orthopaedic patho Flashcards
What are the key factors involved in the pathogenesis of osteoarthritis?
The pathogenesis involves multiple factors, including increased load on joints, degradation of articular cartilage, biochemical abnormalities like reduced proteoglycans, and genetic mutations (e.g., COL2A1).
What are the primary clinical variants of osteoarthritis?
The three main clinical variants are:
Primary generalized OA (common in postmenopausal women)
Erosive inflammatory OA (severe with rapid progression)
Hypertrophic OA (slow progression with florid osteophyte formation)
What are the typical radiological findings in osteoarthritis?
Radiological features include narrowing of joint space, sclerosis (thickening of subchondral bone), subchondral cysts, and osteophytes (bone spurs).
What complications can arise from disc bulging or herniation?
Complications include:
Myelopathy: Spinal cord injury leading to spasticity, unsteady gait.
Radiculopathy: Nerve root injury causing dermatomal neurological deficits.
What is the role of cytokines in the pathology of rheumatoid arthritis?
Cytokine-mediated inflammation, primarily driven by CD4+ T cells, leads to synovial inflammation, pannus formation, and destruction of adjacent bone, resulting in joint deformity.
What is the pathogenesis of gout?
Gout is caused by problems with purine metabolism, leading to increased uric acid production and decreased elimination. This results in urate crystal deposition in joints, causing inflammation.
What are the key clinical features of septic arthritis?
Septic arthritis presents with acute joint pain, warmth, swelling, and systemic symptoms like fever. It can cause rapid joint destruction if untreated.
What are the potential complications of osteomyelitis?
Complications include pathological fractures, spread of infection, chronic osteomyelitis, bone abscesses, and secondary amyloidosis. Severe cases may lead to malignant transformation.
What are some extra-articular manifestations of rheumatoid arthritis?
Extra-articular manifestations of RA include subcutaneous rheumatoid nodules, vasculitis (e.g., necrotizing vasculitis), amyloidosis, lung involvement, and possible cardiovascular complications.
What are the key pathological differences between osteoarthritis (OA) and rheumatoid arthritis (RA)?
OA: Degeneration of articular cartilage, eburnation of subchondral bone, osteophyte formation, and minimal inflammation.
RA: Synovial inflammation, pannus formation, destruction of articular cartilage and bone, and presence of rheumatoid nodules.
What is the characteristic pathology of ankylosing spondylitis?
Ankylosing spondylitis is characterized by the destruction and fibrotic fusion (ankylosis) of the vertebral column and sacroiliac joints, often leading to severe spinal deformities.
How do the crystals in gout differ from those in pseudogout?
Gout: Urate crystals are needle-shaped and negatively birefringent under polarized light.
Pseudogout: Calcium pyrophosphate crystals are rhomboid-shaped and positively birefringent.
What are the key pathological features of suppurative osteomyelitis?
Suppurative osteomyelitis involves bacterial proliferation in the bone, acute inflammation, and cell death (necrosis). The infection spreads through the bone’s haversian system, potentially leading to periosteal lifting and subperiosteal abscess formation.
What are common complications of tuberculous osteomyelitis?
Complications include compression fractures, severe spinal deformities (scoliosis and kyphosis), and neurological deficits due to spinal cord and nerve compression.
What is the typical pathogenesis of septic arthritis?
Septic arthritis typically arises from hematogenous spread of bacteria, direct inoculation, or contiguous infection. It leads to acute suppurative inflammation of the synovium, which can rapidly destroy the joint if not promptly treated.
