Joint Diseases cont. Flashcards
Juvenile Idiopathic Arthritis
Arthritis before age 16 that persists for at least 6 weeks
What is present and what is absent with Juvenile Idiopathic Arthritis?
(+) ANA
(-) Rheumatoid nodules
Ankylosing Spondylitis is associated with what HLA?
HLA-B27
Ankylosing Spondylitis is an autoimmune ___ cell response
T cell response
Where do the changes occur with Ankylosing Spondylitis?
Ligamentous attachments
What are the symptoms of Ankylosing Spondylitis?
Low back pain and spinal immobility
Reactive Arthritis is associated with what HLA?
HLA-B27
Reactive Arthritis often follows an ___
Infection
What are the symptoms of Reactive Arthritis?
Conjunctivitis
Nongonoccoal urethritis/cervicitis
Arthritis
What are the symptoms of Reactive Arthritis?
Conjunctivitis
Nongonococcal urethritis/cervicitis
Arthritis
The Arthritis with Reactive Arthritis presents how?
Waxes and wanes
– Acute onset and Asymmetric
Besides the triad of symptoms with Reactive Arthritis, what else can present?
Cardiac valvular disease
Psoriatic Arthritis is associated with what HLA?
HLA-B27
What DIP change can be seen with Psoriatic Arthritis?
Pencil in cup of DIP
Where else are symptoms common for Psoriatic Arthritis?
Nails – thicken, rough and discolor
The seronegative joint diseases are?
Psoriatic Arthritis
Reactive Arthritis
Ankylosing Spondylitis
Infectious Arthritis organisms reach the joints how?
Hematogenously
What is the most common cause of Infectious Arthritis?
Lyme Disease – Borrelia Burgdorferi
What is diagnostic of the most common cause of Infectious Arthritis?
(+) anti-Borrelia Antibodies
– lyme disease
If lyme disease goes untreated, what does it cause to occur?
Migratory Arthritis in large joints and obliterative endarteritis
Suppurative Arthritis organisms reach the joints how?
Hematogenously
If Suppurative Arthritis occurs in neonates, how did it likely arise?
Contiguous spread from osteomyelitis
In adults, what are the common causes of Suppurative Arthritis?
Staph. Aureus
Gonococcus
Salmonella if sickle cell patient
In adults, what are the common causes of Suppurative Arthritis?
Staph. Aureus
Gonococcus
Salmonella if sickle cell
In what gender is Suppurative Arthritis more common?
Males
Suppurative Arthritis is more common in men, except for when?
Sexually active women = Gonococcal Arthritis is more common in women
Why is Gonococcal Suppurative Arthritis more common in women?
MAC deficient (c5,c6,c7) –> Disseminated Gonococcus
What are the symptoms of Suppurative Arthritis?
Painful, swollen joint
Fever
What lab changes will be present with Suppurative Arthritis?
Leukocytosis
Increased ESR
IV drug users will likely get Suppurative Arthritis where?
Axial joints»_space; knees
What is diagnostic of Suppurative Arthritis?
Joint aspiration
What are 2 crystal induced arthritises?
Gout
Calcium Pyrophosphate Crystal Deposition
Gout involves transient attacks of acute arthritis due to what?
Monosodium Urate Crystallization in and around joints
What change will be seen in the plasma with Gout?
Hyperuricemia > 6.8
In order to have symptomatic Gout, Hyperuricemia > 6.8 in the plasma must be present along with a few of the following?
Age and Male gender Alcohol Obesity Thiazide diuretics Lead toxicity
What is the hallmark of Gout?
Tophi
= Urate crystal aggregates with foreign body giant cells
What is the hallmark of Gout?
Tophi
= Urate crystal aggregations with foreign body giant cells
Gout Acute Arthritis involves pain and warmth where and why?
BIG TOE
– low temps help monosodium urate crystalize
Gout Chronic Tophaceous Arthritis occurs about 10 years after the Acute. What characterizes it?
Urate forms visible deposits in synovium
– Bone erosion too
What shape are the monosodium urate crystals with Gout?
Needle shaped
Calcium Pyrophosphate Crystal Deposition occurs in what joints and what does it look like?
Knees
= Chalky white friable deposits
Calcium Pyrophosphate Crystal Deposition occurs in what joints and what does it look like?
Knees
= Chalky white friable deposits
What shape are the Calcium Pyrophosphate crystals?
Rhomboid shape
What aggregates are seen with Calcium Pyrophosphate Crystal Deposition?
Oval blue-purple aggregates
What Crystal Induced Arthritis is POSITIVE BIREFRINGENT?
Calcium Pyrophosphate Crystal Deposition
– Gout = Negative Birefringent
