Arthritis Flashcards
What is polyarthritis?
Arthritis in more than 5 joints.
What is oligoarthiritis?
Arthritis in between 2-4 joints
Give examples of monoarthritis.
Gout, pseudogout, septic arthritis, osteoarthritis, psoriatic arthritis.
What is a side effect of using aspirin alongside methotrexate?
Bone marrow toxicity risk
Which type of joint is typically affected in rheumatoid arthritis?
Synovial joints
What are the causes of primary osteoarthritis?
Age related
Insidious
No overt cause
What are the causes os secondary osteoarthritis?
Predisposing condition
Excess/inappropriae weight-bearing
Deformity
Injury
Which parts of the body does osteoarthritis typically affect?
Hips, knees, lower lumbar, cervical vertebrae, PIP and DIP joints of fingers
What is the pathogenesis behind osteoarthritis?
Chondrocyte injury
Chondrocyte proliferation - release of inflammatory mediators, proteases, collagen and proteoglycans
Repetitive injury and chronic inflammation - loss of chondrocytes
What is the name of the process that happens when cartilage is lost during osteoarthritis?
Eburnation
What are the symptoms of rheumatoid arthritis?
Malaise, fever
Generalised MSK pain
Symmetrical joint involvement: swollen, warm, painful, limited movement in morning and after inactivity
Small joints before large joints - usually spares hips and lumbrosacral joints
Which genetic factors are linked with rheumatoid arthritis?
HLA DRB1 alleles
Which immune cells are involved in rheumatoid arthritis?
CD4+ T helper cells
Name the antibody involved in the inflammatory process of rheumatoid arthritis.
Rheumatoid factor
What are some extra-articular features of rheumatoid arthritis?
Rheumatoid nodules
Small vessel vasculitis
Necrotising granuloma
Splinter haemorrhages
Peri-ungal infarcts
Ulcers
Gangrene
Pyoderma gangrenosum
Pleural and pericardial effusions
Which gene are seronegative spondyloarthritides associated with?
HLA B27
Which joints do seronegtive spondyloarthritides affect?
Sacro-iliac joints
What is ankylosing spondylitis?
A destructive arthritis affecting mainly the the sacro-iliac and intervertebral joints.
What are the causes of reactive arthritis?
Cervicitis
Conjunctivitis
Auto-immune reaction to infection - chalmydia, shigella, salmonella, campylobacter
What are the causes of enteritis associated arthritis?
Organisms with high lipopolysacharides in cell wall triggering an immune reaction
What are some causes of infectious arthrtitis?
Staph aureus in adults
Haemophilus influenzae in children
Gonococcal infection in young adults
Sickle cell predisposes to salmonella arthritis
Lyme disease
Which joints does infectious arthritis affect typically?
A single joint - knee most common
What is the pathophysiology of gout?
Hyperuricaemia
FROM
Reduced exretion of urate (from chronic renal disease commonly)
Drug side effect - thiazide diuretics reduce urate excretion
What does deposition of urate crystals in soft tissues lead to?
Gouty tophus - mass within tissues that is formed by sheets of urate crystals with surrounding granulamatous inflammatory reaction.
