Joint pain with systemic illness

Question 1

If autoimmunity targets synovial membrane in peripheral joints

Answer 1

Rheumatoid

Question 2

If autoimmunity targets enthesophytes in the spine

Answer 2

ankylosing spondylitis

Question 3

What is the most common cause of inflammatory arthritis?

Answer 3

Rheumatoid arthritis

Question 4

What gender is more likely to have rheumatoid athritis?

Answer 4

Women 3x more before menopause

Question 5

What is the common presentation of rhuematoid athritis

Answer 5

Osteophytes in the distal interphalangeal joints called habitants nodes
Less likely Osteophytes in the proximal interphalangeal joints- Bouchard nodes
Above are lateral and symetrical
Rheumatoid nodules in the subcutaneous part of the skin over bony protuberance
zeta formative their thumb

Question 6

What is the common presentation of spondyloathropathies

Answer 6

Asymmetrical polyarthopathy
Can involve the spine often involve large joints
Involve tendons rather than the joints
Seronegative

Question 7

What is some types of spondyloathropathies

Answer 7

Psoriatic arthritis
Enteropathic-associated arthritis
Ankylosing spondylitis -rare

Question 8

What does Enteropathic-associated arthritis mean?

Answer 8

Associated with inflammatory bowel disease

Question 9

What is a clinical sign of Ankylosing spondylitis

Answer 9

Question mark posture can cause loss of horizontal vision

Question 10

What is the common clinical feaure of SLE?

Answer 10

Butterfly rash

Question 11

Pathophysiology of rheumatoid arthritis

Answer 11

Initiation; involves an antigen presenting cell and a T-cell

• Perpetuation/ dysregulation: secretion of inflammatory cytokines including TNF-alpha, IL-1 and 1L-6
• Recruitment and activation of polymorphonuclear cells, mast cells and macrophages
• Subsequent production of immunoglobulins, metalloproteinases, angiogenic factors and other cytokines
• Result is inflammation and joint destruction