OA vs. RA Flashcards
Osteoarthritis is a disease of the _____
Cartilage
Primary form of OA increases exponentially after age ___
50 – due to aging
OA affects the larger joints first. Specifically which ones for women and men?
Women - hands and knees
Men - hips
What are the symptoms of OA?
Evening stiffness
Crepitus
Decreased ROM
When are the symptoms worse for OA patients?
Worse with use
Is there inflammation with OA?
No
Is there systemic symptoms with OA?
No
Is there morning stiffness with OA?
No
– Evening Stiffness
When OA affects the proximal IP joints
Bouchard’s Nodes
Bouchard’s nodes
OA affecting the proximal IP joints
When OA affects the distal IP joints
Heberden nodes
Heberden nodes
When OA affects the distal IP joints
How do cracks form in the matrix with OA and what does that cause to occur?
Increased water content and decreased proteoglycans
=> cartilage sloughs off
” joint mice or loose bodies”
Cartilage sloughing off with OA
When cartilage sloughs off with OA, what occurs next and what is the pain experienced?
Subchondral bone exposed and rubbed smooth
= Eburnation: bone on bone pain
Once Eburnation is present, what will develop in the bone and how?
Subchondral cysts
– microfractures allow synovial fluid into the bone
What is the end stage OA?
Osteophytes (mushroom shaped bony growths)
What do Osteophytes cause with OA?
Nerve compression and pain
Rheumatoid Arthritis is a disease of the _____
Synovium
Rheumatoid Arthritis is an autoimmune disease that affects which gender/age group more often?
Women 2-4th decades of life
Is there systemic effects with RA?
Yes
When is stiffness felt with RA?
Morning stiffness
When are the symptoms worse with RA patients?
Worse with rest
What type of inflammation is present with RA?
Non-suppurative inflammatory synovitis
What marker is commonly present in the serum with most RA patients?
ACPAs
What marker is not always present with RA and can be present in some patients that do not have RA?
Rheumatoid factor
– IgM/A binds to the Fc region of IgG and deposits into joints
OA is occurring slowly over time. When will joint symptoms present with RA?
Weeks/months
What genetic abnormality is associated with RA?
HLA-DR4
What environmental factors can influence RA?
Smoking
Infections
What joints are affected first with RA and in what fashion?
Small joints of fingers first = symmetrical distribution
How do the joints feel with RA?
Swollen
Warm
Painful
– morning stiffness that does NOT improve with rest
With RA: Boutonniere
Flexed PIP
Extended DIP
With RA: Swan-neck
Extended PIP
Flexed DIP
With RA, what deviation will you see with the fingers and wrist?
Fingers = ulnar deviation Wrist = radial deviation
Hyperplastic synovium that grows and erodes cartilage and causes joint fusion (ankylosis) to occur with RA?
Pannus
Besides Pannus, what other morphological features can be seen with RA?
Synovial hypertrophy with villi
Lymphoid aggregates
Ankylosis (joint fusion) from the pannus
What skin manifestations can be seen with RA?
Rheumatoid nodules
Where do Rheumatoid nodules present?
Extensor surfaces at pressure points in subQ tissue
– forearm, elbow, occiput, lumbar
Are the Rheumatoid nodules tender?
NO
Histo of the Rheumatoid nodules
Necrotizing granulomas with central fibrinoid necrosis
