision
Course: Medicine / Nursing / Pharmacy / Health Sciences
Document type: Comprehensive exam-focused lecture summary with clinical algorithms
INTRODUCTION (EXAM CONTEXT)
Musculoskeletal conditions account for approximately 20% of primary care consultations. Early
recognition and treatment are essential to reduce chronic pain, prevent disability, and enable timely referral
for inflammatory and autoimmune joint diseases.
Common presenting symptoms: - Pain - Stiffness - Swelling
These may involve a single joint or multiple joints.
COMMON INVESTIGATIONS IN MUSCULOSKELETAL DISEASE (HIGH-
YIELD)
Blood Tests
• ESR & CRP: markers of inflammation and disease activity
• Rheumatoid factor: may be positive in RA but also in healthy individuals
Imaging
• X-ray: fractures, joint space narrowing, erosions, osteophytes
• Ultrasound: effusions, Baker’s cyst, tendon pathology
• MRI: early inflammatory arthritis, spinal disorders
• DXA: bone mineral density (osteoporosis)
• Bone scintigraphy: increased bone turnover
• Arthroscopy: diagnostic and therapeutic
ARTHRALGIA
Definition: Non-specific joint pain without inflammation
1
, Features: - Malaise - Joint pain without redness, warmth or swelling
Management: - Paracetamol - Ibuprofen
OSTEOARTHRITIS (VERY HIGH-YIELD)
Epidemiology & Risk Factors
• Increasing age
• Female sex
• Obesity
• Joint injury
• Occupational stress
Pathogenesis (EXAM FAVORITE)
• Cartilage degeneration
• Subchondral bone sclerosis
• Osteophyte formation
• Metalloproteinase activity
• Role of IL-1 and TNF-α
Clinical Features
• Activity-related pain
• Morning stiffness <30 minutes
• Crepitus
• Bony enlargement
Investigations
• Normal ESR & CRP
• X-ray: joint space narrowing, osteophytes
Management
Non-pharmacological: - Weight loss - Exercise - Bracing
Pharmacological: - Paracetamol - NSAIDs (oral/topical) - Intra-articular steroids
Surgical: - Joint replacement
2
High-Yield Rheumatology & Orthopaedics Notes for Exams, OSCEs &
Clinical Revision
Course: Medicine / Nursing / Pharmacy / Health Sciences
Document type: Comprehensive exam-focused lecture summary with clinical algorithms
INTRODUCTION (EXAM CONTEXT)
Musculoskeletal conditions account for approximately 20% of primary care consultations. Early
recognition and treatment are essential to reduce chronic pain, prevent disability, and enable timely referral
for inflammatory and autoimmune joint diseases.
Common presenting symptoms: - Pain - Stiffness - Swelling
These may involve a single joint or multiple joints.
COMMON INVESTIGATIONS IN MUSCULOSKELETAL DISEASE (HIGH-
YIELD)
Blood Tests
• ESR & CRP: markers of inflammation and disease activity
• Rheumatoid factor: may be positive in RA but also in healthy individuals
Imaging
• X-ray: fractures, joint space narrowing, erosions, osteophytes
• Ultrasound: effusions, Baker’s cyst, tendon pathology
• MRI: early inflammatory arthritis, spinal disorders
• DXA: bone mineral density (osteoporosis)
• Bone scintigraphy: increased bone turnover
• Arthroscopy: diagnostic and therapeutic
ARTHRALGIA
Definition: Non-specific joint pain without inflammation
1
, Features: - Malaise - Joint pain without redness, warmth or swelling
Management: - Paracetamol - Ibuprofen
OSTEOARTHRITIS (VERY HIGH-YIELD)
Epidemiology & Risk Factors
• Increasing age
• Female sex
• Obesity
• Joint injury
• Occupational stress
Pathogenesis (EXAM FAVORITE)
• Cartilage degeneration
• Subchondral bone sclerosis
• Osteophyte formation
• Metalloproteinase activity
• Role of IL-1 and TNF-α
Clinical Features
• Activity-related pain
• Morning stiffness <30 minutes
• Crepitus
• Bony enlargement
Investigations
• Normal ESR & CRP
• X-ray: joint space narrowing, osteophytes
Management
Non-pharmacological: - Weight loss - Exercise - Bracing
Pharmacological: - Paracetamol - NSAIDs (oral/topical) - Intra-articular steroids
Surgical: - Joint replacement
2
