Hancock Flashcards
osteoarthritis risk factors
age, obesity, excessive joint loading, athletics military
osteoarthritic joints mc
neck, hip, knees
DIP nodes osteoarthritis
Heberdens node
PIP nodes osteoarthritis
Bouchard node
osteoarthritis
degenerative progressive wear and tear of the joints cartilage at articulating joints
osteoarthritis joint pain
asymmetrical joint pain d/t bone on bone contact loss of cartilage
pain in osteoarthritis characteristic
dull ache, deep, relieved with rest and worse w/ activity
Osteoarthritis presentation
insidious onset w/ progression taking years to present, morning stiffness goes away after 30 minutes
Osteoarthritis findings
joints squaring of thumb, joint narrowing, osteophytes
hip osa pain
groin pain pain with internal and external rotation w/ knee full extension
osa management and workout
weight loss for every 5 lbs lost = 50 lbs in knee strains and swimming good, Tylenol , nsaids, injections, visco injections go to ortho
RA general characteristics
more common in women 3-1 and ages of 20-40 years age genetic predisposition necessary
RA clinical manefesations
joints involved hands, and wrist McPhersons, pip
Rheumatoid arthritis hand and bony characteristics
ulnar deviation of the MCP joint the swan neck contractors will remain ugly af, take care of c spine XR before surgery
Rheumatoid arthritis and pulmonary involvement
Caplan syndrome: multiple rheumatoid nodules with hx of exposure to asbestos and silica dust
Rheumatoid arthritis triad felty syndrome
seropositive ra, neutropenia and splenomegaly
felty santa
splenomegaly, anemia, neutropnenia, thrombocytopenia, arthritis (ra)
rheumatoid arthritis diagnosis
RF+ anti ccp ab: anti cyclic citrullinated peptide protein antibodies
Rheumatoid managemnt
nsaids, steroids short terms
Seronegative spondyloarthropathies
Ankylosing spondylitis, reactive arthritis,
ankylosing spondylosis
hla-b27 Bl sacroilitis, characterized by ascending fusion of back “bamboo back” XR
ankylosing spondylitis onset and characteristics
young males stiffness worse in butt and low back worse with rest and better with exercise + fmhx, WITH ANTERIOR UVIETES
Ankylosis hallmarks
anterior uveitis, sacrolitis, and bamboo spine
psoriatic arthritis findings
sausage fingers, and pencil in a cup XR apperance
reactive arthritis characteristics
can’t see, climb or pee. inflmatorry condition that occurs after certain infections GI or GU, chlamydia, Camplybacter , typically involves 20-40 year old ppl
reactive arthritis involves more?
TOES
reactive arthritis rash
keratoderma blennorrhagicum- waxy papular rash on palms and soles
reactive arthritis diagnostics findings
synovial fluid: cloudy viscous with reiterating cells XR: fluffy periostitis
reactive arthritis TRIAD rosh
conjunctivitis urethritis arthritis, Hal b 27
septic arthritis definition
joint infected with a pathogen that can cause rapid destruction of cartilage and synovium
septic arhtritis pathogen MC
Staph Aures
Gout crystals involved
monosodium urate
gout definition
hyperurecemia is the hallmark of this dz
gout patho
1) too much uric acid 2) decreased excretion of uric acid
gout stages 1
asymptomatic hyperuricemia
gout stage 2
acute gouty arthritis - impacts big toe at MTP joint-Podagra
gout stage 3
intercritical gout symptomatic period after initial attack
gout stage 4
chronic tophaceous gout- noted in poorly controlled gout - conglomerations of rate crystals TOPHI
gout crystal characteristics
negative needle shaped birefringent crystals
XR gout
punched out erosions
gout management
reduce: alcohol, seafood, red meats, and medication that increase uric acid levels
gout and colchicine
N/V/D change for CKD
Pseudogout crystals
calcium pyrophosphate crystal deposition
pseudogout definition
common in elderly patients with DJD, classically monoarticular with larger joints
Pseudogout crystals
weakly positive rod shaped razor like calcium pyrophosphate crystals
XR gout vs pseudo gout
gout: rat bite erosions pseudo XR: white lines of chonedrocalcinosis
when do you not do arhtrocentesis
atrificial joint and INR check do that