Arthritis and Crystal Arthropathy Flashcards
Spectrum of inflammatory arthritis
What is the underlying pathophysiology that causes gout?
Elevated serum urate aka hyperuracemia.
How does elevated serum urate cause gout?
As urate levels rise body tissues become supersaturated and monosodium urate crystals form in and around joints.
These trigger white cell response and inflammation = clinical gout.
Risk factors for hyperuraecemia and gout.
Risk factors for acute attacks of gout.
What is the clinical presentation of gout?
What joints are commonly affected by gout?
Most frequently affected joint is the first MTPJ (first metatarsophalangeal joint).
– Mid-foot, ankle, knee, wrist fingers and elbows.
What are tophi?
Treatment of gout.
Reduce inflammation and pain Affected joints should be rested, elevated and exposed in a cool environment. Bed-cages and ice-packs can be effective adjuncts to management.
- Non-steroidal anti-inflammatory drugs
- Colchicine
- Corticosteroids
What are used as urate lowrering drugs?
Xanthine oxidase inhibitors.
Aim for target serum urate <300 µmols/litre
What are the two crystal arthropathy’s?
Gout
Pseudogout
Pseudogout
Calcium pyrophosphate crystals cause what?
Pseudogout
Rheumatoid arthritis
Auto-immune condition more common and severe in women.
How does rheumatoid arthritis link to increased mortality?
Increased cardiovascular mortality due to ischaemic heart disease.
Non-Hodgkin’s Lymphoma
Clinical features of rheumatoid arthritis.
Which joints are commonly affected in RA?
Normal vs arthritic joints
How can the hands be effected in RA?
Swan neck deformitiy due to RA
What are rheumatoid nodules?
How may the organ systems be effected by rheumatoid arthritis?
Ischaemic heart disease
Eyes: Sjorgens syndrome
Scleritis
Skin: Ulceration
Vasculitis
What are the radiological signs of RA?
Juxta-articular osteopenia is the loss of bone around either side of the joint.
