Musculoskeletal Revision Lecture Flashcards
Sex Ratio- Rheumatoid vs Reactive Arthritis
Rheumatoid = F Reactive = M
Age- Rheumatoid vs Reactive Arthritis
Rheumatoid = all ages Reactive = 20-40 years
Enthesopathy- Rheumatoid vs Reactive Arthritis
Rheumatoid = no reactive = yes
Spondylitis- Rheumatoid vs Reactive Arthritis
Rheum = no apart from atlanto-axial reactive = yes
Urethritis- Rheumatoid vs Reactive Arthritis
Rheum = No Reactive = yes
Skin involvement- Rheumatoid vs Reactive Arthritis
Rheumatoid = subcutaneous nodules
Reactive = K.blennorhagicum
Circinate balantitis
Rheumatoid factor - Rheumatoid vs Reactive Arthritis
Rheumatoid = yes Reactive = no
HLA - Rheumatoid vs Reactive Arthritis
Rheumatoid = HLA DR4 Reactive = HLA B27
Joint space narrowing- Rheumatoid vs Osteoarthritis
Yes
Yes
Subchondral sclerosis- Rheumatoid vs Osteoarthritis
No
Yes
Osteophytes- Rheumatoid vs Osteoarthritis
no
Yes- Bouchards nodes at PIP and Heberden nodes at DIP
Osteopenia- Rheumatoid vs Osteoarthritis
yes
no
bony erosions - Rheumatoid vs Osteoarthritis
yes
no
define osteoporosis
reduction in total or regional bone mass
radiological features of osteoporosis
osteopenia
fragility fractures
bone chemistry of osteoporosis
normal
define osteomalacia
soft bones due to impaired mineralisation in mature bone
radiological features of osteomalacia
osteopenia
pseudofractures = looser’s zones
define rickets
soft bones due to impaired mineralisation in immature bone in chilren
radiological features of rickets
flared ends of bones
bowing of long bones
biochemistry of osteomalacia and rickets
low calcium, low phosphate, high serum alkaline phosphate.
define paget’s
disorganised bone remodelling
radiological features of pagets
bone thickening = sclerosis and cortical thickening
biochem pagets
high serum alkaline phosphatase
what are the radiological findings of osteitis fibrosa cystica
sub periosteal resorption brown tumours chondrocalcinosis osteosclerosis salt and pepper skull rugger jersey spine
what does sub periosteal resorption look like
radial aspect of ring and little fingers, tufuts of the phalanges
what do brown tumour looks like
discrete lytic lesions
aggregates of osteoclasts and fibrous tissue
what does chondrocalcinosis look like
calcification of articular cartilage
easily seen in menisci of knee
what does osteosclerosis look like
bone thickening
what does a salt and pepper skull look like
trabecular bone resorption creating a mottling appearance
what does a rugged jersey spine look like
band like osteosclerosis of the superior and inferior margins of the vertebral bodies
Key features of rheumatoid arthritis
morning stiffness rheumatoid factor symmetrical polyarthritis subcutaneous nodules joint erosions
define rheumatoid factor
IgM anti-IgG antibody (Fc)
what makes synovial fluid viscous
hylaronate = non sulphated glycosaminoglycan
describe type a synoviocytes
macrophage like phagocytic
describe type b synoviocytes
fibroblast like -produce hylarunoate
what type of collagen is in the synovium
type 1
define reactive arthritis
steril inflammation of the synovium following an infection -> enthesopathy, skin inflammation, eye inflammation
two infections associated with reactive arthritis
urogenital = chlamydia
Enterogenic = salmonella, shigella, campylobacter
may be first manifestation of hiv or hep c
define enthesopathy
inflammation where a ligament, tendon or fascia inserts into bone
what are some examples of enthesopathy
plantar fascitis
dactylitis
spondyltitis
achilles tendonitis
what is in articular cartilage
type 2 collagen and aggrecan
define proteoglycan
glycoproteins containing sulphated glycosaminoglycan chains
define glycosaminoglycan
repeating polymers of disaccharides
what is included in renal osteodystrophy
secondary and tertiary hyperparathyroidism
osteomalacia
soft tissue and vascular calcification
list two infections associated with reactive arthritis
urogenital ie chlymadia trachomatis
enterogenic = salmonella, shigella, campylobacter
HLA for SLE , rheumatoid and AS/Reactive
DR3
DR4
B 27