Degenerative vs. Inflammatory Joint Conditions Flashcards
What is the difference in age of onset?
- RA at any point (peaks at 30-40)
- OA later in life
What is the difference in speed of onset?
RA rapid (weeks to months) OA slowly (over years)
What are the differences in joint symptoms?
RA - painful, swollen, stiff
OA - ache, tender, little/no swelling
What are the differences in the patterns of joints affected?
- RA symmetrical = small and large joints
- OA unsymmetrical = begins on 1 side and spreads to other, 1 set of joints limited to, large weight bearing joints
How long does joint morning stiffness last for each?
RA = longer than 1 hour OA = less than 1 hour, returns at end of day or after period of inactivity
What is the difference in the presence of symptoms?
- RA frequent fatigue, general feeling of being ill
- OA no systemic symptom
What nodes do you get in OA?
- Heberden’s nodes = bony outgrowths on DIPs
- Bouchard’s nodes = bony outgrowths of PIPs
What are the risk factors of OA?
- age
- obesity (especially at knee)
- abnormal mechanical loading (dysplasia)
- inherited type II collagen defects in premature polyarticular OA
- inheritance in nodal and erosive OA
- occupation (farmers)
- other arthritic conditions
What are the causes of primary OA?
- idiopathic
- generalised
- erosive
What are the causes of secondary OA?
- prior inflammatory disease (RA)
- due to mechanical congruity (dysplasia)
- endocrine disorders (diabetes, acromegaly)
- metabolic disorders
What are the physical signs in OA?
- crepitus
- osteophytes
- deformity
- instability
- restricted movement
- effusion
- muscle weakness/wasting
How can anaemia of chronic disease present as a result of RA?
- hypochromic normocytic anaemia
- dysregulation of iron homeostasis
- impaired proliferation of erythoid progenitor cells
- shortened lifespan of RBC
- decreased iron availability for RBC production
- blunted EPO response
What are the 4 signs on a radiograph for OA?
- cartilage loss (joint space narrowing)
- osteophytes
- subchondral sclerosis
- trabeculae fractures/subchondral cysts
What is erosive OA?
- more inflammatory form of OA
- confused with RA
- erosions of cartilage in DIP and PIP
What joints does RA commonly affect?
- PIPs, MCP, carpals
- can affect any synovial joint but mostly small