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Musculoskeletal Physiopathology > Lab: Joint Disease 2 > Flashcards

Lab: Joint Disease 2 Flashcards

1
Q

Where is rheumatoid arthritis often seen first?

A

Small joints of hands and feet

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2
Q

Is rheumatoid arthritis bilateral/symmetrical?

A

Yes, autoimmune etiology and inflammatory

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3
Q

Are rheumatoid arthritis lesions osteolytic or osteoblastic?

A

Osteolytic

"rat bite" lesions
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4
Q

rheumatoid arthritis

Blue arrows:
Red arrow:
Purple arrows:
Green arrow:

A

Blue arrows: uniform loss of joint space
Red arrow: prearticular erosions
Purple arrows: swan neck deformity (fibrous ankylosis)
Green arrow: Boutonniere deformity (fibrous ankylosis

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5
Q

What are some radiographic features of rheumatoid arthritis?

A
  • Osteolytic lesions (juxta-articular/periarticular)
  • Juxta-articular osteoporosis
  • Decreased joint space
  • Subluxation/dislocation of joints
  • Fibrous ankylosis (swan neck and Boutonniere)
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6
Q

What are some symptoms of rhematoid arthritis?

A
  • Cardinal signs in affected joints
  • Tenosynovitis and tendon rupture
  • Fibrinoid necrosis (rheumatoid nodules)
  • Necrotizing vasculitis (vascular stenosis, ischemia and necrosis in tissues supplied)
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7
Q

Are spondyloarthropathies inflammatory?

A

Yes

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8
Q

Which joints are primarily involved in spondyloarthropathies?

A

Primarily spine
Asymmetrical peripheral joint involvement possible

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9
Q

The following are all symptoms of which joint pathology?

  • Cardinal signs of inflammation
  • Tenosynovitis and tendon rupture
  • Fibrinoid necrosis
  • Necrotizing vasculitis
A

Rheumatoid arthritis

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10
Q

Generally, spondyloarthropathies are HLA-B27 ___ and rheumatoid factor ___

A

HLA-B27 negative and rheumatoid factor negative

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11
Q

Spondyloarthropathies involve ___ ankylosis of affected joints

A

osseous

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12
Q

What is ankylosing spondylitis?

A

Progressive ankylosis of the spine beginning in the sacral and lumbar regions

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13
Q

What are some signs of ankylosing spondylitis?

A
  • Postural changes
  • Sacroiliitis
  • Bamboo sign (radiograph)
  • Trolley track sign (radiograph)
  • Dagger sign (radiograph)
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14
Q

The following are all signs related to which joint pathology?

  • Postural changes
  • Sacroiliitis
  • Bamboo sign
  • Trolley track sign
  • Dagger sign
A

Ankylosing spondylitis

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15
Q

Is psoriatic arthritis more often seen in the spine or extremities?

A

Frequently extremities

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16
Q

What is noticeable in this radiograph?
What pathology is present?

A

Reactive bone formation (blue arrows), and osseous ankylosis
Psoriatic arthritis

17
Q

This pathology likely previously had what visible presentation?

A

Psoriatic arthritis rash

psoriatic arthritis

18
Q

Psoriatic arthritis has a similar pathogenesis to, but different presentation from ___

A

rheumatoid arthritis

19
Q

How might the spine be affected by psoriatic arthritis?

A
  • May or may not have sacroiliac involvement
  • Paravertebral ossifications
20
Q

What is the triad of symptoms related to reactive arthritis/Reiter’s syndrome?

A
  • Conjuctivitis
  • Urethritis
  • Arthritis
21
Q

If a patient presents with the following, what is their most likely diagnosis?

  • Conjuctivitis
  • Urethritis
  • Arthritis
A

Reactive arthritis/Reiter’s syndrome

22
Q

Enteropathic arthritis is associated with previous ___ issues such as ___

A

previous gastrointestinal issues such as ulcerative colitis or Chron’s disease

23
Q

With enteropathic arthritis, exacerbations of ___ can lead to increased arthritic symptoms

A

gut symptoms

24
Q

How many joints are affected by enteropathic arthritis?

A

Monoarthritic: pain in one joint

25
Q

What is the nature of the pain associated with enteropathic arthritis?

A

Migratory and transient pain in one joint

26
Q

Persistent cases of enteropathic arthritis may resemble changes associated with ___

A

ankylosing spondylitis

27
Q

Which joints are most affected by degenerative joint disease?
Which are most affected by rheumatoid arthritis?

A

DJD: weight bearing joints
RA: small joints

28
Q

80% of those with rheumatoid arthritis are positive for RF
66% of those with rheumatoid arthritis are positive for ___

A

ACPA

29
Q

What is indicated by the pale areas found in the joint?

pannus
A

Fibrin deposition (nodules)

rheumatoid arthritis

these are rice bodies when floating in joint

30
Q

What is pannus in regard to joint pathology?

A

Chronically inflamed “frond like” membrane with abnormal layer of fibrovascular/granulation tissue

rheumatoid arthritis

31
Q

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:

A

Metacarpophalangeal joint: Haygarth, RA
Proximal interphalangeal joint: Bouchard, DJD
Distal interphalangeal joint: Heberden, DJD

RA can affect PIP

32
Q
A

Musculoskeletal Physiopathology (32 decks)

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