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MSK > arthritis (needs reviewal) > Flashcards

arthritis (needs reviewal) Flashcards

1
Q

JIA/JRA (childhood arthritis)

A

juvenile idiopathic arthritis

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2
Q

3 major subtypes

A

Systemic, oligoarticular, polyarticular

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3
Q

all JIA symptoms include

A

joint pain, swelling, and inactivity stiffness
last at least 6 weeks
younger than 16

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4
Q

systemic JIA etiology + epidemiology

A

idiopathic, autoimmune
least common

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5
Q

systemic JIA presentation

A

fever - high spiking, intermittent fever
rash - salmon pink, axilla/around waist. worse with heat
arthritis - wrists, knee, ankles but also any joints
systemic - hepatospenomegaly, lymphandenopathy, serositis. uveitis is rare

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6
Q

systemic JIA diagnosis

A

fever must be present for 2 weeks, arthritis for 6 weeks

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7
Q

systemic JIA labs

A

leukocytosis, thrombocytosis, anemia, ESR and CRP elevation
ANA and RF always negative

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8
Q

systemic JIA treatment

A

NSAIDs, oral glucocorticoids, DMARDS (nonbiologic or biologic), peds rheum referral

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9
Q

DMARDS

A

suppress bodys overactive immune system
take weeks to months to become effective

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10
Q

systemic JIA complications

A

destructive damage
macrophage activation syndrome
severe growth retardation

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11
Q

oligoarticular JIA etiology + epidemiology

A

idiopathic, autoimmune
most common, F>M

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12
Q

oligoarticular JIA presentaiton

A

arthritis - usually asymmetrical, large joints (knees, ankles, wrists, elbows)
limping w/o pain that improves throughout day

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13
Q

oligoarticular JIA diagnosis

A

less than 5 joints during first 6 months

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14
Q

oligoarticular JIA labs

A

ANA - might be positive
ESR - normal/mildly elevated

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15
Q

oligoarticular JIA treatment

A

NSAIDs, glucocorticoids
regular eye exams

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16
Q

oligoarticular JIA complications

A

uveitis - 20%
leg length discrepancy

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17
Q

polyarticular JIA etiology + epidemiology

A

idiopathic, autoimmune
bimodal distribution (2-5, and 10-14)

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18
Q

polyarticular JIA presentation

A

arthritis - symmetric
<10 years - 1-2 joints, epreads rapidly
older children - rapid onset in multiple joints

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19
Q

polyarticular JIA diagnosis

A

arthritis in 4+ joints in first 6 months

20
Q

polyarticular JIA labs

A

ANA +, ESR elevtaed, mild anemia
+ RF in older than 10 maybe

21
Q

polyarticular JIA treatment

A

NSAIDs, DMARDS, oral glucocorticoids
eye exams if positive ANA

22
Q

polyarticular JIA complications

A

may cause destructive damage, uveitis, osteoporosis

23
Q

reactive arthritis

A

conjunctivitis, urethritis, arthritis
arthritis following an infection
seronegaitve

24
Q

seronegative

A

neg RF and ANA

25
Q

reactive arthritis etiology

A

GU or GI infections
chlamydia trachomatis, campylobacter

26
Q

reactive arthritis presentation

A

arthritis, enthesitis, dactylitis, back pain
extraarticular manifestations - conjunctivitis, urethritis

27
Q

reactive arthritis labs

A

HLA-B27
leukocytosis - maybe
genital swab, stool cultures

28
Q

reactive arthritis treatments

A

NSAIDs, intraarticular glucocorticoid injections, ABX for chlamydia

29
Q

RA

A

chronic, systemic, inflammatory disease that involves joints

30
Q

RA etiology

A

unknown, autoimmune
F 2-3 times more often

31
Q

RA presentation

A

morning stiffness 30-60 minutes
symmetric joint swelling
arthritis - peripheral joints. DIP joint spared

32
Q

RA symptoms

A

fatigure, weight loss, malaise, anemia, splenomegaly, sjogrens

33
Q

RA PE findings

A

tenderness to palpation, swelling, bogginess, decreased ROM, joint deformities

34
Q

common joint deformities RA

A

ulnar drift, swan neck, boutonneire, subcutaneous rheumatoid nodules on UE extensor surfaces, foot mirrors

35
Q

RA diagnosis criteria

A

inflammatory arthritis in 3 or more joints
RF, anti-CCP, ESR, CRP elevation
+ANA
duration of sxs > 6 weeks

36
Q

RA imaging

A

joint erosions, displacement on xray

37
Q

RA treatment

A

refer to rheum
education, PT/OT
DMARDS, NSAIDs, glucocorticoids (PO or injection)
consider surgery if advanced

38
Q

RA prognosis + complications

A

joint damage is irreversible
if untreated - destruction

39
Q

OA risk factors

A

advanced age, obesity, female gender, occupation

40
Q

OA presentation

A

arthritis - pain, stiffness less than 30 min, weight bearing joints

41
Q

OA PE

A

tenderness to palpation along joint line
bony enlargments
decreased ROM
crepitus
joint deformities

42
Q

OA joint deformities

A

heberden and bouchard nodes
bony enlargements of knees - varus/valgus

43
Q

OA diagnosis

A

clinical
persistent joint pain
age >45
morning stiffness <30min

44
Q

OA imaging

A

joint space narrowing, sclerosis of joint line, subchondral cysts, osteophytes

45
Q

OA lab findings

A

normal

46
Q

OA treatment

A

education, weight loss, exercise, PT/OT
topical and oral NSAIDs, topical capsaicin, duloxetine, intra-atricular glucocorticoids
surgical if failed conservative

MSK (20 decks)

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