Gout and Osteoarthritis Flashcards

1
Q

What are some symptoms of joint disease?

A
  • Pain
  • Immobility and stiffness
  • Loss of function
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2
Q

What are some signs of joint disease?

A
  • Swelling
  • Deformity
  • Redness
  • Crepitus
  • LOSS OF FUNCTION
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3
Q

What types of swelling might you get in joint disease?

A

-fluctuant (liquid) -bony -synovial (rheumatoid)

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4
Q

Where might you see deformities in joint disease?

A

In joint surfaces or contacts

The bones will meet differently and appear differently

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5
Q

What is crepitus and what is it associated with?

A

o Noise made with bone movements

o Normally associated with the loss of the cartilaginous bone ends

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6
Q

What investigations can be done to diagnose joint probelms?

A
  • 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 & Biopsy
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7
Q

What are acute arthropathies?

A

acute arthritis of a single joint in the body

(it can be the initial stage of polyarthritis)

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8
Q

What are common causes of acute arthropathies?

A
  • Infection
    • Septic arthritis – where an infection has gotten into the joint
  • Crystal arthropathy
    • Gout – urethral crystals are deposited into the joint causing pain and inflammation.
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9
Q

What is gout?

A

When their are uric acid crystal deposition in joints

It causes significant pain from reactive inflammation

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10
Q

Gout happens due to what?

A

the patient having hyperuricaemia (high uric acid levels in the blood)

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11
Q

What might cause hyperuricaemia?

A
  • Drug induced – thiazide diuretics
  • Genetic predisposition
  • Nucleic acid breakdown – chemo
  • Tumour related – myeloma tumours
  • Obesity and alcohol enhance the risk that comes from any of the above
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12
Q

What are the symptoms of gout?

A
  • Acute inflammation of a SINGLE joint
  • Usually affects the great toe but can be any joint in the body
  • There is usually a precipitating event
    • trauma, surgery, illness, diet/alcohol excess
  • Rapid onset – hours
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13
Q

How is gout treated?

A

Just with NSAIDs

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14
Q

What are the dental aspects of gout?

A
  • Avoid aspirin as it interferes with uric acid removal (avoid aspirin in anyone with a history lg gout)
    • Drug treatments used to treat gout may lead to oral ulceration (allopurinol)
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15
Q

What is osteoarthritis?

A

a degenerative joint disease predominately affecting weight bearing joints such as the hips and knees. I

t is NOT a wear and tear problem – it is a cartilage repair dysfunction.

The cartilage doesn’t repair properly over the years and the layer become thinner and thinner until it disappears all together.

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16
Q

What are some symptoms of osteoarthritis?

A
  • Pain that improves with rest and worsens with activity
  • Brief morning stiffness
  • Slowly progressive over the years
17
Q

What are some signs of osteoarthritis?

A
  • Radiographs
    • loss of joint space & subchondral sclerosis (thickening of the bone
    • osteophyte lipping at joint edge
    • radiographs may show ASYMPTOMATIC changes - is OA the cause of symptoms?
  • Joint swelling & deformity
18
Q

How is osteoarthritis treated?

A

No treatments to alter disease progression but treatments available are:

  • Pain improvement
    • Increasing muscle strength around the joint
    • Weight loss
    • Walking aids
  • Role of NSAIDs
  • Prosthetic replacement for PAIN
    • Note that it is for pain and not function. It is normally the pain that is preventing the function.
19
Q

What are the dental aspects of osteoarthritis?

A
  • TMJ can be involved
    • symptoms RARE!
    • It is often seen in radiographs but no symptoms
    • Flattening on condylar head, loss of joint space and subchondral sclerosis are all common changes but pain not normally found
  • Difficulty in accessing care
  • Chronic NSAID use
    • Oral ulceration possible
    • Bleeding tendency - anti-platelet
  • Joint replacements - AB prophylaxis?
    • Usually not needed