OA/RA Flashcards
a systematic inflammatory disease primarily affecting the joint synovium
RA
a localized process involving destruction of cartilage tissue
OA
Diagnostic criteria for RA
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
RA gender and age incidence
women, 60-70 y.o.
pathophysiology of RA
infiltration of synovium by CD4 T/B cells, and hyper plastic pannus formation
What is a pannus?
hyperplastic granulation tissue that invades the synovium and degrades the cartilage, subchondral bone, and articular capsule
3 different presentations of RA and which is the most common
Monocyclic, *polycyclic, and progressive and unremitting
how does RA present at the hand/wrist/fingers?
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
A severe deformity with profound instability and functional impairment – associated w/ RA and complete loss of joint integrity
Mutilans deformity
Foot/ankle involvement assoc w/ RA
rearfoot varus, arch collapse, hallux valgus, MTP subluxation, hammer/claw toes
Interrupts gliding at tendon sheath, causing damage and potential for rupture (RA)
tenosynovitis – flexor tenosynovitis is a poor prognostic factor
4 stages of RA
Early: possible OP, joint pain
Moderate: OP, muscle atrophy
Severe: OP, deformity, extensive atrophy
Terminal: Stage III + Fibrosis or ankylosis
Inflammation disorder of lacrimal and salivary glands (assoc w/ RA)
Sjorgen’s Syndrome
How many RA will have marked disability?
50%
OA characterized by 2 pathologic features
progressive destruction of articular cartilage, and formation of osteophytes at the margins of the joint
What joint is most commonly affected by OA
Knee
Pathophysiology of OA
increase in articular cartilage water content, proteoglycan and collagen synthesis increase, then proteoglycan loss resulting in stiffness and elasticity losses
Kellgren & Lawrence diagnostic criteria
0-4 1- possible osteophytes 2- definite osteophytes 3- mod osteophytes, narrowing 4- large osteophytes, narrowing, sclerosis, deformity
Pattern of joint involvement for OA
PIPs, DIPs, thumb CMC, Herberden’s nodes (at DIP)
3 primary indications for surgical management of OA?
intractable pain, severe deformity, loss of function
What directs evaluation and intervention of rehabilitation in OA?
stage of inflammation!
