Arthritic Disorders Flashcards
Rheumatoid Arthritis (RA)
-Autoimmune, chronic, inflammatory, systemic disease
-Genetic predisposition, but appears to require an environmental trigger (still to be identified)
RA Pathogenesis
-Autoimmune response that leads to inflammation of synnovium and joint destruction
-Undergo hyperplasia with inflammation and starts to over grow in the bone (swelling in the joint capsule)
-Formation of Pannus
RA Articular Manifestations (Inside the joints)
-Symmetric and polyarticular
-Morning stiffness that last more than 30 minutes
-Commonly affects Proximal phalanges and metacarpals.
-Ulnar deviation of the fingers
-Swan deviation of the fingers
RA Extra-Articular manifestations (non-joint symptoms)
-Rheumatoid nodules (usually benign)
-Vasculitis (Type III hypersensitivity reaction)
-Pulmonary Complications
-Dryness in eyes and mouth
-Felty’s Syndrome
RA Diagnostic Criteria
-Confirmed presence of synovitis on more than one joint
-Score of 6 or more to classify as RA
see presentation for details
Osteoarthritis (OA)
-Degenerative Joint Disease (DJD)
-Could be symmetric and asymmetric
-Most prevalent type of arthritis
-Wear-and-tear arthritis
OA Pathogenesis
-Multifactorial (genetic and environmental)
-Breakdown of the cartilage (it may look swollen but is hard due to the osteophyte)
-Formation of spurs or ostephytes
OA Clinical Manifestations
-Partially relieved by rest
-Difficulty initiating movement but then stiffness goes away
-Crepitus (cracking sound)
-Weight bearing joints often affected
-Joint enlargement (from new bone formation)
RA vs OA
RA:
-Autoimmune
-Systemic
-Signs of inflammation
-Stiffness more than 30 minutes
-Bilateral
OA:
-Degenerative Disorder
-Local
-No signs of inflammation
-Stiffness less than 30 minutes
-Often Unilateral
Gouty Arthritis
-Acutely painful and influenced by our diet (high in purine)
-Asymmetrical
Gouty Pathogenesis
-Elevation of serum uric acid levels (overproduction or inadequate elimination)
-Uric acid precipitates in the joints forming crystals
-Primary etiology unknown
-Secundary eitiology CKD and Tumor lysis syndrome.
Tumor Lysis Syndrome
Cancer expose to chemo leaves residual which can be converted into purines then into uric acid.
Microtophi
Small, hard nodules of crystalline deposit of monosodium urate
Tophi
Repeated attacks lead to chronic arthritis and formation of hard nodules.
Gouty Clinical Manifestations
-Usually Monoarticular
-Classic presentation in first metatarsalphalangeal (usually distal)
-Symptoms often begin at night (cold body temperature) and following exercise (dehydration)
-Food high in purine (liver)
