Diseases of the joint

Question 1

Characterized by cartilage degeneration and fibrillation that results in structural and functional failure of synovial joints

Answer 1

Osteoarthritis

Question 2

Lesions stem form degeneration of the articular cartilage and disordered repair

Answer 2

Osteoarthritis

Question 3

Associated with fibrillation of cartilage and subchondral cyts

Answer 3

Osteoarthritis

Question 4

Heberden nodes

Answer 4

Bone excrescences at the DIP

Question 5

Bouchard nodes

Answer 5

Bone excrescences at PIP

Question 6

Characteristic fissuring, flaking, and erosion of cartilage microscopically

Answer 6

Osteoarthritis

Question 7

Symmetric polyarthritis with nonsuppurative proliferative and inflammatory synovitis

Answer 7

RA

Question 8

Pathogenesis of RA

Answer 8

CD4+ helper T cell initiate autoimmune response against self-antigens

Question 9

Major cytokine mediators involved in RA

Answer 9

IFN-gamma
IL-17
RANKL
TNF
IL-1

Question 10

Edematous, thickened, and hyperplastic synovium

Answer 10

RA

Question 11

Pannus

Answer 11

Mass of edematous synovium, inflammatory cells, granulation tissue, and fibroblasts in RA

Question 12

Central zone of fibroid necrosis surrounded by a prominent rim of activated macrophages, lymphocytes, and plasma cells

Answer 12

Rheumatoid nodules

Question 13

Boutonniere deformity

Answer 13

PIP flexion and DIP extension in RA

Question 14

Swan neck deformity

Answer 14

PIP hyperextension and DIP flexion

Question 15

Radiograph shows joint effusions, juxta-articular osteopenia with erosions, narrowing of joint space, loss of articular cartilage, and carpal crowding at wrist

Answer 15

RA

Question 16

Specific marker for RA

Answer 16

Anti-citrullinated peptide antibodies

Question 17

IgM and IgA autoantibodies that bind to IgG Fc regions

Answer 17

Rheumatoid factor

Question 18

Genetic allele seen in many pts with RA

Answer 18

HLA-DRB1

Question 19

Felty syndrome

Answer 19

Splenomegaly, neutropenia, and RA

Question 20

Severe destructive arthropathy in joint deprived of pain and position sense

Answer 20

Neuropathic joint disease or Charcot’s joint

Question 21

X-ray shows either bone resorption or new bone formation with bone dislocation and fragmentation

Answer 21

Charcot’s joint

Question 22

Oligoarthritis of large joints with a positive ANA in children

Answer 22

Juvenile idiopathic arthritis

Question 23

Heterogenous groups of disorders characterized by absence of RF, pathologic changes of ligamentous attachments, SI joint involvement, and HLA-B27.

Answer 23

Seronegative spondyloarthropathies

Question 24

Increased IF-alpha, IL-6, TNF-alpha, and inflammatory markers recruit T cells into skin and joint

Answer 24

Psoriasis and psoriatic athritis

Question 25

Asymmetric joint involvement including DIP and spine with joint stiffness in the morning. Dactylitis is also seen.

Answer 25

Psoriatic arthritis

Question 26

Other conditions seen in psoriasis and psoriatic arthritis

Answer 26

Uveitis Sacroiliitis

Question 27

Chronic inflammatory disorder that causes destruction of articular cartilage and bone ankyloses that primarily involves SI joint and spine

Answer 27

Ankylosing spondylitis

Question 28

Allele associated with 90% of ankylosing spondylitis

Answer 28

HLA-B27

Question 29

Conditions associated with ankylosing spondylosis

Answer 29

Aortitis with regurgitation Anterior uveitis Restrictive lung disease

Question 30

Positive Schober test

Answer 30

Limited spine flexibility in ankylosing spondylitis

Question 31

Radiographic characteristic of ankylosing spondylitis

Answer 31

Bamboo spine due to vertebral body fusion

Question 32

Triad in reactive arthritis

Answer 32

Mono or oligo arthritis Nongonococcal urethritis or cervicitis Conjunctivitis

Question 33

Circinate balanitis

Answer 33

Shallow ulcerations on distal shaft and glans of penis, associated with reactive arthritis

Question 34

Keratoderma blennorrhagicum

Answer 34

Yellow-brown vesico-pustular lesions lesion associated with reactive arthritis

Question 35

Ossification at tendo-ligamentous insertion sites and development of calcaneal spurs and bony outgrowths

Answer 35

Reactive arthritis