OA/RA

Question 1

a systematic inflammatory disease primarily affecting the joint synovium

Answer 1

RA

Question 2

a localized process involving destruction of cartilage tissue

Answer 2

OA

Question 3

Diagnostic criteria for RA

Answer 3

4/7
Morning stiffness >60 mins, arthritis at 3> joint areas, arthritis of hand joints, symmetry, rheumatoid modules, positive serum RhF, radiographic evidence of erosion/bony calcification

Question 4

RA gender and age incidence

Answer 4

women, 60-70 y.o.

Question 5

pathophysiology of RA

Answer 5

infiltration of synovium by CD4 T/B cells, and hyper plastic pannus formation

Question 6

What is a pannus?

Answer 6

hyperplastic granulation tissue that invades the synovium and degrades the cartilage, subchondral bone, and articular capsule

Question 7

3 different presentations of RA and which is the most common

Answer 7

Monocyclic, *polycyclic, and progressive and unremitting

Question 8

how does RA present at the hand/wrist/fingers?

Answer 8

Symmetrical MCP/PIP joint involvement
volar/palmar subluxation and ulnar displacement of the carpals in relations to the radius, and frequent development of flexion contractures, Bouchard’s nodes at the PIPs, progressive HE and CMC involvement

Question 9

A severe deformity with profound instability and functional impairment – associated w/ RA and complete loss of joint integrity

Answer 9

Mutilans deformity

Question 10

Foot/ankle involvement assoc w/ RA

Answer 10

rearfoot varus, arch collapse, hallux valgus, MTP subluxation, hammer/claw toes

Question 11

Interrupts gliding at tendon sheath, causing damage and potential for rupture (RA)

Answer 11

tenosynovitis – flexor tenosynovitis is a poor prognostic factor

Question 12

4 stages of RA

Answer 12

Early: possible OP, joint pain
Moderate: OP, muscle atrophy
Severe: OP, deformity, extensive atrophy
Terminal: Stage III + Fibrosis or ankylosis

Question 13

Inflammation disorder of lacrimal and salivary glands (assoc w/ RA)

Answer 13

Sjorgen’s Syndrome

Question 14

How many RA will have marked disability?

Answer 14

50%

Question 15

OA characterized by 2 pathologic features

Answer 15

progressive destruction of articular cartilage, and formation of osteophytes at the margins of the joint

Question 16

What joint is most commonly affected by OA

Answer 16

Knee

Question 17

Pathophysiology of OA

Answer 17

increase in articular cartilage water content, proteoglycan and collagen synthesis increase, then proteoglycan loss resulting in stiffness and elasticity losses

Question 18

Kellgren & Lawrence diagnostic criteria

Answer 18

0-4
1- possible osteophytes
2- definite osteophytes
3- mod osteophytes, narrowing
4- large osteophytes, narrowing, sclerosis, deformity

Question 19

Pattern of joint involvement for OA

Answer 19

PIPs, DIPs, thumb CMC, Herberden’s nodes (at DIP)

Question 20

3 primary indications for surgical management of OA?

Answer 20

intractable pain, severe deformity, loss of function

Question 21

What directs evaluation and intervention of rehabilitation in OA?

Answer 21

stage of inflammation!