Intro and Signs of JOINT DISEASE Flashcards
Introduction to Joint Disease–WEEK ONE
__________ – joint of tendon or ligament with bone
__________ – inflammatory cellular infiltrate at the enthesis often results in Ca++ or ossification
__________ – loss of bone due to pressure atrophy or
active breakdown of bone tissue
Enthesis
Enthesopathy
Erosion
Introduction to Joint Disease–WEEK ONE
- __________ – few joints involved
- ___________ – more than 4 joints involved
- ___________ – inflammatory ossification WITHIN the SPINAL LIGAMENT, esp. AS (marginal type) or psoriasis/reactive arthritis (Reiter’s syndrome) (non‐ marginal type)
Pauciarticular
Polyarticular
Syndesmophyte
Introduction to Joint Disease–WEEK ONE
• __________ – bony overgrowth degenerative in nature
continuous with underlying cortex, covered with cartilaginous cap at insertion of a ligament
- ___________ – osteophyte in the SPINE
- ___________ – elevated periosteum resulting in localized periosteal new bone
Osteophyte
Spondylophyte
Periostitis
Introduction to Joint Disease–WEEK ONE
- ___________ – inflammatory arthropathy of the spine
- ___________ – no circulating rheumatoid factor
- _____________ – inflammatory arthropathies that simulate RA but are seronegative & show different pathologic & radiographic features.
Spondyloarthropathy
Seronegative
Rheumatoid Variants
Introduction to Joint Disease–WEEK ONE
TYPES OF JOINTS X 4
1 • __________ Joints:
– cranial sutures
– syndesmosis (tibia/fib)
– rare for arthritis
– hard to tell if involved due to normal irregularity of
insertion of fibers – appearance of an enthesopathy
2 • \_\_\_\_\_\_\_\_\_\_\_ Joints: – intervertebral Disc – symphysis pubis – manubriosternal joint – most common fibrocartilage, hyaline cartilage is also there
Fibrous
Cartilaginous
Introduction to Joint Disease–WEEK ONE
TYPES OF JOINTS, CONT’D X 4
3 • Inter Vertebral Disc (IVD)
– 1mm thick cortical bone
– 1mm thick hyaline cartilage
– center posterior – nucleus pulposis – gelatinous becomes _____________ as it ages
– surrounded by annulus fibrosis: inner fibrocartilagenous;
outer collagen; anchors into endplate via ________ fibers at the periphery.
4 • \_\_\_\_\_\_\_\_\_\_ Joints: – knee, toes etc. – SI joint lower 2/3 is synovial (upper 1/3 is fibrous) – complex joint – Capsule, synovium, etc.
fibrocartilage
Sharpey’s
Synovial
Introduction to Joint Disease–WEEK ONE
JOINT COMPONENTS X 4
1 •\_\_\_\_\_\_\_\_\_\_\_\_ – fibrous tissue – acts as a ligament (bone to bone) – often named ligaments are part of it (e.g. ligamentum flavum – zygapophyseal joint) – varying amount of intra capsular bone
2 • ________________
– adheres to the capsule & non articular bone (bare areas)
– produces synovial fluid (filtrate / dialysate of blood – mucoid material & serum) – lubrication & nourishment
– loose vascular tissue
Capsule
Synovial membrane
Introduction to Joint Disease–WEEK ONE
JOINT COMPONENTS X 4
3 • ________ _________
– most common is hyaline cartilage – chondrocytes in collagen & ground substance matrix (mucopolysaccharides – chondroitin sulfate)
– loose vascular connective tissue
4 • \_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_\_ – thickness varies – cancellous bone under it – no periosteum under the cartilage – active – good blood supply
Articular Cartilage
Subchondral bone:
Introduction to Joint Disease–WEEK ONE
INTRODUCTION TO JOINT DISEASE
• There are 3 major categories of joint disease: A– Degenerative B– Inflammatory C– Endocrine/ Metabolic/ Deposition
** We use ___________________ findings
associated with those diseases to help
determine which type of joint disease is
present.
radiographic (roentgen)
Introduction to Joint Disease–WEEK ONE
______ ________ – Radiographic features exhibited by a condition. These radiographic features are alterations or changes from normal.
ROENTGEN SIGNS
Introduction to Joint Disease–WEEK ONE
DEGENERATIVE CATEGORY • Roentgen signs: – \_\_\_\_\_\_\_\_\_\_\_ loss of joint space – Osteophyte or spondylophyte formation – Subchondral SCLERORSIS (eburnation) – Subchondral CYST formation – Asymmetrical – Monoarticular or polyarticular – \_\_\_\_\_\_\_\_\_/\_\_\_\_\_\_\_\_\_\_ calcification/ ossification – Intra‐articular LOOSE bodies – ABNORMAL alignment
NON‐uniform
Ligament/ tendon
Introduction to Joint Disease–WEEK ONE
INFLAMMATORY CATEGORY • Causes = \_\_\_\_\_\_\_\_\_\_\_\_ disorders • Rheumatoid Arthritis • Lupus erythematosus • Ankylosing spondylitis • Psoriatic arthritis – \_\_\_\_\_\_\_\_\_\_ process elsewhere that triggers a reaction
Autoimmune
Inflammatory
Introduction to Joint Disease–WEEK ONE
INFLAMMATORY CATEGORY PART 2…
• Roentgen signs: – \_\_\_\_\_\_\_\_\_\_\_ joint space loss – Soft tissue SWELLING – Bone EROSION – Juxta‐articular osteoporosis – Subchondral BONE DESTRUCTION – Occasionally periostitis of adjacent metaphysis – Usually SYMMETRIC, but can be asymmetric – Monoarticular or polyarticular –\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_\_ calcifications – Abnormal alignment – DEFORMITY, subluxation, dislocation – Overlapping degenerative disease – Late stage fibrous or \_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_\_
Uniform
Soft tissue
bony ankylosis
Introduction to Joint Disease–WEEK ONE
DEPOSITION / ENDOCRINE / METABOLIC / VASCULAR CATEGORY
1 • \_\_\_\_\_\_\_\_\_\_ Causes – Pituitary gland dysfunction – Thyroid gland dysfunction – Parathyroid gland dysfunction – Pancreatic gland dysfunction – Renal dysfunction
2 •_________ Causes
– Idiopathic or AGE
– Genetic and CONGENITAL causes
– Vitamin increases and deficiencies
3 • ________ Causes
– Can be related to the other conditions
4 • ___________ Causes
– OsteoNECROSIS
Endocrine
Metabolic
Deposition
Vascular
Introduction to Joint Disease–WEEK ONE
DEPOSITION / ENDOCRINE /METABOLIC / VASCULAR CATEGORY
5 • Changes in the bodies metabolism creates reactions that can affect the joints
– These changes can create _______ of normally
occurring metabolites that then DEPOSIT IN JOINTS, soft tissues and other areas of the body.
– _________ effects can manifest throughout all
systems and change normal morphology
excesses
Glandular
