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MSK Lectures > AP: Joint Function and Arthritis I/II > Flashcards

AP: Joint Function and Arthritis I/II Flashcards

1
Q

Define a joint.

A

Articulations that allow bones to move relative to one another.

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2
Q

What are the three different type of joints?

A
  • Fibrous.
  • Cartilaginous.
  • Synovial.
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3
Q

When the joint is under stress, normal joint function relies upon:

A

Proper distribution of forces throughout joint.

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4
Q

What does the synovial membrane secrete?

A

Synovial fluid.

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5
Q

Arthritis is the loss of ____ function.

A

Arthritis is the loss of regular joint function.

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6
Q

What does the enthesis connect?

A
  • Tendon/ligament and bone.
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7
Q

Tendons and ligaments are both ____, ____ tissue.

A

Tendons and ligaments are both fibrous, connective tissue.

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8
Q

Describe two histological changes of the articular cartilage during arthritis.

A
  • Blue-purple basophilia of the cartilage disappears; becomes paler.
  • Clefts (cracks/fissures) form in the cartilage.
  • cloning repair & metaplasia (hyaline replaced with fibrocartilage)
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9
Q

What type of cartilage is articular cartilage?

A

Hyaline cartilage.

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10
Q

Articular cartilage can damage permanently. It repairs itself as what type of cartilage?

A

Fibrocartilage.

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11
Q

The synovial membrane lines the joints. It also has _____ capabilities.

A

The synovial membrane lines the joints. It also has phagocytic capabilities.

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12
Q

Osteoarthritis is a ___-________ condition, and so the joints are not ___, ___, and _______.

A

Osteoarthritis is a non-inflammatory condition, and so the joints are not red, hot, and swollen.

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13
Q

What is the name for bone death? What is the most common form/cause?

A
  • Osteonecrosis.

- Avascular necrosis.

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14
Q

Define eburnation.

A
  • The loss of hyaline cartilage, exposing subchondral bone

- Degeneration of bone into a hard ivory-like mass.

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15
Q
  • 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.
A
  • Deposition of crystalline material in joints.

- Formation of uric acid crystals in the joints.

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16
Q

What is another name for uric acid crystals?

A

Tophi.

17
Q

What is another name for osteoarthritis of the spine?

A

Spondylosis.

18
Q

Rheumatoid arthritis can lead to secondary ________.

A

Rheumatoid arthritis can lead to secondary osteoarthritis.

19
Q

In pseudogout, what do the crystalline deposits consist of?

A

Calcium pyrophosphate.

20
Q

Hyperuricemia results in which joint disorder?

A

Gout.

21
Q
  • Intervertebral discs form ____ joints.

- What is the outermost component of the intervertebral joints?

A
  • Intervertebral discs form fibrocartilaginous joints.

- Annulus fibrosus.

22
Q
  • List four general categories of spondyloarthropathies (from learning outcomes)
  • What IS a spondyloarthropathy?
A
  • Ankylosing spondylitis
  • Reactive arthritis
  • Psoriatic arthritis
  • Enteropathic arthritis (IBD)
  • Any joint condition of the spine/vertebral column.
23
Q

Osteoarthritis is associated with a loss of ____ ____.

A

Osteoarthritis is associated with a loss of articular cartilage.

24
Q

Ankylosis is another term for…

A

Joint fusion.

25
Q

What is the most common location for gout to occur?

A

The base of the big toe.

26
Q

Uric acid is the end result of the breakdown of what family of molecules?

A

The purines.

27
Q

What is the most common inflammatory arthropathy?

A

Rheumatoid arthritis.

28
Q
  • What are osteophytes?

- What are their function?

A
  • Bone outgrowths from joint margin.

- Increases joint stability.

29
Q

Osteophytes increase stability, but at the cost of what?

A

Loss of motion.

30
Q

Presenting symptoms of Osteoarthritis:

  • age
  • speed of onset
  • joint symptoms
  • pattern
  • systemic symptoms
  • variation w time
A
  • 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
31
Q

What is Charcot’s joint?

Who is it seen in?

A

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
32
Q

Name for AVN of the femoral head in children?

Seen on scans as…

A

Perthe’s disease

flattening of the femoral head on X-ray

33
Q

What is rheumatoid factor? Do all patients with RA have it?

A

Many but not all RA patients have rheumatoid factor in their blood, which are immunoglobulins to autologous IgG and form immune complexes with them.

34
Q

What is a pannus?

A
  • 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
35
Q

Presenting symptoms of Rheumatoid Arthritis:

  • age
  • speed of onset
  • joint symptoms
  • pattern
  • systemic symptoms
  • variation w time
A
  • 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
36
Q

What is reactive arthritis?
What is another name for it?
What is a common pathogen resulting in reactive arthritis?

A

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.

37
Q

What is enteropathic arthritis?

A

Patients with chronic inflammatory bowel disease i.e. ulcerative colitis or Crohn’s, can develop a peripheral arthritis, sacroileitis and ankylosing spondylitis.

38
Q

What is the clinical presentation of Gout?

A
  • 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
39
Q

What are some common extra-articular manifestations of RA?

A
  • rheumatoid nodules on extensor surfaces of arms & hands
  • cardiovascular disease (atherosclerosis = most common cause death in RA patients)
  • eye disease (ie dryness and conjunctivitis)

MSK Lectures (22 decks)

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