Gout and Osteoarthritis Flashcards
What are some symptoms of joint disease?
- Pain
- Immobility and stiffness
- Loss of function
What are some signs of joint disease?
- Swelling
- Deformity
- Redness
- Crepitus
- LOSS OF FUNCTION
What types of swelling might you get in joint disease?
-fluctuant (liquid) -bony -synovial (rheumatoid)
Where might you see deformities in joint disease?
In joint surfaces or contacts
The bones will meet differently and appear differently
What is crepitus and what is it associated with?
o Noise made with bone movements
o Normally associated with the loss of the cartilaginous bone ends
What investigations can be done to diagnose joint probelms?
- 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
What are acute arthropathies?
acute arthritis of a single joint in the body
(it can be the initial stage of polyarthritis)
What are common causes of acute arthropathies?
- 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.
What is gout?
When their are uric acid crystal deposition in joints
It causes significant pain from reactive inflammation
Gout happens due to what?
the patient having hyperuricaemia (high uric acid levels in the blood)
What might cause hyperuricaemia?
- 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
What are the symptoms of gout?
- 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
How is gout treated?
Just with NSAIDs
What are the dental aspects of gout?
- 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)
What is osteoarthritis?
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.
What are some symptoms of osteoarthritis?
- Pain that improves with rest and worsens with activity
- Brief morning stiffness
- Slowly progressive over the years
What are some signs of osteoarthritis?
- 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
How is osteoarthritis treated?
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.
What are the dental aspects of osteoarthritis?
- 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
