Gonnococcal arthritis Flashcards
What are the two complications of gonococcal arthritis? What are the features of the latter?
Localised septic arthritis
or arthritis/dermatitis syndrome
- Tenosynovitis
- Rash
- Migratory polyarthritis
Treatment
IV cephalosporin
Neisseria gonorrhoea colonises which part of the body?
GU tract
Rectum
Pharynx
Epidemiology
F>M
What are the symptoms of gonorrhoea?
Often asymptomatic
Osteoarthritis vs rheumatoid arthritis
Osteoarthritis: More in DIP Herbenden's nodes (DIP) Squaring at base of thumb Bouchard's nodes (PIP)
?
avascular necrosis of teh scaphoid if fractured
What is de quervain’s tenosynovitis?
Inflammation of first tensoynovitis??
Features of osteoarthritis on xray
Joint space narrowing Whitening around joint Osteophyte formation (new bone formation) Subchondral cysts Subchondral sclerosis
Risk factors for osteopathic
FH Prior trauma Paget's RA Acromegaly Alkaptonuria (metabolic d Obesity Manual work/sport Neuropathic joint (if they can't feel their leg, it's likely they'll put too much load onto it
What is alkpatonuria?
Lack of homogenisitic dioxygenase resulting in darkening of urine/connective tissues
Management
Education - no drugs, chronic Physical measures -lose weight physiothearpy OT
Pain Paracetamol Topical NSAIDs/capsaicisn Avoid oral NSAIDS/codeine/tramaldol Avoid prednisolone
Joint infection
intra-articular corticosteroids
Pseudo gout - where and who does it affect?
Knee
Wrists
OLDER WOMEN
What are the crystals in pseudogout?
Calcium pyrophosphate crystals
What is gout?
Increased uric acid deposition?
Mechanisms of gout formation
High purine load
High urate production
Reduced urate excretion
What is the polarisation of crystals for gout? What is the colour?
NEGATIVELY birefringent -> yellow or blow
needle shaped crytals
If the uric acid deposition is in the soft tissue?
Tophi
What is seen on xray of joint in long term?
Periarticular/rat bit erosions
Management of gout in acute attack
Colchicine 500mcg twice a day
NSAIDs 500mg twice a day
Prednisoone 15-20mgs for 5-7 days
Inject steroid
Chronic disease treatment
Allopurinol or
Febuxostat
Dietary advice
Low purine diet
Reduce alcohol, esp beer Fish game Offal Moderate vegetables such as spinach, cauliflower, asparagus, mushrooms MOderate pulses Moderate meat and fish Avoid obesity
What is chondrocalcinosis?
Calciump yrophosphate deposition in the cartilage
Antibodies for RA
Anti-CCP
95% specific RA
60-70% sensitive RA
IgM against IgG Fc
60-70% specific/sensitive
