18.3 - Joints

Question 1

degenerative joint disease consists of joint stiffness in the morning that ___________ (improves / worsens) during the day

Answer 1

worsens

Question 2

how does degenerative joint disease differ from RA in terms of location?

Answer 2

• DJD: DIP and PIP involved

- RA: only PIP

Question 3

heberden and bouchard nodes are involved in what disease? where are they located?

Answer 3

degenerative joint disease

• heberden: DIP
• bouchard: PIP

Question 4

what is eburnation? eburnation of subchondral bone is seen in what condition?

Answer 4

• eburnation: “polishing”

- degenerative joint disease

Question 5

RA is associated with what HLA?

Answer 5

DR4

Question 6

what is the hallmark of RA?

Answer 6

synovitis leading to formation of a pannus (inflamed granulation tissue)

Question 7

HLA-DR4 is associated with _______

Answer 7

RA

Question 8

RA consists of joint stiffness in the morning that ___________ (improves / worsens) during the day

Answer 8

improves

Question 9

what are the XR findings of RA?

Answer 9

• joint space narrowing
• loss of cartilage
• osteopenia

Question 10

what are the extra-articular findings of RA?

Answer 10

• rheumatoid nodules: skin, visceral organs
• vasculitis
• baker cyst: popliteal
• pleural effusion

Question 11

what is rheumatoid factor?

Answer 11

IgM autoantibody against Fc portion of IgG

Question 12

what are the two main findings in synovial fluid in RA?

Answer 12

• neutrophils

- high protein

Question 13

spondyloarthropathies are associated with what HLA?

Answer 13

B27

Question 14

are spondyloarthropathies associated with rheumatoid factor?

Answer 14

no

Question 15

ankylosing spondyloarthritis involves what joints?

Answer 15

SI and spine

Question 16

bamboo spine is seen in what condition?

Answer 16

ankylosing spondyloarthritis

Question 17

what are the extra-articular manifestations of ankylosing spondyloarthritis?

Answer 17

• uveitis

- aortitis (aortic regurgitation)

Question 18

what is the triad of reiter syndrome?

Answer 18

• arthritis
• urethritis
• conjunctivitis

Question 19

seronegative spondyloarthropathies arise in young adults (usually males) weeks after what types of infections?

Answer 19

• GI

- chlamydia trachomatis

Question 20

sausage fingers (dactylitis) are seen in what condition?

Answer 20

psoriatic arthritis

Question 21

what are the two main organisms responsible for infectious arthritis?

Answer 21

• n. gonorrhoeae

- s. aureus

Question 22

is infectious arthritis monoarticular or polyarticular?

Answer 22

monoarticular

Question 23

gout is due to deposition of what type of crystals?

Answer 23

monosodium urate

Question 24

what cell type is seen in synovial fluid aspirate in gout?

Answer 24

neutrophils

Question 25

pseudogout is due to deposition of what type of crystal? what is the crystal appearance?

Answer 25

• calcium pyrophosphate dihydrate (CPPD)

- rhomboid shaped crystals with weakly positive birefringence