Arthritis - OA and RA

Question 1

Radiographic features of OA

Answer 1

Joint space narrowing, marginal osteophytes, subchondral cysts, bony sclerosis

Question 2

Laboratory features of OA

Answer 2

NONE! NEGATIVE!

Question 3

Distribution of primary OA

Answer 3

Knees, hips, MCP, PIP, DIP, lumbar and cervical vertebrae SPARES THE WRISTS, ANKLES, AND JAWS (unless secondary OA)

Question 4

Players in the pathogenesis of OA

Answer 4

MMP, IL-1, NO, and PGE

Question 5

Signs and symptoms of OA

Answer 5

Pain worse through day, minimal morning stiffness (LESS THAN 20 MINUTES, IF HOURS THINK RA), bony enlargement, crepitus

Question 6

Risk factors for OA

Answer 6

AGE, female, obesity, trauma

Question 7

Epidemiology of RA

Answer 7

Older age, 3x more in females, increased mortality

Question 8

Genetic risk for RA associated with which genes?

Answer 8

HLA-DRB1, PTPN22

Question 9

Pathogenesis of RA

Answer 9

T cell activation via HLA-DR4

Question 10

Rheumatoid factor

Answer 10

IgM antibodies to the Fc portion of IgG

Question 11

RF in RA

Answer 11

NONSPECIFIC - also seen in Hep C + cryoglobulinemia, cigarette smoking, aging, and chronic conditions

Question 12

Specific marker of RA

Answer 12

Anti-CCP

Question 13

Signs and symptoms of RA

Answer 13

Morning stiffness (AT LEAST 30 MINUTES), swelling, warmth, and erythema around joint, ulnar deviation, swan neck deformities, neck pain (atlantoaxial subluxation)

Question 14

Joint involvement in RA onset

Answer 14

Begins as a few random joints usually large (knee, hip)

Question 15

Joint involvement in RA late

Answer 15

Symmetric; wrist and proximal hand joint, MCP + PIP, DIP SPARING; Also: knees, hips, ankles, elbows, shoulders

Question 16

Rheumatoid nodules

Answer 16

Commonly on extensor surfaces

Question 17

Other extraarticular manifestations of RA

Answer 17

Dry eyes, dry mouth, respiratory and cardiac involvement, peripheral neuropathy