Joint Disorders Flashcards
Osteoarthritis
Degenerative joint disease affecting articular cartilage
Related to wear & tear on a weight bearing joints
Little to no inflammation
Osteoarthritis Pathophysiology
Excessive mechanical stress
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Articular cartilage is damaged & eroded
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Surface of cartilage is worn↓ joint movement
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Release of enzymes ↑ cartilage destruction
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New bone development (bone spurs- osteophytes)
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Osteophyte fragments can irritate synovial membrane joint effusion
Osteoarthritis continued
Areas mostly affected: weight bearing joints
Hips/ knees/ wrists/ ankles/ vertebrae
Symptoms of stiffness occur with movement & last for 30 min
Activity related joint pain is relieved by rest
Limited ROM
Crepitus
Rheumatoid Arthritis
Chronic inflammatory autoimmune disease of synovial joints
First joint affected: synovial membranes
Affects: fingers, wrists, elbows, ankles, knees, feet
Can spread to sites such as: heart, kidney, skin, lungs
Can be exacerbated by stress
Etiology: unknown, may be linked to genetics
Onset: insidious
Lab tests show the presence of Rheumatoid Factor (RF)
Rheumatoid Patho
1) Antigen? Environment? Genetics?
2) RF forming immune complexes
3) complexes deposit in joint tissue in synovial membranes
4) inflammatory reactions
5) Hyperplasia of membrane & decreased blood flow = hypoxia
6) Joint destruction, Ankylosis..
Rheumatoid Arthritis Clinical Manifestations
Systemic: Fever Fatigue Weakness Aching & stiffness
Localized: Tender joints with pain Joint swelling Morning stiffness Joint feels warm Skin over joint reddened
Gout
Inflammatory response due to uric acid
Crystals of urate deposit in connective tissue throughout the body (depositions of crystal results in painful inflammation of the joint)
Prolonged accumulation leads to joint damage and the formation of tophi
More common in males between 40-50 years
Uric Acid
By-product of purine metabolism
Purine is needed for DNA & RNA synthesis
Purine is found in:
Meats (bacon, beef, pork, game meat)
Anchovies, sardines, scallops
Gravy, beer
Risks of Uric Acid
Uric acid is eliminated from the body via kidneys
↑ Amounts of uric acid> ↑ potential to develop renal calculi
Stones are 1000x more prevalent people with gout
If untreated can lead to damage of glomerulus acute kidney injury
Uric Acid Clinical Manifestations (3 stages)
Symptoms appear in 3 stages
1) Asymptomatic hyperuricemia ↑ Serum urate level No symptoms are present 2)Acute gouty arthritis Higher serum urate level that occurs suddenly Symptoms are present 3)Tophaceous gout Chronic stage Tophi appear in cartilage, synovial membranes, soft tissue ( chalky, gritty accumulations of uric acid crystals that build up in the soft tissue of a gouty joint)
Ankylosing Spondylitis
Chronic inflammatory joint disease
Stiffening & fusion of spine & sacroiliac joint (fibrocartilaginous joints)
Results in uncontrolled bone formation
Etiology: unknown
Affects men 3x more than women
Ankylosing Spondylitis Patho
Inflammation & subsequent repair process results in:
- Fibroblasts synthesizing collagen
- Collagen becomes scar tissue that calcifies
- Joint loses flexibility due to fusion
- Spine loses concavity
Ankylosing Spondylitis Clinical Manifestations
*Early signs: Lower back pain & stiffness
- Pain becomes progressive & persistent
- Pain is alleviated by physical activity
- Postural changes
↓ Lumbar lordosis
↑ kyphosis
Head and neck are forward
Fibromyalgia
Chronic musculoskeletal syndrome
Affects women more commonly between ages 30-50 years old
Widespread joint & muscle pain, Presents with fatigue, ↑ sensitivity to touch, and tender points
There are no signs of systemic or localized inflammation
Diagnosed through subjective data
Fibromyalgia Clinical Manifestations
- Diffuse soft tissue pain at tender points (at least 11/18 sites)
- Pain is chronic (burning or gnawing)
- Profound fatigue
- Non-restful sleep
- Headaches
- Memory loss
- Irritable bowel
- Anxiety
- Depression
