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Y4 MSK > Non-inflammatory arthritis > Flashcards

Non-inflammatory arthritis Flashcards

1
Q

What does non-inflammatory arthritis cover?

A
  • OA
  • Septic Arthritis
  • Gout
  • Pseudogout
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2
Q

What is the presentation of OA?

A
  • Localised disease
  • Joint pain and stiffness (worse with activity/end of day)
  • Deformity
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3
Q

What are the examination findings of OA?

A
  • Bulky, bony enlargement of joint (Heberden’s and Bouchard’s nodes)
  • Squaring at the base of CMC joint (thumb base)
  • Restricted range of motion
  • Crepitus on movement
  • Effusions around joint
  • Joint warmth and/or tenderness
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4
Q

What are the x-ray findings of OA?

A 
LOSS
•	Loss of joint space
•	Osteophytes
•	Subarticular sclerosis
•	Subchondral cysts
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5
Q

What is the management of OA?

A

Weight loss
Physiotherapy

Analgesia
o Oral paracetamol and topical NSAIDs
o Oral NSAIDs + PPI
o Codeine

Steroid injections

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6
Q

What are the risk factors for OA?

A
  • Obesity
  • Age
  • Occupation
  • Trauma
  • Female
  • Family Hx
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7
Q

What is the presentation of gout?

A
  • Hx of self-limiting attacks
  • Pain (rapid onset)
  • Swelling
  • Erythema
  • Monoarticular or oligoarticular (<4 joints)
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8
Q

What are the examination findings of gout?

A
  • Gouty tophi (DIPJ, elbows and ears)
  • Systemically swell
  • Common joints: Podagra (1st MTPJ), Ankle, Wrist and Knee
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9
Q

What are the risk factors for gout?

A
  • Male
  • Alcohol intake
  • High purine intake (meat)
  • Renal insufficiency
  • Diuretics
  • Overweight
  • Metabolic syndrome: HTN + DM
  • Lesch-nyhan syndrome
  • Cytotoxic drugs
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10
Q

What does joint aspiration show for gout?

A
  • Monosodium urate crystals (MSU)
  • Needle-like morphology
  • Negative birefrindgence
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11
Q

What does a XR show for gout?

A
  • Punched out erosions
  • Maintenance of joint space
  • Soft tissue swelling
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12
Q

What is the immediate treatment for gout?

A
  • NSAIDs/colchicine + PPI

- Joint aspiration and injection of corticosteroid

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13
Q

When do you start urate-lowering treatment?

A
  • Recurring attacks (>2 attacks in 12 months)
  • Tophi
  • Chronic gouty arthritis
  • Joint damage
  • Renal impairment (eGFR <60)
  • Hx renal stones
  • Diuretic therapy use
  • Primary gout starting at a young age
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14
Q

What medications does allopurinol interact with?

A
  • Azathioprine
  • Cyclophosphamide
  • Theophylline
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15
Q

What do you do to prevent an early increase in gout attacks with allopurinol?

A

Give NSAIDs or colchicine 2 weeks prior to starting ULT

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16
Q

What does joint aspiration show for pseudogout?

A
  • Calcium pyrophosphate dihydrate (CPPD) crystals
  • Rhomboid crystals
  • Positively birefringent
17
Q

What does a XR show for pseudogout?

A
  • Chondrocalcinosis

- LOSS (OA mnemonic)

18
Q

How do you manage pseudogout?

A
  • Aspiration of joint fluid

- NSAIDs/steroids

Y4 MSK (11 decks)

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