Inflammatory Flashcards
rheumatoid types
seropositive
rheumatoid variants
seronegative
generalized connective tissue autoimmune disease involving synovial tissue resulting in polyarticular joint inflammation
RA
most common inflammatory arthritis
RA
what is the prevalence for RA
20-60 years - females > males
characterized by bilateral symmetry and progressive nature leading to deformity
RA
when testing, what is RA positive and negative for
(+) RA factor
severe joint disease/deformity
arthritis mutilans
enlargement of the gastrocnemius bursa
baker’s cyst
PIP flexion, DIP extension
boutonniere deformity
leukopenia, splenomegaly, RA
felty’s syndrome
soft tissue swelling at MCP
haygarth’s nodes
stiff joints after inactivity
jelling phenomena
accumulation of inflammatory cells, with necrotic area and fibrosis seen on extensor surfaces
rheumatoid nodule
flexion of DIP and extension of PIP
swan neck deformity
intermitten absence of the articular cortex due to erosion
dot-dash appearance
rat bite, pocket erosions localized loss of intra-articular cortex adjacent to the capsular insertion due to pannus erosion at the anatomical bare area
margina erosion
vascular granulation tissue that spreads over the intra-articular surfaces of the bone and cartilage
pannus
occular complications such as lacrimal gland atrophy which leads to dry eyes is characteristic of
RA
to be diagnosed with RA 4 of the following must be present
- morning stiffness for at least 6 weeks
most common sites of involvement for RA
NAME?
a synovial cyst that extends into soft tissues posterior to the knee
baker’s cyst
most common cause of upper cervical neurological symptoms
atlanto-axial impaction from RA
where does RA erosion affect the dens
NAME?
cranial settling is an effect of RA, what is it
NAME?
still’s disease
juvenile chronic arthritis (juvenile RA)
onset of RA at less than 16 years old
still’s disease
loosely attached periosteum in children
periostisis
symptoms of JCA
hands - periostitis and shortening
generalized seropositive connective tissue disorder involving multiple organs, most common in females, elevated ESR and ANA positive
systemic lupus erythematosis (SLE)
butterfly rash
systemic lupus erythematosis (SLE)
most frequent and serious feature of SLE
kidney involvement leading to nephropathy and renal failure
administration of steroids as a treatment for SLE may lead to
NAME?
radiographic changes of SLE
NAME?
how does SLE affect the hands
NAME?
how does SLE affect the spine
increase ADI in about 8.5%
disorder following rheumatic fever and multiple connective tissue disorders
jaccoud’s arthropathy
antecedent strep. pharyngitis
jaccoud’s arthropathy
transitory and migrating arthralgia, myalgia, weight loss and residual mitral valve disease
jaccoud’s arthropathy
marked by non-erosive, reversible joint deformity
jaccoud’s arthropathy
how does jaccoud’s affect the hands and feet
NAME?
generalized systemic inflammatory connective tissue disorder involving skin, lungs, GI tract, kidneys and musculoskeletal system
progressive systemic sclerosis
cutaneous manifestation of progressive systemic sclerosis
scleroderma
causes small vessel disease and fibrosis in multiple organ systems
progressive systemic sclerosis
three stages of skin appearance in progressive systemic sclerosis
NAME?
puffy painful swelling in the extremities
progressive systemic sclerosis
a sympathetic nervous system dysfunction characterized by cyclic vascular changes usually of the hands which is precipitated by the cold or emotional upset
raynaud’s phenomenon
components of CREST syndrome
NAME?
what is SLAC
scaphoid-lunate advanced collapse
are most cases of JCA seropositive or seronegative
seronegative
is RA seropositive of seronegative
seropositive
scleroderma distribution to the chest
interstitial fibrosis
scleroderma distribution to the GI
smooth muscle dysfunction causing esophageal aperistalsis and reduced lower sphincter pressure
clinical features of CREST
NAME?
chronic inflammatory disorder, predominately affecting young adults males primarily involves axial skeleton
ankylosing spondylitis (AS)
characterized by a sequela of articular ankylosis, ligamentous ossification and enthesopathic changes
AS
synonyms for AS
marie strumpell’s disease and rhizomelic spondylitis
50% of AS patients will also have
peripheral disease especially of the hips and shoulders
most common seronegative spondyloarthropathy
AS
are females or males more likely to get AS
males 10:1
what does HLA-B27 have to do with AS
90% of people with AS are positive for HLA-B27
distribution of AS
NAME?
clinical features of AS
NAME?
management of AS
NSAIDS to limit joint inflammation and pain
sclerosis at the inferior aspect of the SI joint especially at the iliac aspect in post partum females
osteitis condensans ilii
where does AS target the spine
thoracolumbar and lumbosacral
joints involved in AS
NAME?
roman’s lesions
corner erosion of vertebral body (AS)
shiny corner sign
reactive sclerosis (AS)
vertebral squaring
loss of anterior concavity (AS)
bamboo spine
thin syndesmophytes (AS)
dagger sign
interspinous or supraspinous ligament ossification (AS)
trolley track sign
z joint capsular ossification (AS)
whiskering
ischial enthesopathy (AS)
andersson lesion
endplate destruction (AS)
carrot stick fracture
spinal fracture associated with AS
syndesmophytes imply
seronegative joint disease
vertically oriented spurs that represent the sequalae of inflammatory disease of the spinal ligaments. they are ossification of the outer fibers of the annulus and the inner fibers of the ALL
syndesmophytes
syndesmophytes that are thicker and non marginal indicate
NAME?
syndesmophytes that are thinner and marginal indicate
NAME?
if there is ossification on the anterior portion of the vertebral bodies but you are unsure if it is seronegative, what do you need
HLA-B27 test
osteophytes are more horizontal as syndesmophytes are more
horizontal
arthritis associated with gut sidorders, usually ulcerative colitis and regional enteritis (crohn’s disease)
enteropathic arthritis
asymmetrical small joint involvement (hands) mostly DIPs. mediated by immune system
psoriatic arthritis
mouse ears appearance
peripheral erosions with periostitis (psoriatic arthritis)
pencial and cup appearance
central erosion (psoriatic arthritis)
ray pattern
when the distribution is more prominent along one digit than across joint type (psoriatic arthritis)
which types of syndesmophytes are associated with psoriatic arthritis
non-marginal
reactive arthritis
reiter’s disease
some symptoms and causative factors of reiter’s
NAME?
arthritis occurring in association with genitourinary or gastrointestinal infections
reiter’s syndrome
where is reiter’s most commonly located
lower extremity (calcaneus)
classic triad of reiter’s syndrome
NAME?
how is reiter’s syndrome differentiated with psoriatic arthritis
psoriatic - nail pitting, psoriatic plaques
lover’s heel
reiter’s
arthropathy characterized by intra-articular deposition of calcium pyrophosphate crystals
calcium pyrophosphate deposition disease
CPPD
calcium pyrophosphate deposition disease
synonyms for CPPD
NAME?
may mimic gout during acute flare
CPPD
most common location for CPPD
affinity for joints containing menisci
DJD at an unusual location should raise suspicion of
CPPD
an inherited disorder that causes the body to absorb and store too much iron
hemochromatosis
most common genetic disorder in the USA
hemochromatosis
gout is which type of joint disease
metabolic
a sodium urate induced arthropathy
gout
disorder of purine metabolism principally in males
gout
most common location for gout
MTP of first toe
chronic gout
tophi
