OSCE

Processes
Inflammation

Acute Short duration (Few minutes-2 days) Oedema (increased blood flow) Leucocytes (neutrophils) have chemotactic agents Four signs Rubor - redness Tumor - swelling Calor heat Dolor - pain

Chronic Long durations (>2-3days) Not uniform Macrophages & lymphocytes followed by proliferation of fibroblasts (fibrosis)

Healing and tissue repair Trauma inflammatory response Fibril proliferation Scarring (Needs movement) Remodeling

Fibril proliferation

Fibroblasts make extra cellular matrix & collagen Parenchymal cells hold it together Fibrosis of collagen fibers make scar tissue

Factors that impede healing Nutrition Infection Mechanical factors Inadequate blood supply

1. Inflammatory 0-7days 2. Proliferation 7-21days 3. Remodeling >21days

OSCE

Fractures Proliferation Callus formation: 1st part is sticky, 2nd part calcified Boney phase: lamellar bone replaces callus Remodeling: osteoblast & osteoclasts lay down osteoids Upper limb bones take 3-12 weeks Lowe limb 12-18 weeks

Signs & symptoms Pain Swelling Bruising Loss of function Deformation Muscle spasms

Osteoarthritis (OA) Wear and tear Thickened capsule, inflamed synovium Decrease in joint space and range of movement Pain Cartilage damage Radiographic or symptomatic Primary ageing Secondary trauma

Increase activity to prevent further degeneration and muscle wasting. Increase strength and endurance.

Rheumatoid (RA) Auto-immune Increase in joint swelling Morning stiffness (30mins+) Weight loss & fever

Stages 1. Synovitis 2. Cartilage destruction 3. Joint disintegration

Thermotherapy & exercise & early intervention is key.