Dougherty Part 6 Flashcards
enteritis-associated arthritis is caused by what
liposaccharide stimulate immune response
GI infection from yersinia, salmonella, shigella, campylobacter
enteritis-associated arthritis is most often found where and lasts how long
abrupt in knees and ankles
generally clears in less than 1 year
psoriatic arthritis seen in what patients and associated with what
10% of psoriasis patients
HLA-B27
HLA-Cw6
when is the typical onset of psoriatic arthritis
30-50
the pencil cup deformity is seen in what
psoriatic arthritis
what sites does psoriatic arthritis affect
50% asymmetric in DIP of hands/feet
can affect large joints
psoriatic arthritis can cause what disease
sacroiliac and spine disease
what limited extra-articular complications are involved with psoriatic arthritis
conjunctivitis
iritis
infectious arthritis in a child less then 2 is most commonly caused by what
H. Flu
infectious arthritis in a adolescent/young adult is most commonly caused by what
gonococcus (F>M)
infectious arthritis in a elderly and children over 2 is most commonly caused by what
Staph Aureas
infectious arthritis in sickle cell disease is most commonly caused by what
salmonella
bacterial infectious arthritis due to gonococcus is often what and where
subacute
one joint
knee > hip > shoulder > elbow
bacterial infectious arthritis in drug abuses affects what
axial joints
Viral infectious arthritis can be caused by what
Parvovirus B19
HCV, HBV
HIV
infectious arthritis due to tuberculosis is what
monoarticular typically from adjacent osteomyelitis or hematogenous spread
vertebrae, hips, knees ankles
lyme disease can present when after the bite form ixodes
2weeks - 2 years
gout is caused by what
uric acid from purine metabolism
the crystals seen in gout exhibit what
negative birefringent
gout is the end point of what
hyperuricemia
what is a tophi
mass deposits of urates
macrophages, lymphocytes, and giant cells
if gout is chronic what is common to see
urate nephropathy
patients with gout get acute arthritis, why?
monosodium urate precipitation in joint
can become chronic
about what percent of the population has hyperuricemia and what percent of that has gout
10% of pop with hyperuricemia
gout in 0.5% of this population
primary gout is due to what
unknown cause (90%) known enzyme defects (e.g. partial HGPRT)
in gout where to the monosodium rate precipitates usually occur and why
fingers and toes
precipitates better at lower temperatures
what are the phases of gout
asymptomatic hyperuricemia
acute arthritis
intercritical grout
chronic tophaceous gout
the acute arthritis caused by gout is normally found where
first MTP joint foot
tophi are pathognomonic of what
gout
tophaceous arthritis is found where and what happens
joints and periarticular tissue
inflammation destroys synovium, joint and adjacent bone
what are the risk factors for primary gout
over 30 years of age genetic predisposition heavy drinking obesity drugs lead toxicity
what drugs cause gout
thiazides
calcium pyrophosphate crystal deposition disease (CPPD) is also known as what
pseudogout or chondrocalcinosis
calcium pyrophosphate crystal deposition disease (CPPD) is typically found in what patients and where
over 50 years old (increases to 50% at 85 years)
found in knee > wrist
the crystals in calcium pyrophosphate crystal deposition disease (CPPD) sow what
positive birefringent
where are the crystals in CPPF first seen
articular matrix, menisci, and intervertebral disc
when the crystals in CPPD are released into a joint what happens
acute inflammation followed by chronic inflammation and fibrosis
white chalky deposits are seeing what
calcium pyrophosphate crystal disease (CPPD)
what is a ganglion cyst
less than 2cm cyst near joint or tendon sheath
what is the most common site for a ganglion cyst
wrist
ganglion cysts are what type of degeneration of tissue
cystic or myxoid
what type of cyst has no communication with the joint space
ganglion cyst
what is a synovial cyst
a cyst connected to a joint capsule or bursa
what is a baker cyst
popliteal synovial cyst often in setting of rheumatoid arthritis
tenosynovial giant-cell tumor what is the neoplastic cell type and what is seen in them
macrophages and giant (macrophage) cells
hemosiderin and lipid vacuoles are in them
what is a type of diffuse tenosynovial giant-cell tumor
pigmented villonodular synovitis (PVNS)
what is seen in pigmented villonodular synovitis (PVNS)
lush villous surface locking or swelling (later decreased range of motion) red/brown to yellow from hemosiderin can erode bone and create a mass often recurs after excision
80% of pigmented villonodular synovitis (PVNS) is found where
80%
a lush villous surface is seen in what
pigmented villonodular synovitis (PVNS) a diffuse tenosynovial giant-cell tumor
localized tenosynovial giant-cell tumor is found where
fingers and wrist
what is the most common soft tissue tumor of hand (especially fingers)
localized tenosynovial giant cell tumor
how does a tenosynovial giant cell tumor present
well circumscribed
often attached to synovium or tendon
slow growing painless
