Arthritis Flashcards
Arthritis
Inflammation of joint
Types of arthritis
- Degenerative
- Immune mediated
- Metabolic
- Infectious
- Neoplastic
___ major source of morbidity
Osteoarthritis
Types of osteoarthritis
OA
DJD
MC joint disorder
Osteoarthritis
Advanced osteoarthritis can cause
Inflammation and subchondral changes
___ have limited growth capacity
Chondroctyes
MC form OA
Primary
Secondary OA due to
Previous injury or deformity
Common locations for OA
Cervical and lumbar spine
DIP joints
1st MCP joint
1st TMT joint
Least likely to cause ankylosis
OA
____ Patients have clinically significant inflammation
50%
____ and ____ seen with advanced OA
Inflammation
Subchondral cyst
Joint mice
Free fragment of bone causing pain
Risk factors for OA
>50 yo Genetics Estrogen High bone density Mechanical stress
Osteophytes ____ impinge nerve roots
Rarely
____ at DIP joints observed in OA
Heberden’s nodes
RA is ___ Disease and is chronic and ___
Autoimmune
Systemic
___ present in 80% RA cases
Rheumatoid factor
___ present in 70% RA
Anti-cyclic citrullinated peptides
Signs of RA
Weakness Malaise Fever Decrease ROM Cachexia
RA MC affects
Small joints
____ observed in 30% of RA
Atlanto-axial instability
Pannus in RA can cause
Ulnar deviation
Swan-neck deformity
Age for RA
Age 35-50
Sex more likely to get RA
Females 3-5X
Felty Syndrome combo of
RA
Neutropenia
Splenomegaly
Felty Syndrome MC in
Elderly females
Caplan Syndrome combo of
RA
Pneumoconiosis
Caplan Syndrome can mimic
Asthma
Juvenile RA
Autoimmunity of mult tissues
Juvenile RA affects what part of body
Large joints
Knee, hip
JRA MC in
Females
Biphasic age of JRA
MC 1-3 yo
6-13 yo
Still’s disease
JRA + spiking fever, rash, pericarditis
JRA is ___ for RF
Negative
Scheuermann’s Disease aka
Juvenile kyphosis
Diagnosis for scheuermann’s Disease
Wedge shaped vertebrae
> 3 consecutive
5 degree angle
Scheuermann’s Disease MC in
Adolescent males
Symptoms of scheuermann’s
Excesses T kyphosis
Schmorl’s nodes (end plate herniation up into vertebral body)
Aching pain worse with activity
Seronegative spondyloarthropathies
Autoimmune attack (PEAR)
PEAR
Psoriatic arthritis
Enteropathic arthritis
Ankylosing spondylitis
Reactive arthritis
Enterophathic arthritis associated with
Crohn’s
UC
Ankylosing spondylitis associated with
Inflammation
Sacroiliitis
Syndesmophytes
Ankylosis of SI joint
AS MC in
Males
Radiographic findings associated with advanced Ankylosing spondylitis
Syndesmophytes Bamboo spine Trolly track sign Ankylosis of SI joint Ankylosis of L spine Dagger sign Hypolordosis of L spine Squaring of V bodies
Rhyme for reactive arthritis
Can’t see
Can’t pee
Can’t climb tree
Can’t see for Reactive arthritis refers to
Conjunctivitis
Uveitis
Can’t pee of reactive arthritis refers to
Urethritis
Cervicitis
Diarrhea
Can’t climb tree of reactive arthritis refers to
Arthritis in large joints (esp Achilles’ tendon)
Reactive arthritis is ____ and associated with ____
Autoimmune
Infection
Infections that can trigger reactive arthritis
GI: salmonella, shigella
GU: gonorrhea, chlamydia
Reactive arthritis MC in
Males 20-40
Polymyalgia rheumatica (PMR) aka
Idiopathic chronic inflammation
Symptoms of PMR
Prolonged morning stiffness
Shoulder pain
Hip pain
PMR MC in
Females
> 50 yo
Northern Europeans
PMR associated with
Giant cell arteritis
Treatment for PMR
Corticosteroids
Primary gout
Abnormal purine metabolism
MC
Secondary gout
After disease or medication
Chronic topheaceous gout
Erosion of joint and loss of joint space Gouty nephropathy (20% lethal)
Symptoms of gout
Tissues red, swollen, warm, painful
Gout MC to affect
MTP joint of Hallux
Gout involves _____ accumulating
Uric acid/ monosodium urate crystals
