Arthritis

Question 1

GALS

Answer 1

Gait, arms, legs, spine

Question 2

REMS

Answer 2

Regional examination of the musculoskeletal system

Question 3

Rheumatoid arthritis deformities

Answer 3

1. Ulna deviation
2. Boutonniere deformity
3. Z-shaped thumb deformity
4. Swan neck deformity
   (Rhemuatoid nodules - bone prominences)

Question 4

Rheumatoid arthritis usually spares?

Answer 4

Distal interphalangeal joints (effects MCP, PIP)

Question 5

Vascular effects of rheumatoid arthritis

Answer 5

Vasculitis - toe median artery inflammation > gangrene, rash in armpit, red/purpley spots (venusitits)

Question 6

What is osteoarthritis?

Answer 6

Disease of synovial joints, slow progressive destruction of articular cartilage (weight bearing joints and digits)

Question 7

Components of a typical synovial joint

Answer 7

1. Joint capsule

2. Synovial membrane

Question 8

Joint capsule

Answer 8

Joint enclosure, reinforced by and strengthened with ligaments

Question 9

Synovial membrane

Answer 9

Continuous sheet of connective tissue lining capsule - cells produce synovial fluid - lubricates the joint, preventing two cartilage caps rubbing together

Question 10

Synovial fluid

Answer 10

Produced by synovial membrane, lubricates the joint, very little fluid, exists in the cavity

Question 11

Hyaline cartilage

Answer 11

Where bones actually meet

Question 12

Clinical features of osteoarthritis

Answer 12

1. Herbeden’s nodes (DIP)
2. Bouchard’s nodes (PIP)
   Symmetrical/windswept position

Question 13

Where does osteoarthritis commonly occur?

Answer 13

Fingers, big toes, knees (weight bearing joints)

Question 14

Radiographic osteoarthritis

Answer 14

Narrowed joint space, bony spurs, subchondrial scleorsis, cyst-like

Question 15

Who does osteoarthritis commonly affect?

Answer 15

Old women, familial, diabetics, obese

Question 16

Primary osteoarthritis

Answer 16

Prevalence increases with age, before 45 males, after 55 females, ‘wear and tear’, not familial/type 2 collagen mutation, NO PREDISPOSING CAUSE

Question 17

Secondary osteoarthritis

Answer 17

ASSOCIATED WITH PREDISPOSING CONDITION (congenital abnormal joint/slipped femoral epiphysis, trauma to joint, abnormal stress on a joint, previous inflammation, neuropathic joints - diabetes)

Question 18

Psoriatic arthritis often effects where?

Answer 18

Elbows, knees, bottom, back

Question 19

Is psoriatic arthritis asymmetrical or symmetrical?

Answer 19

Asymmetrical

Question 20

Clinical features of psoriatic arthritis

Answer 20

Shortening of digits (telescoping - restore), phalanges destroyed, any joint in hand, dacytilysis, sausage digit

Question 21

Pseudo gout

Answer 21

Crystal different calcium pyrophosphate