joint disease - joints

Question 1

unilateral arthritis in sij joint

Answer 1

rheumatoid arthritis
infectious arthritis

Question 2

Hip degeneration - features

Answer 2

non-uniform loss of joint space
- superior migration m/c: medial uncommon; axial rare

osteophytes:
- outer supra-acetabular margin
- collar osteophytes - see lat and inferomedial aspect femoral neck

subchondral cysts:
- lge near reduced joint space site
- either side of joint

subchondral sclerosis

Question 3

bilateral asymmetric arthritis in SIJ

Answer 3

psoriatic arthritis
reactive arthritis

Question 4

bilateral symmetric
arthritis in SIJ

Answer 4

ankylosing spondylitis
enteropathic arthritis

Question 5

rheumatoid arthritis description of features

Answer 5

• connective tissue disorder targetting synovial joints
• m/c hands, feet, cervical spine
• bilateral and symmetric
• can inv heart, lung, blood vessels, nervous, system, eye

Question 6

Diagnostic criteria rheumatoid arthritis

Answer 6

joint involvement:
serology - RF and anti-CCP
acute phase reactants - CRP & ESR
duration of symptoms

Question 7

Rhuematoid arthritis clinical features

Answer 7

• onset 20 - 60; peak 40 - 50
• 2 - 3 X more likely in females
• insidious onset of articular pain, tenderness, swelling, stiffness
• bilateral symmetric peripheral joint inv
• cervical spine up to 80% late stage
• fatigue, malaise, muscle weakness, fever, tendon rupture, bursitis
• firm, non tender nodules in 20% people - forearms, knees, ankles, hands
• Haygarth’s nodes - ST swelling adjacent to MCP
• progressive deformity & disability with periods of remission & exacerbation

Question 8

radiographic features rheumatoid arthritis

Answer 8

• periarticular ST swelling - edema; intra-articular effusion -> displaced fat pad planes & peripheral skin contour
• juxta-articular osteoporosis - earliest bone changes; inflammation & hyperemia –> local loss of bone density (epi/meta physis)
• uniform loss of joint space
• marginal erosions (rat bite) - localized loss of cortex at bare area, joint margin (no reactive sclerosis)
• lge pseudo cysts - synovial fluid & extension of pannus into subarticular bone
  -deformity - joint destruction, ligament laxity; dislocation, misalignment