Gout and Osteoarthritis Flashcards
Joint disease - symptoms
- pain
- immobility stiffness
- loss of function
Signs of joint disease
swelling
- flutist, bony, synovial
deformity
redness
crepitus
loss of function
Joint disease - investigations
radiography
- plain, MRI, arthrography
blood
- C-reactive protein (CRP)
- rheumatoid factors (RF)
- extractable nuclear antigens (ENA’s)
- anti DS-DNA, anti-nuclear antibody (ANA)
arthroscopy and biopsy
What is an acute monoarthropathy?
acute arthritis of a single joint
common causes of acute monoarthropathies
infection
- septic arthritis
crystal arthropathy
- gout
Gout cause
deposition of uric acid crystals
Hyperuricaemia (high uric acid levels) causes
drug induced
genetic predisposition
tumor related
nucleic acid breakdown
myeloma
thiazide diuretics
obesity and alcohol tolerance
gout symptoms
acute inflammation of a single joint
- usually big toe
usually a triggering event
- trauma, surgery. illness, diet/alcohol excess
rapid onset - hours
Gout treatment
NSAIDs
Gout - dental considerations
avoid aspirin
- interferes with removal of uric acid
drug treatments may give oral ulceration
Symptomatic osteoarthritis prevelance
10% of population
What is osteoarthritis?
- a degenerative joint disease affecting weight bearing joints, predominantly hips and knees
Why can osteoarthritis lead to joint damage?
dysfunction in cartilage repair
Osteoarthritis symptoms
pain
- improves with rest
- worsens with activity
brief morning stiffness
slowly progressive over years
osteoarthritis signs
radiographically
- loss of joint space and subchondral sclerosis (hardening of bone just beneath cartilage surface)
- osteopyhtic lipping at joint edge (bone spurs)
*radiographs may show asymptomatic changes
joint swelling and deformity
osteoarthritis treatment
disease progression cannot be altered
pain improved by
- increasing muscle strength around joint
- weight loss
- walking aids
NSAIDS
prosthetic joint replacements
Osteoarthritis dental considerations
TMJ can be involved
- symptoms are rare
difficulty accessing care
chronic NSAID use
- oral ulceration possible
- bleeding tendency due to anti platelet effects
joint replacement = antibacterial prophylaxis?
- usually not needed
