AP: Joint Function and Arthritis I/II Flashcards
Define a joint.
Articulations that allow bones to move relative to one another.
What are the three different type of joints?
- Fibrous.
- Cartilaginous.
- Synovial.
When the joint is under stress, normal joint function relies upon:
Proper distribution of forces throughout joint.
What does the synovial membrane secrete?
Synovial fluid.
Arthritis is the loss of ____ function.
Arthritis is the loss of regular joint function.
What does the enthesis connect?
- Tendon/ligament and bone.
Tendons and ligaments are both ____, ____ tissue.
Tendons and ligaments are both fibrous, connective tissue.
Describe two histological changes of the articular cartilage during arthritis.
- Blue-purple basophilia of the cartilage disappears; becomes paler.
- Clefts (cracks/fissures) form in the cartilage.
- cloning repair & metaplasia (hyaline replaced with fibrocartilage)
What type of cartilage is articular cartilage?
Hyaline cartilage.
Articular cartilage can damage permanently. It repairs itself as what type of cartilage?
Fibrocartilage.
The synovial membrane lines the joints. It also has _____ capabilities.
The synovial membrane lines the joints. It also has phagocytic capabilities.
Osteoarthritis is a ___-________ condition, and so the joints are not ___, ___, and _______.
Osteoarthritis is a non-inflammatory condition, and so the joints are not red, hot, and swollen.
What is the name for bone death? What is the most common form/cause?
- Osteonecrosis.
- Avascular necrosis.
Define eburnation.
- The loss of hyaline cartilage, exposing subchondral bone
- Degeneration of bone into a hard ivory-like mass.
- Gout is a crystal arthropathy. Crystal arthropathy is a joint disease secondary to __________ ___ ________ _________ in joints.
- Gout is characterised by formation of ____ ____ crystals in the joints.
- Deposition of crystalline material in joints.
- Formation of uric acid crystals in the joints.
What is another name for uric acid crystals?
Tophi.
What is another name for osteoarthritis of the spine?
Spondylosis.
Rheumatoid arthritis can lead to secondary ________.
Rheumatoid arthritis can lead to secondary osteoarthritis.
In pseudogout, what do the crystalline deposits consist of?
Calcium pyrophosphate.
Hyperuricemia results in which joint disorder?
Gout.
- Intervertebral discs form ____ joints.
- What is the outermost component of the intervertebral joints?
- Intervertebral discs form fibrocartilaginous joints.
- Annulus fibrosus.
- List four general categories of spondyloarthropathies (from learning outcomes)
- What IS a spondyloarthropathy?
- Ankylosing spondylitis
- Reactive arthritis
- Psoriatic arthritis
- Enteropathic arthritis (IBD)
- Any joint condition of the spine/vertebral column.
Osteoarthritis is associated with a loss of ____ ____.
Osteoarthritis is associated with a loss of articular cartilage.
Ankylosis is another term for…
Joint fusion.
What is the most common location for gout to occur?
The base of the big toe.
Uric acid is the end result of the breakdown of what family of molecules?
The purines.
What is the most common inflammatory arthropathy?
Rheumatoid arthritis.
- What are osteophytes?
- What are their function?
- Bone outgrowths from joint margin.
- Increases joint stability.
Osteophytes increase stability, but at the cost of what?
Loss of motion.
Presenting symptoms of Osteoarthritis:
- age
- speed of onset
- joint symptoms
- pattern
- systemic symptoms
- variation w time
- usually begins later in life
- onsets slowly over years
- pain & tenderness, may be limited range of movement, crepitus (cracking/crunching) and small effusions but no significant signs of inflammation.
- monoarticular, large weight bearing joints (hip or knee), fingers (DIPs or PIPs) or thumbs, CMC joints, spine
- no systemic symptoms
- morning stiffness under 30 mins, worse with activity
What is Charcot’s joint?
Who is it seen in?
Severe osteoarthritis from denervation of the joint meaning that the patient continues weight bearing on a damaged/fractured joint, accelerating progression.
Seen in:
- tertiary syphilis
- diabetic neuropathy
- chronic alcoholics
- leprosy
Name for AVN of the femoral head in children?
Seen on scans as…
Perthe’s disease
flattening of the femoral head on X-ray
What is rheumatoid factor? Do all patients with RA have it?
Many but not all RA patients have rheumatoid factor in their blood, which are immunoglobulins to autologous IgG and form immune complexes with them.
What is a pannus?
- An inflammatory mass begins periphery of the joint
- advances over the surface of the cartilage, proliferates over the surface of internal and intra-articular structures and erodes bone, cartilage, capsule, and ligaments
- Found in rheumatoid Arthritis
Presenting symptoms of Rheumatoid Arthritis:
- age
- speed of onset
- joint symptoms
- pattern
- systemic symptoms
- variation w time
- can present any age
- fast, weeks/months
- hot, red, swollen, tender
- generally bilateral & symmetrical, most often small joints hands & feet
- fatigue & malaise
- stiffness > 30 mins, better with activity
What is reactive arthritis?
What is another name for it?
What is a common pathogen resulting in reactive arthritis?
Infection of the gut or genitourinary tract, followed weeks later by a sterile synovitis with or without extra articular manifestations
Reiter’s Syndrome.
Chlamydia trachomatis.
What is enteropathic arthritis?
Patients with chronic inflammatory bowel disease i.e. ulcerative colitis or Crohn’s, can develop a peripheral arthritis, sacroileitis and ankylosing spondylitis.
What is the clinical presentation of Gout?
- Sudden onset
- Usually monoarticular, often the big toe
- Inflammed, hot, swollen
- EXTREMELY painful
- Low grade fever
- Leukocytosis
- Synovial fluid = inflammatory exudate with needle-like crystals
What are some common extra-articular manifestations of RA?
- rheumatoid nodules on extensor surfaces of arms & hands
- cardiovascular disease (atherosclerosis = most common cause death in RA patients)
- eye disease (ie dryness and conjunctivitis)
