Arthritis Flashcards
What type of hypersensitivity reaction is rheumatoid arthritis?
Type 3 and 4 hypersensitivity
What causes rheumatoid arthritis to occur?
Type 2 collagen and vimentin are citrullinated and proteins unfold
Immune cells therefore do not recognise the protein and attack them
What becomes inflamed in rheumatoid arthritis?
Synovium
How is Anti-CCP relevant to rheumatoid arthritis?
It is specific to RA and correlates with disease activity
What are the main symptoms of rheumatoid arthritis?
Symmetrical pain and stiffness
Reduced grip strength
Swelling of affected joints
Prolonged early morning stiffness
Loss of joint ROM
What investigations should be done in suspected rheumatoid arthritis?
Inflammatory markers
Rheumatoid Factor
Anti-CCP
X-ray
How should rheumatoid arthritis be managed?
DMARDs - methotrexate monotherapy + short course of bridging prednisolone
NSAIDs and steroids
Smoking cessation
When should biologics be introduced to the management of rheumatoid arthritis?
When a patient has not responded well to 2 different DMARDs
What is psoriatic arthritis?
Inflammatory arthritis that is associated with psoriasis
What joints are typically affected by psoriatic arthritis?
Sacroiliac joints and DIPs
What are the possible x-ray findings of psoriatic arthritis?
Marginal erosions
Whiskering
‘Pencil in a cup’ deformity
What is the management plan for psoriatic arthritis?
NSAIDs
DMARDs
Anti-TNFs
Use steroids for flare-ups
What is osteoarthritis?
A chronic disease involving imbalance between wear and repair
What is eburnation and what condition is it commonly seen in?
Bone rubbing on bone
Osteoarthritis
What are the four common x-ray findings in osteoarthritis?
Loss of joint space
Osteophytes
Subchondral cysts
Subchondral sclerosis
What are the main symptoms of osteoarthritis?
Pain worse with use / at night
Short lived morning stiffness
Instability and crepitus
Bony swellings
Big joints typically affected
What is the management of osteoarthritis?
Weight loss and exercise / physio
Topical NSAIDs
Oral NSAIDs - paracetamol
Intra-articular injections
Surgery - joint replacement
