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Bone > Dougherty Part 5 > Flashcards

Dougherty Part 5 Flashcards

1
Q

what is the cause of primary osteoarthritis

A

idiopathic with aging

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2
Q

where does primary osteoarthritis primarily effect men and women

A

men: hips predominate
women: knees and hands

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3
Q

what are the main causes of secondary osteoarthritis

A

repeated injuries to a joint
hemochromatosis
obesity

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4
Q

osteoarthritis is also called what and is due to what by what

A

degenerative joint disease (DJD)

degeneration of cartilage outpaces repair

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5
Q

what are the phases of osteoarthritis

A

chondrocyte injury
chondrocytes proliferate
chondrocytes drop out with loss of cartilage

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6
Q

what is bone eburnation and when is it seen

A

exposed bone on surface-looks like polished ivory and underlying bone sclerosis
seen in osteoarthritis

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7
Q

what is an osteophyte (bone spur) and when is it seen

A

extra bone at joint edge

seen in osteoarthritis

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8
Q

what is seen grossly in osteoarthritis

A 
superficial roughened and cracked cartilage
subchondral cysts of synovial fluid
bone eburnation
joint mice
osteophytes
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9
Q

what is joint mice and when are they seen

A

loose bodies of cartilage

seen in osteoarthritis

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10
Q

what happens to osteoarthritis with use

A

worsens

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11
Q

what is a heberden node and when is it seen

A

osteophytes in DIP in women

seen in osteoarthritis

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12
Q

what does a patient with osteoarthritis present with

A 
deep achy pain
morning stiffness
worsens with use
crepitus of joint
limited range of motion
vertebral osteophytes impinge on nerve roots
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13
Q

osteoarthritis spares what

A

wrists, elbows, shoulders

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14
Q

what is rheumatoid arthritis

A

systemic autoimmune inflammatory disease

nonsuppurative proliferative inflammatory synovitis often destroying cartilage with later ankylosis of the joint

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15
Q

who and when are affected by rheumatoid arthritis

A

females > males

any but most often 40-70

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16
Q

what is pannus

A

exuberant inflamed synovium
chronic inflammation with T-cells (mostly CD4+), B-cells, plasma cells, macrophages
granulation tissue with hemosiderin
erodes articular cartilage
erodes bone (juxtarticular cysts, subschondral cysts, osteoporosis)

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17
Q

what is the pathogenesis of rheumatoid arthritis

A

antigen exposure in a susceptible host creating an ongoing autoimmune processes

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18
Q

80% of rheumatoid arthritis patients have what

A

Rheumatoid factor (non specific)

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19
Q

antibodies to what are found in rheumatoid arthritis that is more specific than RH factor

A

Citrullin-modified peptides (anti-cyclic citrullinated peptide or CCP Ab)

20
Q

Rheumatoid arthritis affects what joints

A

symmetric with small joints before large:
PIP, MCP, MTP
later wrists, ankles, elbow, knees (spares hip)

21
Q

what is seen in the joints of people with rheumatoid arthritis

A

swollen, warm, painful, and stiff with inactivity

22
Q

what is seen on an x-ray of rheumatoid arthritis

A

juxta-articular osteopenia
bone erosions with narrowing of joint space from loss of articular cartilage
joint effusions

23
Q

what is seen grossly in late stage rheumatoid arthritis

A

radial deception of wrist
ulnar deception of fingers
flexion-hyperextension of fingers (swan neck, boutonniere)
synovial cysts

24
Q

what is a Bakers Cyst and whats its associated with

A

synovial cyst of the back of knee (popliteal fossa)

rheumatoid arthritis

25
Q

what is the most common cutaneous manifestation seen in rheumatoid arthritis

A

rheumatoid nodules

26
Q

where are rheumatoid nodules found

A

areas subject to pressure: ulnar aspect of forearm, elbows, occiput, lumbrosacral

27
Q

what are rheumatoid nodules

A

fibrinoid necrosis surrounded by macrophages

28
Q

what happens to blood vessels rheumatoid arthritis

A

vasculitis:
does not involve kidneys
can be obliterative endarteritis of vasa nervorum and digital arteries
leukocytoclastic venulitis (purpura, skin ulcers, and nail bed infarction)

29
Q

what are the criteria for rheumatoid arthritis (need 4 of them to diagnose)

A 
AM stiffness
more than 2 joints arthritis
typical hand joint involvement
symmetric arthritis
rheumatoid nodules
serum rheumatoid factor
typical radiologic changes
30
Q

juvenile idiopathic arthritis is waht

A

a heterogeneous group by definition before age 16 and present 6 weeks:
oligoarticular (less than 5 joints)

31
Q

where does juvenile idiopathic arthritis normally affect

A

large joints:
knees
wrists

32
Q

what extra-articular manifestations are associated with juvenile idiopathic arthritis

A 
pericarditis
myocarditis
pulmonary fibrosis
uveitis
glomerulonephritis
growth retardation
33
Q

what are the two main differences between juvenile idiopathic arthritis and rheumatoid arthritis

A

absence of rheumatoid factor
absence of rheumatoid nodules
may be ANA positive

34
Q

what is found in both rheumatoid arthritis and juvenile idiopathic arthritis

A

pannus formation

morphology of involved joints

35
Q

seronegative spondyloarthropathites are usually positive for what and negative for what

A

HLA B27 positive (most)

Rheumatoid factor negative

36
Q

ankylosing spondyloarthritis aka “rheumatoid spondylitis” is found in what patients

A

young adults
onset 2-3 decade with low back pain
M > F

37
Q

at what sites is ankylosing spondyloarthritis found

A

axial joints:
sacroiliac joints
apophyseal joints of vertebrae

38
Q

in ankylosing spondyloarthritis what happens to the joints

A

inflammation of tendon/ligament insertion:
ossification of inflammation
fibrous and boney ankylosis

39
Q

what complications are involved with ankylosing spondyloarthritis

A 
1/3 hip, knee, shoulder arthritis
uveitis
aortitis
amyloidosis
spine fractures
40
Q

bamboo spine is due to what and seen in what

A

fusion of the vertebrae

seen in ankylosing spondyloarthritis

41
Q

reactive arthritis is commonly due to what

A

genitourinary: chlamydia
GI: shigella, salmonella (diarrhea)

42
Q

reactive arthritis is also known as

A

Reiter Syndrome

43
Q

what is the triad associated with reactive arthritis (reiter syndrome)

A

arthritis
urethritis or cervicitis
conjunctivitis

44
Q

sausage toe or finger is due to what and seen in what

A

digital tendon sheath synovitis

seen in Reiter syndrome

45
Q

reactive arthritis (weiter syndrome) is associated with what

A

HLA-B27

some HIV

46
Q

what joints and in what pattern does reiter syndrome affect

A

lower extremity: ankles, knees, feet in asymmetric pattern

47
Q

what extra-articular signs are seen in retire syndrome

A

balanitis
conjunctivitis
heart condition defects
aortic regurgitation

Bone (19 decks)

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