Joint Disease Flashcards
What are the four main types of joint inflammation?
Rheumatoid arthritis, osteoarthritis, gout (crystal arthritis), septic arthritis.
What type of arthritis is associated with early morning stiffness >60 minutes and small joint swelling (MCPs, MTPs, wrists)?
Rheumatoid Arthritis.
What is the pathophysiology of RA?
Autoimmune synovial inflammation causing synovitis, joint damage, and systemic inflammation.
What is the primary site of inflammation in RA?
Synovium.
What is the prevalence of RA?
About 1% of the population.
What cytokine plays a key role in RA pathogenesis and is a therapeutic target?
TNF-alpha.
What are the consequences of untreated RA?
Moderate disability by 2 years, severe disability by 10 years, increased morbidity & mortality.
Describe the classic clinical features of RA.
Chronic, symmetrical, inflammatory, deforming, polyarthritis.
What is the aim of RA treatment?
Disease remission through early diagnosis and aggressive treatment.
What are key strategies in RA management?
Early diagnosis, early referral, multidisciplinary team approach, tight inflammation control.
What is the role of an early arthritis clinic?
Rapid diagnosis, early treatment (e.g., methotrexate), and prognosis assessment.
A 76-year-old female with chronic joint pain worse with activity and morning stiffness <30 minutes likely has?
Osteoarthritis.
Which joints are typically affected by OA?
DIP, PIP, CMC, MTP1, knees, hips, spine.
What are the general risk factors for OA?
Age, female sex, genetics, obesity, oestrogen deficiency, high bone mineral density.
What local/biomechanical factors increase OA risk?
Occupation, joint trauma, pre-existing joint abnormalities.
What are causes of pain in OA?
Synovitis, prostaglandins, subchondral fractures, muscle spasm, venous congestion, etc.
What are the core OA management objectives?
Education, pain relief, functional improvement, disease modification.
Name 3 central treatments for OA.
Exercise, weight loss, surgery.
A 35-year-old man with acute onset of severe toe pain at night has what likely diagnosis?
Gout.
What crystal causes gout?
Monosodium urate (uric acid) crystals.
What causes most gout cases: overproduction or underexcretion of urate?
Underexcretion (90%).
What are classic sites for acute gout attacks?
Big toe (podagra), midfoot, ankle, knee, wrist, fingers, olecranon.
What is the gold standard for gout diagnosis?
Synovial fluid analysis showing negatively birefringent urate crystals.
What are modifiable risk factors for gout?
Alcohol, obesity, high-purine diet, medications, dehydration, rapid weight loss.
