Joint Disorders Flashcards
What are the 2 clinical cues most helpful for diagnosis of joint problems?
- joint pattern
- presence or absence of extra-articular manifestations
Joint pattern is defined by the answers to what 3 questions?
1) Is inflammation present?
2) How many joints are involved?
3) What joints are affected?
What does joint inflammation manifest as?
- redness
- warmth
- swelling
- morning stiffness of at least 30 minutes’ duration
What are a few diseases in which inflammation is present?
- RA
- Systemic lupus erythematosus
- Gout
What disease is represented by an absence of inflammation?
OA
Give an example of a monarticular disease, a oligoarticular (2-4 joints) disease and a polyarticular (5+ joints) disease
Mono: Gout
Oligo: Inflammatory bowel disease
Poly: RA
What disease effects the DIP joints?
OA
What disease effects the MCP joints?
RA and Pseudogout
What disease effects the 1st MTP joints?
Gout
What are some examples of extra-articular manifestations?
- fever
- rash
- nodules
- neuropathy
If joint diagnosis is uncertain what should be examined?
synovial fluid
What are 2 contraindications to aspiration? Why?
Aspirating needles should never pass through overlying cellulitis or psoriatic plaque because of the risk of infection
What are 6 things that are studied following aspiration of synovial fluid?
- volume
- clarity
- color
- WBC count
- polymorphonuclear leukocyte count
- culture
Normal volume is typically __ mL in the knee, anything more is considered abnormal
3.5 mL
What are the 3 abnormal groups to distinguish between?
- noninflammatory
- inflammatory
- purulent
