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Locomotor > Joint Pathology > Flashcards

Joint Pathology Flashcards

1
Q

what is the function of collagen in cartilage?

A

Holds GAGs together

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2
Q

because cartilage is avascular where does it receives its nutrients from?

A

NON-articular: Perichondrium

Articular: Synovial fluid

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3
Q

what is synovial fluid?

A

ultra filtrate of blood with added substances such as hyaluronic acid

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4
Q

What are the main types of cells that make up the synovium?

A

Type A synoviocytes (macrophage like)

Type B synoviocyte (fibroblast like)

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5
Q

Arthritis is an umbrella term relating to?

A

damage to joints

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6
Q

osteoarthritis is an example of

A

Degenerative Disease

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7
Q

Rheumatoid Arthritis is an example of

A

Autoimmune Arthritis

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8
Q

Gout (crystal induced) is an example of

A

Acute inflammation arthritis

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9
Q

Osteoarthritis is more common in

A

hard working joints (knee and hands)

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10
Q

first symptoms to be noticed in Rheumatoid Arthritis is

A

oligoarthritis (1-4) or polyarthritis (>5)

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11
Q

one diagnostic characteristics of Rheumatoid Arthritis is

A

Morning Stiffness

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12
Q

Gout is described as

A

incredibly painful inflammation in a single joint due to the accumulation of crystals of uric acid

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13
Q

what is podagra?

A

inflammation of the articulation of the hallux of the foot in the context of gout

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14
Q

in Osteoarthritis what parts of the joint are affecteD?

A

the caspsule, synovium, cartilage and bone

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15
Q

in Osteoarthritis, explain why there is hypertrophy and hyperplasia of the cartilage

A

because as part of the pathological disease there is a reduction in the amount of matrix present in the cartilage decreasing its shock absorbent properties. proliferation is a deficient savaging mechanism

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16
Q

what is fibrillation of the cartilage?

A

destruction of the cartilage with the formation of gaps or clefts

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17
Q

what is eburnation?

A

It is an ivory-like reaction of bone occurring at the site of cartilage erosion. The bone tissue now becomes the outer most layer and there is the formation of subchondral cysts

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18
Q

in the context of Osteoarthritis what is the changes observed in Bone and Cartilage

A

B –> Eburnation and osteophytes

C –> Erosion and Fibrillation

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19
Q

What are osteophytes?

A

out pouches of bone caused by the proliferation of bone tissue

20
Q

what are some of the signs observed in Osteoarthritis?

A

Crepitus, osteophytes, painful [slow onset] worst after activity [end of day]
NO FEVER

21
Q

how is diagnosis of Osteoarthritis performed?

A

mostly clinical [diagnosis of exclusion]

X rays do not correlate with the symptoms of the patient

22
Q

if an X-ray is performed on a patient with Osteoarthritis what will be seen?

A

loss of joint space
subchondral cysts
subchondral sclerosis –> thickening of the bone
osteophytes

23
Q

in Osteoarthritis how doe subchondral cysts form?

A

the lack of articular cartilage and the destruction of the bone allows for synovial fluid to enter the the bone

24
Q

What are the risk factors for the development of Osteoarthritis?

A 
Ageing 
Obesity
Previous Injury
Repeated heavy use
[all that relate to damage to cartilage]
25
Q

Rheumatoid Arthritis needs to be treated with medication because

A

Rapidly progressive, patient disabled in 10 years

26
Q

in Rheumatoid Arthritis there is the formation of granulation tissue in the synovium, which is known as

A

Pannus

27
Q

what cells and cytokines are central to Rheumatoid Arthritis

A

Th17
Th1
TNF-alpha

28
Q

what are some of the histological features of Rheumatoid Arthritis

A

Villus Formation form the synovium
Synovial Hperplasia
Mononuclear Infiltration
Development of germinal centres
deposition of fibrin and neutrophils into the joint space
erosion of the cartilage and bone due to the pannus
destruction of bone, cartilage and ligaments
scarring and LORM [if untreated]

29
Q

what are some of the signs of Rheumatoid Arthritis?

A

Warm, swollen joints (rubbery)
Systemic Symptoms present (LOW, fever)
Morning Stiffness

30
Q

if the joint gets better with use it is more likely to be —1—- if not —2—

A

1 Rheumatoid Arthritis

2 Osteoarthritis

31
Q

What is a rheumatoid nodule?

A

Granulomatous Inflammation with central necrosis

32
Q

Diagnosis for Rheumatoid Arthritis

A 
Inflammatory Tests (ESR, CRP, FBE)
more specific Tests (rheumatoid factor--> autoantibody)
33
Q

Xray indicators of Rheumatoid Arthritis

A

Osteopenia
Uniform loss of joint space*
Erosion of bone surrounding the synovium

34
Q

Risk factors for the development of Rheumatoid Arthritis

A

Genetic (some HLA haplotypes, ~50%)
Female
Increasing age (up to 55)
Smoking

35
Q

what is the main cause of Gout

A

too much uric acid in the body

36
Q

Hyperuricaemia is a strong indicator of Gout

A

Necessary for the development of the condition but not determinant
Create levels change and not accordingly with the condition

37
Q

what is the cause of pain in gout?

A

the immune reaction and activation of the inflammasome due to the uric acid crystals

38
Q

Why is there lysis of neutrophils in the gouty joint?

A

because the crystals are filamentous and penetrate the cell membrane causing leaking and death

39
Q

what are tophi and where do they form?

A

accumulation of uric acid in soft tissue

40
Q

some of the events that can trigger gout are?

A

alcohol, dehydration, trauma and dietary indiscretion

41
Q

what type of inflammation occur in the tophi?

A

Granulomatous Inflammation

42
Q

what are some of the signs in gout?

A

acutely inflamed joint
rarely systematic signs
tophi if chronic and uncontrolled
Pain, redness, swelling, heat in joint

43
Q

what is the gold standard for the diagnosis of gout?

A

Joint or tophi Aspiration (negatively birefringent crystals with neutrophils)

44
Q

in x rays what is the main finding?

A

Tophi

No loss of joint space

45
Q

what are the risk factor for gout?

A 
Male
Obese 
Age
Defects in uric acid metabolism
Genetic

Locomotor (20 decks)

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