1.97 Arthritis Flashcards
Define arthralgia…
Joint pain
Define athropathy…
Joint problem +/- inflammation
What are the classifications of arthritis…
• Inflammatory v non-inflammatory • Acute v chronic • Which joints Mono v Oligo v Poly Spinal v Peripheral
What are connective tissue diseases…
○ vasculitis inc. temporal arteritis - headaches, blindness,
○ systemic sclerosis
○ systemic lupus erythematosus
○ polymyositis / dermatomyositis
Sjogren’s syndrome - destruction of parotid gland - parotid swelling, rashes, dry nouth
What are soft tissue disorder…
Non-bony structures that support, connect or encompass an orogan or structure of the body
Eg Tendon, Ligament, Bursa
What is fibromyalgia?
Fibromyalgia • Chronic widespread pain in muscle and joints • Fatigue and sleep disturbance • No joint inflammation or damage • Pathology not well understood ○ Chronic pain Biopsychosocial model
What are inflammatory arthritis symptoms?
• History • Presence of early morning joint stiffness (>30 mins) • History of joint swelling • Response to anti-inflammatories • Examination • Presence of synovitis • Investigations • Inflammatory markers • Auto-antibodies • Imaging Joint aspiration
What is the treatment of inflammatory arthritis…
It is an autoimmune disease - immunosurpressant
What is rheumatoid arthritis..
• Chronic inflammatory symmetrical polyarthritis • ~ 1% of population • Unknown aetiology • Autoimmune • Genetic • Environmental • Typically MCPs, PIPs, wrists • Extra-articular features • Cellullar proliferation Secretes more fluid
What is ankolysing spondilytis…
• Inflammatory arthritis – axial spine • Men > women, 3:1 • Peak age of presentation is 20s • Inflammatory back pain • Extra-articular features • Inflammatory bowel disease • Iritis Respiratory / Cardiac problems
What is psoartic arthritis…
• Psoriasis associated with arthritis in ~1/3 cases • Prevalence 0.2% population • Occurs in different patterns • Similar to rheumatoid • Few large joints (oligoarthritis) • Spondylitis • Arthritis mutilans Dactylitis, enthesitis, nail changes - whole digit is swollen; inflammation where tendons attached to bone are inflammed
What is Gout…
• Crystal related inflammatory arthritis • Commonly monoarthritis, can be poly - • Monosodium urate crystals within joint • Genetic predisposition • Environmental causes • Alcohol / Diuretics • Co-morbidity • Renal failure / Obesity • Most commonly 1st MTP joint • Big toe Can be due to genes
What is septic arthritis…
• Joint infection with pyogenic bacteria
• Commonly monoarthrits (knee), can be poly-
• Staph aureus most common pathogen (50%)
• Most have predisposing conditions
• Pre-existing joint disease (eg RA, OA, prosthetic joint)
• Immunocompromised – medication eg steroids, elderly
Joint aspiration is essential
What is a non inflammatory arthritis..
Osteoarthritis
What is osteoarthritis…
• Traditionally ‘wear and tear’, ‘degenerative’ • Dynamic, reparative process • Common – >10% of middle age and elderly • Genetic predisposition • Other factors • Age, gender, trauma, obesity • Pain without inflammatory features • Worse with exercise, better with rest Knees, hips, hand
