2.2 Bone and Joint Pathology II

Question 1

progressive degeneration of articular cartilage, most common type of arthritis, often due to wear and tear

Answer 1

osteoarthritis

Question 2

risk factors for osteoarthritis?

Answer 2

age (after 60 yrs), obesity, trauma

Question 3

Joint stiffness in the morning that worsens during day, affects hip, lower lumbar spine, knees, DIP and PIPs

Answer 3

osteoarthritis

Question 4

disruption of cartilage that lines articular surface, eburnation of subchondral bone, osteophyte formation (reactive bony outgrowths), Heberden nodes in DIP and Bouchard nodes in PIP

Answer 4

osteoarthritis

Question 5

• chronic, systemic, autoimmune disease
• women of late childbearing age
• associated with HLA-DR4

Answer 5

rheumatoid arthritis

Question 6

hallmark is synovitis leading to formation of a pannus (inflamed granulation tissue) and destruction of cartilage and ankylosis (fusion) of the joint

Answer 6

rheumatoid arthritis

Question 7

• arthritis with morning stiffness that improves with activity
• PIP joints of fingers: swan neck deformity
• radial deviation of wrists
• DIPs usually spared

Answer 7

rheumatoid arthritis

Question 8

central zone of necrosis surrounded by _________, skin and visceral organs in rheumatoid arthritis

Answer 8

epithelioid histiocytes

Question 9

mass of synovium and synovial stroma consisting of inflammatory cells, granulation tissue, fibroblasts
-grows over articular cartilage and causes erosion

Answer 9

pannus formation

Question 10

arthritis due to an infectious agent, usually bacterial

Answer 10

infectious arthritis

Question 11

N gonorrhoeae the most common cause, classically involves a singled joint (usually the knee)

Answer 11

infectious arthritis

Question 12

presents as warm joint with limited range of motion, fever, increased white count, elevated ESR

Answer 12

infectious arthritis

Question 13

• pathologic changes in ligamentous attachments rather than own synovium
• involves sacroiliac joint and spine
• lack of rheumatoid factor, HLA-B27 association

Answer 13

seronegative spondyloarthropathies

Question 14

triad of arthritis, urethritis, and conjunctivits, in young adults weekds after a GI or chlamydia infection

Answer 14

Reiter syndrome

Question 15

deposition of monosodium urate (MSU) crystals in tissues, due to hyperuricemia (decreased excretion by kidney, from purine metabolism)

Answer 15

gout

Question 16

• occurs in 10% of people with psoriasis

- affects hands and feet

Answer 16

psoriatic arthritis

Question 17

• Borrelia burgdorferi

- immune response, erythema chronicum migrans

Answer 17

Lyme disease

Question 18

• calcium pyrophosphate crystal deposition

- rhomboid shaped crystals

Answer 18

pseudogout