Chapter 25: Recognizing Joint Disease - An Approach To Arthritis Flashcards
Arthritis types Diagnosed clinically?
Septic (pyogenic) arthritis
Psoriatic arthritis
Gout
Hemophilia
Arthritis types diagnosed radiologically?
Osteoarthritis Early Rheumatoid Arthritis Calcium pyrophosphate deposition disease Ankylosis spondylitis Septic TB Charcot (neuropathic) joint - late
What are hallmarks of Hypertrophic arthritis?
Bone formation
Osteophytes
What are the types of hypertrophic arthritis?
Primary osteoarthritis
Secondary osteoarthritis
Charcot arthropathy
Calcium pyrophsphate deposition disease
Causes of hypertrophic arthritis?
Mechanical stress in hands, hips, and knees most common
Degenerative joint disease secondary to prior trauma or avascular necrosis
Fragmentation, joint destruction, and sclerosis secondary to diabetes
Chondrocalcinosis = DJD in unusual sites
Hallmarks of Erosive arthritis?
Erosions
Type of Erosive arthritis?
Rheumatoid
Gout
Psoriatic
Hemophilia
Ankylosis spondylitis
Seronegative spondyloarthropathies
Causes of erosive arhritis?
Osteoporosis and soft tissue swelling
Juxtaarticular erosions with overhanging edges; no osteoporosis
Juxtaarticular erosions of distal interphalangeal joints of hands; enthesophytes
Remodeling from hemarthroses and hyperemia
HLA B27+; bilateral sacroiliac joints; syndesmophytes
Rheumatoid factor negative; SI joints
Syndesmophytes; reactive, psoriasis
Hallmarks of Infectious arthritis?
Osteopenia and soft tissue swelling
Early and marked destruction of most or all of the articular cortex
Types of infectious arthritis?
Pyogenic
TB
Causes of infectious arthritis?
Early destruction of articular cortex; osteoporosis
Gradual and late destruction of articular cortex; marked osteoporosis
What are some causes of secondary osteoarthritis?
Trauma Infection Avascular Necrosis Calcium Pyrophosphate Deposition Disease Rheumatoid Arthritis
What are causes of Charcot Arthropathies in the Shoulders?
syrinx
spinal tumor
syphillis
What are causes of Charcot Arthropathies in the hips?
Tertiary Syphillis
Diabetes
What are causes of Charcot Arthropathies in the ankles and feet?
Diabetes (common)
Syphillis (uncommon)
What are some causes of Erosive Arthritis?
Rheumatoid Arthritis Gout Psoriatic arthritis Ankylosing spondylitis Rheumatoid variants Reactive arthritis Sarcoid Hemophilia
What is arthritis?
a disease of a joint that invariably leads to joint space narrowing and changes to the bones on both sides of the joint
What are the three types of Arthritis?
Hypertrophic
Infectious
Erosive
What are the features of Hypertrophic arthritis?
subchondral sclerosis
marginal osteophyte production
subchondral cyst formation
What is primary osteoarthritis?
type of hypertrophic arthritis
typically occurs on weight bearing surfaces of the hip and knee and DIPs
What is the most common type of arthritis?
Primary Osteoarthritis
What deposits in calcium pyrophosphate deposition disease?
calcium pyrophosphate crystals
What does calcium pyrophosphate deposition disease (CPPD) produce?
large, multiple subchondral cysts
Narrowing of patellofemoral joint space
metacarpal hooks
proximal migration of distal carpal row
What are the features of Charcot or Neuropathic Joints?
fragmentation
sclerosis
soft tissue swelling
What is the most frequent cause of Charcot/Neuropathic joints?
Diabetes
What is associated with Erosive/Inflammatory arthritis?
inflammation and synovial proliferation (pannus formation) which produces lytic lesions in or near the joint
What are the lytic lesions produced in Erosive arthritis called?
Erosions
What does rheumatoid arthritis effect?
carpals and proximal joints of the hand
widens the predentate space in the cervical spine
produces fusion of the posterior elements in the cervical spine
What does gout effect?
metatarsal-phalangeal joint of the great toe with juxtaarticular erosions and little or no osteoporosis
What are late manifestations of Gout?
Tophi
What does psoriatric arthritis effect?
distal joints primarily in hands
What does psoriatric arthritis produce?
characteristic erosions that resemble a pencil in a cup
What is Ankylosing spondylitis and its characteristics?
chronic and progressive arthritis
characterized by symmetric fusion of the sacroiliac joints and ascending involvement of the spine
What does Ankylosing spondylitis look like?
bamboo-spine
What are the features of infectious arthritis?
Soft tissue swelling
Osteopenia
Relatively early and marked destruction of most or all of the articular cortex = pyogenic
What are the common organisms that cause infectious arthritis?
Staphylococcus and Gonococcus
