OA & RA

Question 1

OA & RA are both?

Answer 1

Joint diseases

Question 2

OA has systemic effects?

Answer 2

No

Question 3

RA is a _____ _____ disease?

Answer 3

systemic autoimmune

Question 4

OA: Age related ____ joint disease of ____ joints.

Answer 4

Degenerative; Synovial

Question 5

OA: Characterised by:

• Loss of ____
• ____ formation where?
  
  • called what?

Answer 5

Articular cartilage
New bone formation on Joint margins
Called Osteophytes

Question 6

OA: Bone changes where?

Answer 6

Subchondral

Question 7

OA: 4 common sites?
OA: Where on spine?

Answer 7

Hands; KNEES; HIPS; Spine
Cervical (Neck)
Lumbar (Lower Back)

Question 8

OA: How common? Age? Men/Women? Age?

Answer 8

Rare Women until >55y.o.

Question 9

OA: Multifactorial causes?

Skeletal (3); Others (3)

Answer 9

Skeletal:
Joint inflammation, Joint instability, Congenital/Acquired skeletal deformities

Other: Drugs, Obesity, Trauma

Question 10

Articular cartilage is a_____. Why?

Answer 10

Shock absorber. Protects bone.

Question 11

Healthy articular cartilage depends on ____ to ____.

Answer 11

Chondrocytes. To balance Synthesis & Breakdown of Tissue

Question 12

OA results when? How?

Answer 12

Equilibrium disturbed

Degenerative changes & Chondrocytes can’t keep up

Question 13

OA: Age?

Answer 13

40’s & 50’s

Question 14

Key feature of early OA?

Answer 14

Use-related joint pain EASED BY REST

Question 15

OA: S/S in joints? (3)

Answer 15

Pain & stiffness

Enlargement/swelling

Question 16

OA: S/S 3 degradations?

Answer 16

˅ROM (Range of motion)
Muscle wasting
Deformity

Question 17

OA: S/S: Early stages? (2)

Answer 17

Formation of OSTEOPHYTES

Joint space narrowing

Question 18

OA: S/S: Later stage: Loss of ROM due to? (2)

Answer 18

No joint space

Tendon & joint capsule contracture

Question 19

Difference: Tendon, Ligament, Cartilage?

Answer 19

Tendon: Muscle to bone
Ligament: Bone to bone
Cartilage: Covers ends of bones (shock absorber)

Question 20

What is indicative of erosive phase of OA?

Answer 20

Subchondral cysts

Question 21

What is Crepitus?

Answer 21

Crackling of joints

Question 22

Crepitus palpable on movement due to? (2)

Answer 22

Cartilage loss & Joint surface irregularity

Question 23

OA: S/S: Late changes:

____ form from ____ & ____.

Answer 23

LARGE osteophytes

Bone repair & remodelling

Question 24

Joint destruction due to? (2)

Answer 24

Cartilage loss & Subchondral bone collapse

Question 25

RA: What is affected first?

Answer 25

Synovial membrane

Question 26

RA: What is affected after synovial membrane? (3)

Answer 26

Articular cartilage Fibrous joint capsule Surrounding ligaments

Question 27

RA affects joints only?

Answer 27

No. Systemic & autoimmune. Widespread changes in a number of tissues in body.

Question 28

Why do people with RA die younger?

Answer 28

Chronic inflammation in organ systems

Question 29

RA: Powerful drug used to treat? Why is it used?

Answer 29

Methotrexate (treats autoimmune diseases) | Prevent deterioration & further deformity.

Question 30

What does synovial fluid cover? What does it do?

Answer 30

Synovium & cartilage | Is a lubricant for synovial-cartilage interaction

Question 31

Early stage RA: Synovium becomes? | Later RA: Inflamed synovium develops what? AKA?

Answer 31

Oedema, Thicken, Hyperplastic (^cells-->enlarged) Granulation tissue aka Pannus (New tissue from healing)

Question 32

What does Granulation tissue (Pannus) do? Resulting in?

Answer 32

Invades & destroys Articular cartilage & Bone | Bone erosion & formation of Subchondral cysts

Question 33

RA Diagnosis: Inflammation of joints? (4) Rheumatoid? (2) Radiographic?

Answer 33

- Inflammation of joints: Morning stiffness > 1hr Arthritis: >=3joints, Hand joints, Symmetric - Rheumatoid; Rheumatoid nodules (swelling tissue lump) Serum Rheumatoid Factor (RF) Test - X-RAY (radiographic changes)

Question 34

Most common joints affected by RA?

Answer 34

FINGERS HANDS WRISTS | elbows feet ankles knees

Question 35

RA causes? Internal (3)/External (2)?

Answer 35

Internal: Genetic, Hormonal, Reproductive factors External: Infectious agent (Trigger), Environmental exposure

Question 36

``` RA: S/S: Onset is sudden? Systemic signs of inflammation? (6) Joints become? Deterioration/Degradation? ```

Answer 36

No. Gradual Fever, fatigue, weakness, weight loss, body aches, stiffness Pain, Tender, Stiff Y Mobility, Y Muscle (wasting), Joint deformities

Question 37

RA: Complications: Formation of synovial cysts where? 2 other complications?

Answer 37

Articular cartilage OR Subchondral bone Rupture cyst Rheumatoid nodules

Question 38

``` OA & RA differences: Inflammation? Seriousness? Symmetrical? Main target area & End result? Population affected? ```

Answer 38

``` OA Little RA A lot OA varies RA Always serious OA Weight bearing worse RA Yes OA Articular cartilage --> Osteophytes RA Synovial membrane--> Synovial cysts OA Everyone RA 1% population ```