Arthritis Flashcards
What are the 2 main joint examinations?
- GALS
- REMS
What does GALS stand for?
Gait, Arms, Legs and Spine.
What does REMS stand for?
Regional Examination of the Musculoskeletal System.
Which joint examination is more thorough?
REMS.
What is rheumatoid arthritis?
Chronic inflammation of joints.
What proportion of the population are affected by rheumatoid arthritis?
1%.
What deformities does rheumatoid arthritis lead to? (2)
- Joint deformity (swan neck)
- Rheumatoid nodules (over bony prominences)
Why are rheumatoid nodules very rare now?
Due to improved treatments.
What is the pattern of rheumatoid arthritis deformities?
Occurs symmetrically, mainly proximal phalangeal joints.
What vascular problem can rheumatoid arthritis lead to?
Vasculitis.
-inflammation of the vascular system
What joints are mainly affected by rheumatoid arthritis?
Fingers
Feet
Elbows
What is osteoarthritis?
Degeneration of synovial joints and underlying bone»_space; progressive destruction of hyaline cartilage.
-‘wear and tear’
What makes osteoarthritis so painful?
Cartilage is destroyed»_space; bones rub together.
What joints are mainly affected by osteoarthritis?
Weight-bearing joints/digits.
-hip, knee, thumb
What nodes form due to osteoarthritis? (2)
- Heberden’s nodes
- Bouchard’s nodes
What position did osteoarthritis used to lead to?
‘Windswept’ position.
What is primary osteoarthritis?
Osteoarthritis without a known cause.
What proportion of 75-79 year olds are affected by osteoarthritis?
85%.
Which gender is osteoarthritis more common in in
More common in males.
What is the familial pattern found in some cases of osteoarthritis?
Mutation of type II collagen.
What is secondary osteoarthritis?
Osteoarthritis that is caused by another disease/condition.
-e.g. obesity, trauma, surgery
What causes secondary arthritis?
Injury to the joint.
-e.g. bleeding, stress, inflammation
What causes psoriatic arthritis?
PSORIASIS; skin condition»_space; red patches on skin with silvery flakes.
Which areas of the body does psoriasis commonly affect?
Elbows, knees, bottom.
Which joints does psoriatic arthritis normally affect?
Any joint in the hand.
What deformity does psoriatic arthritis lead to?
Dactylitis.
- ‘sausage digit’
- inflammation of the digit
- shortened digits
What is gout?
Defective metabolism of uric acid»_space; arthritis and chalk-stone deposits.
What joints are most commonly affected by gout?
Smaller joints in the feet.
What are the 2 main types of gout?
- Acute podagra
- Chronic tophaceous gout
What is acute podagra?
Very painful arthritis due to gout.
-usually affects 1-2 joints
What is chronic tophaceous gout?
Nodular tophi (uric acid crystals) are deposited in soft tissue areas.
What is another name for Still’s disease?
Juvenile chronic arthritis.
What are the main effects/symptoms of Still’s disease? (3)
- Joint inflammation
- Rash (lasting ~1/2 an hour)
- Splenomegaly
What condition is ‘prayer sign’ present in?
Diabetes mellitus.
-cannot straighten fingers when hands are together
What is rheumatology?
The study of arthritis and other disorders of joint/muscles/ligaments.
List some other rheumatological conditions.
- Hypercholesterolaemia
- Ankylosing spondylitis
- Ricketts
- Scurvy
- Dermatomyositis
- Marfans
- Pseudo-gout
- Milwaukee shoulder
- Acromegaly
- Vasculitis
What problem does hypercholesterolaemia lead to in the heels?
Xanthelasma on the heel (yellow plaques).
-cannot straighten heel properly
What is ankylosing spondylitis?
Arthritis of the spine.
-joints fuse if untreated»_space; stiffened spine
What used to be the treatment for ankylosing spondylitis?
Radiotherapy.
-but lead to leukaemia and skin cancer
What is Ricketts?
Vitamin D deficiency.
-leads to swelling on chest wall, decreased growth and knees bow out (» osteoarthritis)
What is the main source of vitamin D?
Sunlight.
What is scurvy?
Vitamin C deficiency.
|»_space; spontaneous bleeding from skin and joints
What are the main signs of dermatomyositis? (2)
- Heliotropic rash around eyes/knuckles
- Muscle inflammation
How is dermatomyositis treated?
Steroids and immunosuppressants.
What is Marfans?
Defect in fibrinogen (collagen component) .» longer, hypermobile limbs, eye lens dislocation, aortic aneurysm.
-affects all collagen
What is pseudo gout?
Inflammation of joints due to deposits of calcium pyrophosphate crystals.
-not uric acid
What crystals are deposited to cause Milwaukee shoulder?
Calcium hydroxyaptite crystals.
What is acromegaly?
Increased growth hormone»_space; increased growth of body tissue and larger hands/feet.
-leads to 2* osteoarthritis
Name 3 types of vasculitis.
- Henoch-Schoenlein purpura
- Erythema nodosum
- Lupus pernio
