Arthritis Flashcards
What is the definition of arthritis?
Inflammation of joints
What is the most frequent cause of disability in the US?
Arthritis
What fraction of the US is affected by arthritis?
Half of all adults
What are the three major types of joints?
- Synarthroses
- Amphiarthroses
- Diarthroses
What are synarthroses? Are they moveable?
Skull sutures, which are immovable
What are amphiarthroses? Are they moveable?
Pubis symphysis, sacroiliac, and spine
Limited movement
What are diarthroses? Are they moveable?
Moveable joints
What are the moveable joints?
Diarthroses
What is the synovium? What is the role of this?
- Single cell layer that lines the joint capsule
- Secretes thick viscous fluid
What is cortical bone?
Outer, denser layer of bone
What is trabecular bone?
Inner, highly vascularized bone
How is cortical bone arranged?
Along lines of stress
True or false: almost none of the labs that are available in rheumatology are 100% specific
True
What are the components of the history taking that are specifically important to rheumatic diseases? (5)
- Location
- Symmetry
- Onset
- Chronology
- Inflammation and weakness
What is the difference in the affected areas of the hand with RA vs OA?
RA affects MCPs
OA affects DIPs
Which affects the PIPs: OA or RA?
Both
What is the difference between acute, subacute, and chronic in terms of rheumatological diseases?
Acute = hours Subacute = days Chronic = weeks (6+ weeks)
What is the infectious diseases that causes RA-like symptoms in adults, but is self limited?
5th’s disease (parvovirus B19)
How common are fevers with rheumatologic diseases?
Common
What are four features that should be elicited with the joint exam on every joint?
- Signs of inflammation
- ROM
- Deformities
- Condition of surrounding structures
Why is acute monoarticular arthritis a red flag?
If a bacterial infection of the joint, can cause necrosis of the joint in a few days
Why are cranial symptoms in elderly patients with muscle pain a red flag?
Giant cell arteritis leading to blindness
Why is morning stiffness lasting over an hour in patients with back pain a red flag?
Suspicious for ankylosing spondylitis
What are the three major purposes of lab testing?
- Screening
- Confirming a dx
- Monitoring treatment
What are the acute phase reactants? (6)
ESR CRP Serum amyloid A Ferritin Fibrinogen Haptoglobin
What is the general use of measuring acute phase reactants?
Reflect the intensity of inflammation (regardless of etiology)
What is the role of measuring acute phase reactants in rheumatic disease?
Sensitive, but very non-specific
What is the role of CRP in anemia?
Will be higher
What, generally, is an ESR? How is it performed?
The rate at which red blood cells sediment in a period of one hour.
To perform the test, anticoagulated blood was traditionally placed in an upright tube, known as a Westergren tube, and the rate at which the red blood cells fall was measured and reported in mm/h.
Which produces a much faster change with inflammation: CRP or ESR
CRP
True or false: you should never order both an ESR and CRP
False–should do together
What happens to ESR with age?
Elevates