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MSK pathology > Athritis and Infection > Flashcards

Athritis and Infection Flashcards

1
Q

What are the most commmon organisms that cause osteomyelitis in children and adults?

A

staph aureus

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2
Q

What are the 3 non-inflammatory types of athritis

A

osteoathritis
avascular necrosis
neuropathic athropathy/charcot joint

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3
Q

What are the 3 inflammatory athritis disorders?

A

rheumatoid athritis
crystal deposition
septic athritis

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4
Q

What are the features of osteoathritis?

A

loss of articular cartilage,
radiographical joint space narrowing
synovial changes
bone remodeling

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5
Q

The risk factors for osteomyelitis are:

A 
increasing age
obesity
joint instability
abl joint shape
trauma
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6
Q

The clinical manifestation of osteoathritis:

A

pain that is worse with movement,
morning stiffness
decreased range of motion
bouchard/heberden nodes

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7
Q

The gross pathological findings of osteoathritis include:

A 
loss of articular cartilage
eburnation
thickened subchondral bone
subchondral cysts
osteophytes
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8
Q

What are the histological findings of osteoathritis?

A 
articular cartilage clefts, 
chondrocyte cloning, 
eburnation, 
osteophyte formation
villous synovial hyperplasia
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9
Q

The therapies for osteoarthritis include:

A

physical therapy
NSAIDS
athroplasty

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10
Q

How is Neuropathic athropathy/Charcot Joint different from osteoathritis?

A

Very rapid and severe, usually related to underlying disease

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11
Q

Avascular necrosis, is described as?

A

A joint ischemic disease where there is loss of adequate perfusion which leads to vascular disturbance at the ends of long bones. Only until stgae IV does athritis present

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12
Q

At what stage is reative bone seen at ende of necrotic bone?

A

Stage II.

Stage I involves just bone necrosis wedge

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13
Q

At what stage do we see the crescent sign? What is it?

A

A fracture of the end plate is seen in stage 3 with a wedge of necrotic bone.

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14
Q

What is Leg-Calve-Perthes disease?

A

ITs AVN in children, more common bc children’s ciculation in bone is less developed and children have more minor trauma, resulting from injury to the epiphyseal plate

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15
Q

What is rheumatoid athritis?

A

Autoimmune inflammatory reaction against joints, typically affecting women

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16
Q

What makes up rheumatic factor?

A

IgM against self IgG-Fc portion

these complexes depost

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17
Q

How would one with rheumatic athritis present? what joints are affected more often?

A

malaise, fatigue, generalized bone pain, swollen painful joints, in a polyarticular/bilateral/symmetrical fashion

affecting hands and feet then wrists, then ankles then elbows, then knees.

18
Q

What does radiographic imaging show of rheumatioid athritis? What does the soft tissue destruction lead to?

A

joint effusion
subchondral osteopenia- bone loss/destruction
marginal erosions
joint space narrowing

subluxations and periarticular cysts

19
Q

How is rheumatoid athritis seen in gross pathological review?

A

joint desctruction: thickened synovium, pannus, joint capsule destruction, rice bodies, osteophytes and joint fusion

20
Q

In histological review? Synovium

A

hypertrophic synovium with lymphoid follicles and fibrin with PMNs

bone cartilage destroyed by pannus, subchondral bone resorption, chronic inflammation

21
Q

What are the histological findings for bone in rheumatoid athritis?

A

cartilage destruction, subchondral bone resorption, chronic inflamm

22
Q

What lab tests can be done to test for rheumatoi athritis?

A

rheumatid factor- more sensitive

antiCCP- more specific

23
Q

What are rheumatic nodules? Where do they form?

A

in 25% of RA pt, they are palisading granulomas that occur subQ on extensor surfaces of elbow and forearm

24
Q

How is RA treated?

A

NSAIDs, PT, synovectomy

athroplasty, systemic immunosuppression

25
Q

What is the difference between juvenile rheumatoid athritis?

A

large joints, RF- ANA+, less severe, favorable outcome

26
Q

Name the 5 seronegative spondyloarthropathies

A 
ankylosing
reiters
enteropathic athroplasty
psoriative athropathy
IBD- associated athropathy
27
Q

What is the pathology of Gout?

A

Na-urate crystals deposited in periarticular tissue typically affecting males

28
Q

What are the physical complaints of gout sufferers?

A

swelling, erythema and severe pain at a joint

29
Q

What is the main difference bw gout and chondrocalcinosis?

A

The deposition of Ca pyrophosphate in articular caartilage and the crystals are rhomboid shaped

30
Q

What types of infections present as joint/bone disease?

A

joint- pyogenic

bone- granulomatous

31
Q

What are the ways a pyogenic infection can get into joints?

A

Hematogenous, adjacent gangrenous areas, direct inoculation from surgery

32
Q

Where does pyogenic osteomyelitis from hematogenous spread typically present as in adults?

A

spinal,

drug addits: spine and pelvis/ flat bone osteomyelitis

33
Q

What is the most likely organism to cause of pyogenic osteomyelitis?

A

staph aureus and sometimes: Ecoli, Hflu, salmonella

34
Q

What are the clinical features of pyogenic osteomyelitis?

A

bone pain, fever, chills

+/- blood cultures

35
Q

How are radiographic studies of bacterial osteomyelitis ?

A

radiolucent, destructive focus
intense surrounding reactive bone
periosteal reaction

36
Q

The histological findings of osteomyelitis include:

A

Acute- PMNs and necrotic bone
subacute- PMNs, plasma cells, lymphocytes
chronic- lymphocytes and fibrosis

37
Q

What are some complications of developing chronic osteomyelitis?

A

squamous cell CA
systemic amyloidosis
somtimes sarcomas

38
Q

What conditions often form granulomatous osteomyelitis?

A

Tb- AIDS- blood borne and direct spreas
mycotic infections,
echinococcal cyts
and sarcoidosis

39
Q

What are some radiographical characteristics of TB osteomyelitis?

A

soft tissue swelling, subchondral bone destruction
osteopenia
joint destruction

40
Q

Histologically, TB osteomyelitis?

A

caseating granulomatous inflammation in the synovium and bome

41
Q

What is septic athritis? What kids of organisms are involved?

A

supporative, bacterial infections of joints that hemotegenously seeds after direct inoculation from trauma.
bacilli
Organisms are typically staph, gonococcus gram -

42
Q

What diseases/conditions are involved?

A

TB- AIDS

lyme athritis- borrelia burgdorferi infections

MSK pathology (2 decks)

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