All of the following are causes of secondary osteoarthritis of the hip, except
diabetes
The exception is diabetes mellitus. Secondary osteoarthritis follows a definable structural insult that damages articular cartilage or alters joint congruity and load transmission. Diabetes classically causes neuropathic (Charcot) arthropathy of the foot and ankle, adhesive capsulitis and Dupuytren contracture, and contributes to generalised OA mainly through obesity, but is not a recognised direct cause of secondary hip osteoarthritis.
Trauma - acetabular fracture, hip dislocation or slipped upper femoral epiphysis - leaves an incongruent articular step-off and is a leading cause of post-traumatic hip OA. Perthes disease is idiopathic avascular necrosis of the capital femoral epiphysis at about 4 to 8 years, healing with a flattened coxa plana that degenerates in adult life. Avascular necrosis (steroids, alcohol, sickle cell disease, femoral neck fracture) causes subchondral collapse and loss of the spherical head.
Key point: Secondary hip OA follows anything leaving the head non-spherical or the joint incongruent - trauma, dysplasia, Perthes, slipped epiphysis, avascular necrosis and inflammatory or septic arthritis.
Important Questions from Bones & Joints
- A 40-year-old lady complains of progressive deformities of her hands and fingers associated with stiffness which is present in both the hands and improves as the day progresses. On examination, there is symmetrical involvement of hands and fingers of both the upper limbs with flexion and ulnar deviation at the metacarpophalangeal joints. What is the most likely diagnosis in this lady?
- A 52-year-old female complains of increasing pain in the right shoulder. She is also finding it increasingly difficult to do overhead abduction of the affected joint. She had been diagnosed as a diabetic 20 years back and is on treatment since then. What is the most likely cause of her clinical condition?
Consider the following :
1. Pain relief
2. Prevention of infection
3. Anaesthesia
4. Restoration of anatomy
Which of the features given above are benefits of fracture treatment?
- Hangman's fracture is
- Which of the following is NOT true about Dupuytren's Contracture?
