Lab: Joint Disease 2 Flashcards
Where is rheumatoid arthritis often seen first?
Small joints of hands and feet
Is rheumatoid arthritis bilateral/symmetrical?
Yes, autoimmune etiology and inflammatory
Are rheumatoid arthritis lesions osteolytic or osteoblastic?
Osteolytic
rheumatoid arthritis
Blue arrows:
Red arrow:
Purple arrows:
Green arrow:
Blue arrows: uniform loss of joint space
Red arrow: prearticular erosions
Purple arrows: swan neck deformity (fibrous ankylosis)
Green arrow: Boutonniere deformity (fibrous ankylosis
What are some radiographic features of rheumatoid arthritis?
- Osteolytic lesions (juxta-articular/periarticular)
- Juxta-articular osteoporosis
- Decreased joint space
- Subluxation/dislocation of joints
- Fibrous ankylosis (swan neck and Boutonniere)
What are some symptoms of rhematoid arthritis?
- Cardinal signs in affected joints
- Tenosynovitis and tendon rupture
- Fibrinoid necrosis (rheumatoid nodules)
- Necrotizing vasculitis (vascular stenosis, ischemia and necrosis in tissues supplied)
Are spondyloarthropathies inflammatory?
Yes
Which joints are primarily involved in spondyloarthropathies?
Primarily spine
Asymmetrical peripheral joint involvement possible
The following are all symptoms of which joint pathology?
- Cardinal signs of inflammation
- Tenosynovitis and tendon rupture
- Fibrinoid necrosis
- Necrotizing vasculitis
Rheumatoid arthritis
Generally, spondyloarthropathies are HLA-B27 ___ and rheumatoid factor ___
HLA-B27 negative and rheumatoid factor negative
Spondyloarthropathies involve ___ ankylosis of affected joints
osseous
What is ankylosing spondylitis?
Progressive ankylosis of the spine beginning in the sacral and lumbar regions
What are some signs of ankylosing spondylitis?
- Postural changes
- Sacroiliitis
- Bamboo sign (radiograph)
- Trolley track sign (radiograph)
- Dagger sign (radiograph)
The following are all signs related to which joint pathology?
- Postural changes
- Sacroiliitis
- Bamboo sign
- Trolley track sign
- Dagger sign
Ankylosing spondylitis
Is psoriatic arthritis more often seen in the spine or extremities?
Frequently extremities
What is noticeable in this radiograph?
What pathology is present?
Reactive bone formation (blue arrows), and osseous ankylosis
Psoriatic arthritis
This pathology likely previously had what visible presentation?
Psoriatic arthritis rash
psoriatic arthritis
Psoriatic arthritis has a similar pathogenesis to, but different presentation from ___
rheumatoid arthritis
How might the spine be affected by psoriatic arthritis?
- May or may not have sacroiliac involvement
- Paravertebral ossifications
What is the triad of symptoms related to reactive arthritis/Reiter’s syndrome?
- Conjuctivitis
- Urethritis
- Arthritis
If a patient presents with the following, what is their most likely diagnosis?
- Conjuctivitis
- Urethritis
- Arthritis
Reactive arthritis/Reiter’s syndrome
Enteropathic arthritis is associated with previous ___ issues such as ___
previous gastrointestinal issues such as ulcerative colitis or Chron’s disease
With enteropathic arthritis, exacerbations of ___ can lead to increased arthritic symptoms
gut symptoms
How many joints are affected by enteropathic arthritis?
Monoarthritic: pain in one joint
What is the nature of the pain associated with enteropathic arthritis?
Migratory and transient pain in one joint
Persistent cases of enteropathic arthritis may resemble changes associated with ___
ankylosing spondylitis
Which joints are most affected by degenerative joint disease?
Which are most affected by rheumatoid arthritis?
DJD: weight bearing joints
RA: small joints
80% of those with rheumatoid arthritis are positive for RF
66% of those with rheumatoid arthritis are positive for ___
ACPA
What is indicated by the pale areas found in the joint?
Fibrin deposition (nodules)
rheumatoid arthritis
these are rice bodies when floating in joint
What is pannus in regard to joint pathology?
Chronically inflamed “frond like” membrane with abnormal layer of fibrovascular/granulation tissue
rheumatoid arthritis
What are the terms for subcutaneous nodules in the following locations? What pathologies are associated with each?
Metacarpophalangeal joint:
Proximal interphalangeal joint:
Distal interphalangeal joint:
Metacarpophalangeal joint: Haygarth, RA
Proximal interphalangeal joint: Bouchard, DJD
Distal interphalangeal joint: Heberden, DJD
RA can affect PIP
