general Flashcards
cause of polyarthralgia/ polyarthritis
bacterial arthritis (staphylococcal, streptococcal, gonococcal, meningococcal)
bacterial endocarditis
viral arthritis
reactive arthritis
crystal-induced arthritis: gout, pseduogout,
RA
seronegative arthritis: ankylosing spondylitis, psoriatic arthritis, IBD
CT disease: SLE, systemic vasculitis, systemic sclerosis, Still’s disease
other: sarcoidosis, palindromic rheumatism, malignancy, hyperlipoproteinemia, Lyme disease, rheumatic fevwer
difference of symptoms between inflammatory and degenerative arthritis
inflammatory
- pain at rest, relieved by motion
- morning stiff > 1hour
- warm, erythema, swelling
- malalignment/ deformity
- exta-articular manifestations
degenerative
- pain with motion, relieved by rest
- morning stiff
important test for joint fluid analysis
3 c
- cell count and differential
- culture and gram stain (bac, mycobac, fungi)
- crystal (microscopy with polarized light)
what does gout and pseudogout look like under micrscopy with polarized light
gout (monosodium urate) -> needle shape, negatively birefringent (yellow)
pseuodogout (calcium pyrophosphate dihydrate) -> rhomboid shape, +ve birfingent (blue)
jt fluid white cell count, clarity, % of neutrophils for normal, non-inflame, inflame, septic
classification clarity WBC/ml % of neutrophils
normal transparent 90
causes of monoaritis
infective - septic arthritis (stepa, gonococcal, fungi) - tuberculous arthritis crystal induced arthritis - gout/ pseudogout trauma - overuse - haemarthrosis degenerative - OA monoarthritic onset of RA spondyloarhtritis: - ankylosing spondylitis, psoriatic arthritis reactive arthritis less commone: neoplastic - tumour or AVN