Chapter 25: Recognizing Joint Disease - An Approach To Arthritis Flashcards

1
Q

Arthritis types Diagnosed clinically?

A

Septic (pyogenic) arthritis
Psoriatic arthritis
Gout
Hemophilia

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2
Q

Arthritis types diagnosed radiologically?

A
Osteoarthritis
Early Rheumatoid Arthritis
Calcium pyrophosphate deposition disease
Ankylosis spondylitis
Septic TB
Charcot (neuropathic) joint - late
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3
Q

What are hallmarks of Hypertrophic arthritis?

A

Bone formation

Osteophytes

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4
Q

What are the types of hypertrophic arthritis?

A

Primary osteoarthritis
Secondary osteoarthritis
Charcot arthropathy
Calcium pyrophsphate deposition disease

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5
Q

Causes of hypertrophic arthritis?

A

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

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6
Q

Hallmarks of Erosive arthritis?

A

Erosions

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7
Q

Type of Erosive arthritis?

A

Rheumatoid

Gout

Psoriatic

Hemophilia

Ankylosis spondylitis

Seronegative spondyloarthropathies

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8
Q

Causes of erosive arhritis?

A

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

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9
Q

Hallmarks of Infectious arthritis?

A

Osteopenia and soft tissue swelling

Early and marked destruction of most or all of the articular cortex

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10
Q

Types of infectious arthritis?

A

Pyogenic

TB

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11
Q

Causes of infectious arthritis?

A

Early destruction of articular cortex; osteoporosis

Gradual and late destruction of articular cortex; marked osteoporosis

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12
Q

What are some causes of secondary osteoarthritis?

A
Trauma
Infection
Avascular Necrosis
Calcium Pyrophosphate Deposition Disease
Rheumatoid Arthritis
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13
Q

What are causes of Charcot Arthropathies in the Shoulders?

A

syrinx
spinal tumor
syphillis

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14
Q

What are causes of Charcot Arthropathies in the hips?

A

Tertiary Syphillis

Diabetes

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15
Q

What are causes of Charcot Arthropathies in the ankles and feet?

A

Diabetes (common)

Syphillis (uncommon)

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16
Q

What are some causes of Erosive Arthritis?

A
Rheumatoid Arthritis
Gout
Psoriatic arthritis
Ankylosing spondylitis
Rheumatoid variants
Reactive arthritis
Sarcoid
Hemophilia
17
Q

What is arthritis?

A

a disease of a joint that invariably leads to joint space narrowing and changes to the bones on both sides of the joint

18
Q

What are the three types of Arthritis?

A

Hypertrophic
Infectious
Erosive

19
Q

What are the features of Hypertrophic arthritis?

A

subchondral sclerosis
marginal osteophyte production
subchondral cyst formation

20
Q

What is primary osteoarthritis?

A

type of hypertrophic arthritis

typically occurs on weight bearing surfaces of the hip and knee and DIPs

21
Q

What is the most common type of arthritis?

A

Primary Osteoarthritis

22
Q

What deposits in calcium pyrophosphate deposition disease?

A

calcium pyrophosphate crystals

23
Q

What does calcium pyrophosphate deposition disease (CPPD) produce?

A

large, multiple subchondral cysts
Narrowing of patellofemoral joint space
metacarpal hooks
proximal migration of distal carpal row

24
Q

What are the features of Charcot or Neuropathic Joints?

A

fragmentation
sclerosis
soft tissue swelling

25
Q

What is the most frequent cause of Charcot/Neuropathic joints?

A

Diabetes

26
Q

What is associated with Erosive/Inflammatory arthritis?

A

inflammation and synovial proliferation (pannus formation) which produces lytic lesions in or near the joint

27
Q

What are the lytic lesions produced in Erosive arthritis called?

A

Erosions

28
Q

What does rheumatoid arthritis effect?

A

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

29
Q

What does gout effect?

A

metatarsal-phalangeal joint of the great toe with juxtaarticular erosions and little or no osteoporosis

30
Q

What are late manifestations of Gout?

A

Tophi

31
Q

What does psoriatric arthritis effect?

A

distal joints primarily in hands

32
Q

What does psoriatric arthritis produce?

A

characteristic erosions that resemble a pencil in a cup

33
Q

What is Ankylosing spondylitis and its characteristics?

A

chronic and progressive arthritis

characterized by symmetric fusion of the sacroiliac joints and ascending involvement of the spine

34
Q

What does Ankylosing spondylitis look like?

A

bamboo-spine

35
Q

What are the features of infectious arthritis?

A

Soft tissue swelling
Osteopenia
Relatively early and marked destruction of most or all of the articular cortex = pyogenic

36
Q

What are the common organisms that cause infectious arthritis?

A

Staphylococcus and Gonococcus