MSK/Rheumatology - RA, OA - Exam 3 Flashcards
External trigger (ex: smoking) > Autoimmune + Inflammatory response > synovial hypertrophi + joint inflammation > Destruction of joints > Joint deformity is the progression of what disease?
Rheumatoid arthritis
What inflammatory disease is characterized by symmetrical polyarthritis that progresses from periphery to proximal and has improvement with movement?
Rheumatoid arthritis
How can Rheumatoid arthritis present in the hand?
Affects MCP and PIP joints
Spares DIP joints
Swan neck and boutonniere deformaties
Ulnar deviation
How can Rheumatoid arthritis present in the upper extremities?
Carpal tunnel
Frozen shoulder
Rheumatoid nodules
How can Rheumatoid arthritis present in the lower extremities?
Affects MTP joints on the feet
Popliteal (bakers cyst)
What part of the axial skeleton can rheumatoid arthritis affect t?
Cervical spine C1-C2
How does rheumatoid arthritis affect the cervical spine?
Cerval subluxation
Cervical myelopathy
What is seen in the lab results of person with rheumatoid arthritis?
Rheumatoid factor (RF)
ant-CCP antibodies
ANA ~30% of patients
What pharmacological agent is given to all patients dx with rheumatoid arthritis?
DMARDs
How long does morning stiffness last with rheumatoid arthritis?
More than 1 hr
What are the characteristics of the joints with rheumatoid arthritis?
Soft, warm, tender
Does RA or OA have more extraarticular manifestations?
RA
What degenerative disease is characterized by joint pain stiffness and functional impairment of all joint tissues and has improvement with rest?
Oesteoarthritis
How can osteoarthritis present in the hand?
Affects the MCP, PIP, and DIP joints
Heberden’s nodes
Bouchard’s nodes
How can osteoarthritis present in the lower extremities?
Most common in knees and hip
Swelling
Restricted ROM
How long does morning stiffness last with osteoarthritis?
Less than 30min
What are the characteristics of the joints with osteoarthritis?
Hard and bony
How is osteoarthritis diagnosed?
Clinical
Weight baring imaging
No definitive lab tests
How is rheumatoid arthristis diagnosed?
ACR/EULAR criteria
1 joint with definitive clinical synovitis
What is the treatment for osteoarthritis?
Treat pain and inflammation
Surgery if conservative tx fails
What inflammatory disease is characterized by proximal aching and stiffness associated
with giant cell temporal arteritis?
Polymyalgia Rheumatica
How long does morning stiffness last with polymyalgia rheumatica?
More than 1 hr
Symptoms of PMR are due to what?
Synovitis, tenosynovitis, and bursitis
Where are the most common locations of pain with polymyalgia rheumatica?
Shoulder and pelvic girdle
Difficulty brushing hair or rising from a chair
How does polymyalgia rheumatica affect the shoulders?
Restricted ROM
Pain
Normal muscle strength
How is polymyalgia rheumatica diagnosed?
No established criteria
Elevated ESR
Rapid resolution with glucocorticoids
What inflammatory disease is characterized by widespread pain lasting for more than 3 months, extreme fatigue, cognitive disturbances with an absence of joint swelling/inflammation?
Fibromyalgia
What are the nonpharmacological treatment option for Fibromyalgia?
Exercise
PT
Cognitive behavioral therapy
What are the pharmacological treatment options for Fibromyalgia?
Tricyclic antidepressant
SNRIs- Duloxetine, Milnacipran
Anticonvulsants- Pregabalin, Gabapentin
