inflammatory arthritides Flashcards
what is ankylosing spondylitis
chronic systemic disorder mainly involving spine
idiopathic
ppl have antigen called HLA-B27 - can be genetic
disease begins with symptoms of the SI joints and gradually moves up to spine
what are syndesmophytes
vertical bone growth replacing intervertebral discs
with severe long standing AS what appearance does the spine take on
fused appearance called BAMBOO SPINE
early stages of AS
- fatigue
- morning stiffness in lumbar
- pain in buttocks, low back, posterior legs
- lumbar lordosis due to spasm
- flexion contractures in hips
- symptoms = worse after periods of immobility
late stages of AS
- spine movement = severely reduced & m wasting due to disuse atrophy
- thoracic curve becomes more evident
- chest becomes fixed and flattened
- thoracic mm’s atrophy
- chest expansion is reduced from costovertebral involvement
- breathing becomes DIAPHAGMATIC
- as it progresses neck movements are lost
- FORWARD HEAD POSTURE DEVELOPS
what joints does AS affect
sometimes only SI and lumbar
extreme cases = whole spine fused into flexion, causing person to look down instead of ahead
pain can diminish over time w fusion
what is gout
crystals of monosodium urate are deposited into the tissues
attacks of acute arthritis
area most attacked by gout
metatarsophalangeal joint of big toe
w tarsal area and ankle can be involved
what is pseudogout caused by
calcium pyrophosphate dihydrate crystals
cause of gout
malfunction of normal chemical process that breaks down PURINES
people either have an overproduction of uric acid or underexcretion of uric acid or both
what does an acute attack affect in gout
a single joint
red hot swollen
skin over joint is shiny and taut
initially onset is extremely painful
what happens in chronic stage of gout
inflammation spreads to peripheral joints
occurs 10 years after initial attack
marked by subcutaneous deposits of urate crystals called TOPHI
lumps occur outside of joints
