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Clin Pod Med Exam III > 22: Joint Pathology - Carnevale > Flashcards

22: Joint Pathology - Carnevale Flashcards

1
Q

characterized by degeneration of the cartilage resulting in structural or functional failure of synovial joints

A
  • osteoarthritis

- aka degenerative joint disease

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2
Q

most common form of arthritis

A

osteoarthritis

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3
Q

s/s osteoarthritis

A
  • deep achy pain that worsens with use
  • morning stiffness
  • crepitus
  • limited ROM
  • can lead to joint deformity but not fusion
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4
Q

heberden nodes

A
  • prominent osteophytes at the DIP joints

- common in women

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5
Q

what parts of the body are usually spared with osteoarthritis?

A

wrists, elbows, shoulders

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6
Q

due to osteophytes at the PIPs

A

bouchard nodes

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7
Q

early v. late OA

A
  • early (erosion) = chondrocytes proliferate, edema, inflammation, extracellular matrix production, metalloprotease activation, which act together to remodel the cartilage and initiate changes in the synovium and subchondral bone
  • late (osteophytes) = repetitive injury and chronic inflammation lead to chondrocyte drop out, marked loss of cartilage, and extensive subchodrl bone changes (microfractures, bone thickening and sclerosis, cyst formation, osteophyte formation)
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8
Q

tx osteoarthritis

A

pain management, activity modification and joint replacement

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9
Q

autoimmune disorder that may affect many tissues and organs but principally attacks the joints, producing a nonsuppurative proliferative and inflammatory synovitis

A

RA

5F:1M

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10
Q

what is the joint pattern for RA?

A
  • hands ( MCP and PIP )
  • feet
  • wrist and ankles
  • elbow and knee
  • uncommon spine
  • NO lumbosacral or hips
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11
Q

inflamed synovium

A

RA

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12
Q

describe RA s/s

A
  • affected joints swollen, warm, painful
  • particularly stiff when rising in the morning or following inactivity
  • progressive joint enlargement
  • decreased ROM evolving to complete ankylosis
  • greatest damage in first 4-5 yrs
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13
Q

production of rheumatoid factor, a ____, in _____% of RA cases

A
  • IgM autoAB to Fc portion of autologous IgF
  • 80%
  • citrullinated peptides CCP contribute to chronic RA
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14
Q

pannus formation

A

RA

- granulation tisue, synovial and inflamamtory cells, fibrous CT

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15
Q

nonsuppurative, proliferative, desdtructive synovitis

A

RA

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16
Q

ulnar deviation

A

RA

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17
Q

inflammation, pannus, bony ankylosis

A

RA

also see systemic lesions

18
Q

less than 16 yo and persists for at least 6 weeks

A

juvenile idiopathic arthritis

19
Q

joint pattern for juvenile idiopathic arthritis

A

frequently large joint oligoarthritis - knees, wrists, elbows, ankles
- systemic features too

20
Q

still’s disease

A

febrile illness with hepatosplenomegaly, rash, and increased WBc count
- a variant of juvenile idiopathic arthritis

21
Q

what are the lab results for juvenile idopathic arthritis?

A

ANA+ no rheumatoid factor or odules

22
Q

*** 4 unifying features of seronegative spondyloarthopathies

A
  • pathologic changes in the ligamentous attachments rather than synovium
  • involvement of sacroiliac joints, with or without other joints
  • absence of rheumatoid factor
  • association with HLA-B27
    (usually axial skeleton)
23
Q
  • most common subtype spondyloarthropathy
  • 2.5:1 male female
  • gradual onset of IBP
  • acute anterior uveitis most common extra-articular manifestation
  • can lead to sacroiliac fusion and spinal syndesmophyte formation
A

ankylosing spondylitis

24
Q
  • between 10-40% of pts with psoriasis

- skin disease precedes joint disease in approximately 70% cases

A

psoriatic arthritis

25
Q
  • 5-29% of pt with IBD develop arthritis
  • peripheral arthrits can parallel bowel inflammation and occur in up to 20%
  • spndylitis occurs in 3-6%
A

enteropathic (IBD-assoc) arthrtis

26
Q
  • typical acute asymmetric oligoarticular arthritis 1-3 mo after GI and GU infection
  • triad = urethritis, conjunctivitis, and arthritis seen in 35% pts
  • keratoderma blenorrhagica and circinate balanitis
A

reactive arthritis

80% HLAB27 positive
men in 20-30s

27
Q

enthesitis

A

seronegative spondyloartopathies

28
Q
  • young adult male
  • lower back pain and spinal immobility
  • pain worse at rest and improves with mobility
A

anklyosing spondylitis

29
Q

gene associated wtih anklyosing spondylitis

A

approx 90% pts are HLA-B27 positive

30
Q

“bamboo spine”

A

ankylosing spndylitis

31
Q

due to autoimmune reaction initiated by prior infection of GU system or GI tract

A

reactive arthritis

may be found in pt who are HIV pos

32
Q

sausage toes

A

reactive arthritis

33
Q

kertaderma blenorrhagica

A

scaly lesions associated with reactive arthritis

34
Q

gram neg lipopolysaccharides stimulate a range of immunoloigcal responses

A

enteropathic arthritis

35
Q

pitting of nails

A

psoriatic arthritis

36
Q

sudden painful swollen joint with decreased mobility

A

suppurative arthritis

fever, leukocytosis, elevated ESR, neutrophils

37
Q

chronic progressive monoarticular infection caused by m. tuberculosis usually from pulmonary spread

A

mycobacterial arthritis

chronic results in fibrous akylosis and obliteration of the joint space

38
Q

monosodium urate within and around joints

A

gout

common feature of hyperuricemia

39
Q

after ______ of hyperuricemia gout usually appear

A

20-30

40
Q

calcium pyrophosphate deposition

A

pseudo-gout and chondrocalcinosis

41
Q

small cyst that is located near joint capsule or tendon sheath

A

ganglion and synovial cysts

42
Q

benign neoplasms that develop in the synovial lining of joints, tendon sheaths, and busae

A

tenosynovial giant cell tumor

knee in 80% of cases

Clin Pod Med Exam III (13 decks)

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