18.3 Joints Flashcards
What is articular cartilage made of?
Type 2 Collagen
Degenerative Joint Disease
Progressive degeneration of articular cartilage most often due to wear and tear
What is the major risk factor for degenerative joint disease?
Age
How does degenerative joint disease present?
Joint stiffness in the morning that worsens during the day
What joints of the hand does degenerative joint disease affect?
Both the DIPs and PIPs
What HLA mutation is rheumatoid arthritis associated with?
HLA-DR4
Who is the common patient seen with rheumatoid arthritis?
Middle-aged women
What is the hallmark of rheumatoid arthritis?
Synovitis with formation of a pannus - thick layer of granulation tissue
What is the presentation of rheumatoid arthritis in the morning?
Morning stiffness that improves with activity
What joints of the hand are affected in rheumatoid arthritis?
Wrists and DIP but PIP is normally spared
What Ab if found in rheumatoid arthritis?
IgM Ab against Fc portion of IgG
What HLA are seronegative spondyloarthropathies associated with?
HLA-B27
What bones do seronegative spondyloarthropathies tend to involve?
Axial Skeleton
Ankylosing Spoondyloarthropathy
Involvement of the vertebral spine that can lead to fusion of the vertebrae - and can have uveitis and aortitis
Reiter Syndrome
Arthritis, urethritis and conjunctivitis that arises after GI or C. trachomatis infection
Who is the typical patient of Reiter syndrome?
Young Males
Psoriatic Arthritis
Seen with psoriasis occasionally and can cause sausage fingers/toes
What is the most common cause of infectious arthritis?
N. gonorrhea
Gout
Deposition of monosodium rate crystals in joints due to hyperuricemia
What are some causes of secondary gout?
- Leukemia
- Renal Insufficiency
- Lesch-Nyhan Syndrome
Lesch-Nyhan Syndrome?
HGPRT enzyme deficiency that leads to increased levels of uric acid and has strange symptoms like self mutilation
Tophi
White chalky deposits of uric acid
Pseudogout
Deposition of calcium pyrophosphate
What is the appearance of pseudo gout crystals?
Rhomboid shape with positive birefringence under polarized light
What is the appearance of gout crystals?
Needle shaped
