Joint diseases pt 1

Question 1

there are 2 types of connections between joints…

Answer 1

1. Solid (nonsynovial)
2. Cavitated (synovial):

Question 2

a Solid (nonsynovial) joint connection is describes as how?

an example is what?

Answer 2

lack a joint space, tightly connected to provide structural strength

cranial sutures

Question 3

a Cavitated (synovial) joint connection is described as how?

Answer 3

have a joint space to allow for a wide range of motion.

Question 4

a Joint space is what?

what is it made of?

what makes up a joint capsule? and what cells make it up?

Answer 4

Articular surface of adjoining bones

hyaline cartilage (type II collagen), that is surrounded by joint capsule.

Synovial membrane lines the joint capsule.

Composed of synoviocytes.

Question 5

who secretes Synovial fluid (SF)?

what color is synovial fluid? what is it made of? what is its purpose?

Answer 5

synoviocytes

• Pale yellow to clear, viscous
• Rich in hyaluronic acid: acts as lubricant
• provides nutrition for articular cartilage.

Question 6

what Routine studies of Synovial fluid are usually done?

Answer 6

1. Gross appearance: normally pale yellow
2. WBC count and differential count :

• normally <200 cells/ mm3,
• neutrophils <25% of total count.

3. Culture & Gram stain :if infection is suspected
4. Crystal analysis

Question 7

joint diseases are Classified and Subdivided into four major categories, what are these?

Answer 7

Group I: Non-inflammatory

Group II: Inflammatory

Group III: Septic

Group IV: Hemorrhagic

Question 8

what are the Group I: Non-inflammatory joint diseases?

Answer 8

osteoarthritis

neuropathic (Charcot’s joint)

Question 9

what are the Group II: inflammatory joint diseases?

Answer 9

• rheumatoid arthritis
• gout
• pseudogout
• Seronegative spondyloarthropathy

Question 10

what are the Group III: Septic joint diseases?

Answer 10

infectious arthritis due to bacteria, fungi, and viruses

Question 11

what are the Group IV: Hemorrhagic joint diseases?

Answer 11

• hemophilia
• trauma
• scurvy

Question 12

what is Osteoarthritis?

it is characterized by?

Answer 12

a degenerative joint disease

1. Progressive erosion (degeneration, loss) of articular cartilage and
2. Associated reactive changes at the margin of the bone and in the subchondral bone.

Question 13

osteoarthritis depends on what?

what Joints are usually involved?

Answer 13

age - usually starts after 65 in women

Hips, knees, Cervical and lumbosacral spine (weight bearing joints) also:

• Distal interphalangeal joint (DIP)
• Proximal interphalangeal joint (PIP)

Question 14

what are the 2 types of osteoarthritis?

Answer 14

primary and secondary

Question 15

why does primary osteoarthritis occurs?

why does secondary osteoarthritis occurs?

Answer 15

as a result of aging phenomenon - seen in old ppl

develops as a result of a predisposing condition:

1. Trauma to joint (players)
2. Obesity (knees, particularly in women)
3. Ochronosis* : (Alkaptonuria: accumulation of homogentisic acid)
4. Hemochromatosis*

Question 16

Most important factor that predisposes to development of OA is what?

Answer 16

effect of abnormal load (mechanical trauma) on a weight bearing joint

• Results in wear and tear plus degeneration of articular cartilage

Question 17

what findings can be seen in a joint with osteoarthritis?

Answer 17

Erosions and clefts in articular cartilage with Fibrillation

• Fibrillation = Clefts penetrate into underlying subchondral bone, a process called fibrillation.

Fragmentation of cartilage and subchondral bone = will form loose bodies

eburnation = polished ivory like appearance because bone rubs on bone

Subchondral bone cysts on x-ray beneath the auricular suface

Question 18

Reactive bone formation at the margins of joints, seen in osteoarthritis, will produce what?

whit formation will be responsible for what?

Answer 18

osteophytes or bony spurs

Heberden’s nodes: found at the base of the distal interphalangeal joints (DIP) of the hands.

Bouchard’s nodes: in the proximal interphalangeal (PIP) joints of the hand.

Question 19

what are the clinical findings for osteoarthritis?

Answer 19

• Joint stiffness in the morning that worsens during the day***
• Pain with passive motion of joint
• Crepitus:
• Heberden’s nodes develop in the DIP joints and
• Bouchard’s nodes in the PIP joints of the hand