Arthritis, Rheumatology Flashcards
Name 5 main types of arthritis
- osteoarthritis
- rheumatoid arthritis
- ankylosing spondylitis
- gout
- septic arthritis (infection)
What does arthritis mean?
inflam of bone
What is rheumatology?
study of locatmotive system
- joints, muscles, ligaments
Name 3 main subtypes of rheumatic disease and list diseases within these subtypes
- Degenerative
- osteoarthritis
- cervical spondylitis - Inflammatory
- rheumatoid arthritis
- crystal arthropathies - gout / pseudo-gout
- septic arthritis
- connective tissue disease
- Seronegative SpA (spondyloarthritis) - eg - ankylosing spondylitis - Soft tissue
- tennis elbow
- golfer’s elbow
- mechanical back pain
- repetitive strain - Other
- fibromyalgia
- osteoporosis
What are risk factors for osteoarthritis?
age
trauma
osteoporosis
obesity
What is fibromyalgia?
rheumatic condition characterized by muscular or musculoskeletal pain with stiffness and localized tenderness at specific points on the body
Name 4 Seronegative Spondylarthropathies
- ankylosing spondylitis
- reactive arthritis
- psoriatic arthritis
- enteropathic arthritis
Common for young men to get them
Lots of joints can be affected
Rheumatoid factor not present (therefore seronegative)
Where ligaments enter joints = issue (not synovial fluid)
What is reactive arthritis?
inflam caused by an infection - eg UTI, sore throat
can occur anywhere
No treatment
Usually self limiting
What is psoriatic arthritis?
inflam of any joint
associated with psoriosis (scaly skin)
What is enteropathic arthritis?
inflam of joints
linked to Crohn’s or ulcerative colitis
What gender / age often get Seronegative Spondylarthropathies?
young men
Why are they called Seronegative Spondylarthropathies?
Rheumatoid factor not present (therefore seronegative)
What part of joint is affected by Seronegative Spondylarthropathies?
Where ligaments enter joints = issue (not synovial fluid)
Name 6 connective tissue disorders
- SLE - lupus
- Sjogren’s syndrome
- Scleroderma
- polymyositis
- dermatomyositis
- Vascularitis
- giant cell arteritis
- PMR - polymyalgia rheumatica
- Takayasu’s arteritis
- polyarteritis nodosa
- Wedener’s granulomatisis
- Behcet’s syndrome
What is main area affected by giant cell arteritis?
temples are sore because carotid a. inflam
What is scleroderma?
all organs become fibrous
therefore tighter
eg harder to open mouth
What is polymyositis and dermatomyositis?
attack on striated muscle, esp thighs
Dermatomyositis = panda eyes
What is polymyalgia rheumatica?
Vasculitis
inflam of medium to large arteries
What is Takayasu’s arteritis?
Vasculitis
inflam of aorta
What is affected in Wegener’s granulomatisis?
Vasculitis
inflam of small arteries
kidney issues
What are symptoms of Behcet’s syndrome?
Vasculitis
- miscarriages
- oral ulcers
- genital ulcers
Name components of a normal joint
bone cartilage capsule (ligament) synovium synovial fluid enthesis
How think is cartilage in a healthy joint?
1-3mm
What does the synovium do?
produces synovial fluid
passes on nutrients from blood to cartilage
Is blood and / or nerves present in cartilage?
Neither
What is the enthesis?
Where ligaments/tendons joins bone
part of joint
What are causes of 5 main types of arthritis?
- osteoarthritis - cartilage death
- rheumatoid arthritis - inflam of synovium
- ankylosing spondylosis - inflam of enthesis, new bone formation (syndesmophytes)
- septic arthritis - infection
- gout - crystal formation (sodium urate = gout, calcium pyrophospate = pseudogout)
What is osteoarthritis?
asymmetrical loading of joint reduced cartilage - in patches subchondral bone thickens / sclerosis- to protect itself capsule thickens maybe increase in synovial fluid osteophytes form
Why does subchondral bone thicken / sclerose in osteoarthritis?
to protect itself and cartilage dies
What happens to joint space in osteoarthritis?
It narrows
NB may have increase in synovial fluid
What are two bony reactions of osteoarthritis?
- osteophytes form
- subchondral thickening
What happens to capsule in osteoarthritis?
It thickens, becomes fibrotic
What happens to synovium in osteoarthritis?
may become inflam
may produce more synovial fluid
If patient stays they have arthritis, what is best question to ask to determine type?
Do you see a rheumatologist?
If no = osteoarthritis
If yes = rheumatoid arthritis
What are swellings on finger joints called in osteoarthritis?
main knuckle = Bouchard’s node
top knuckle = Heberden’s node
What do swellings on finger joints feel like in osteoarthritis?
Feel hard and painless
What can be seen in xrays with osteoarthritis?
joint space narrowing
subchondral bone thickening / sclerosis
osteophytes
Who is more prone to osteoarthritis?
women
>50yrs
What is rheumatoid arthritis?
Inflam and overgrowth of synovium
- mixture of acute and chronic changes (synovitis)
synovial cells enlarge and ‘eat’ bone = bone erosions
What are systemic symptoms of rheumatoid arthritis?
fever, malaise, low BMI, reduced weight
increased risk ischemic heart disease
What are local symptoms of rheumatoid arthritis?
Pain
stiffness
How will the joints feel if acute or chronic rheumatoid arthritis?
acute = squishy joints chronic = joints look deformed
What happens to cartilage in rheumatoid arthritis?
generalised loss
NB osteoarthritis = patchy loss of cartilage
Where is more most likely to thin in rheumatoid arthritis? What is this called?
juxta-articular osteoporosis
