osteo and reactive arthritis Flashcards
what is reactive arthritis?
response to infection:
joint pain and swelling triggered by an infection in another part of your body — most often your intestines, genitals or urinary tract
GI infection eg shigella, salmonella, camplylobacter infections
HIV Hep C infection
HLA class B association (genetic risk factor)
what are the typical presentations of reactive arthritis
asymetrical oligoarthritis lower limbs heel pain swollen fingers spondylitis (spinal inflammation)
what are non articular features of reactive arthritis
sterile conjunctivitis
urethritis
skin inflammation
how do you make a diagnosis?
clinical presentation
rule out septic arthritis which needs to be treated immediately
synovial fluid investigation (sterile in reactive arthritis, positive in septic arthritis)
microbial culture
serology (test for HIV, HepC)
no bugs on gram stain culture
how is reactive arthritis treated?
most settle down on own NSAIDs inject joint with corticosteroids oral-glucocorticoids steroid sparing agents
what is osteoarthritis?
NOT autoimmune
gradual degradation of the joint over time
pain and stiffness in joints
what are the typical joints affected in osteoarthritis?
hands: DIP distal interphalangeal joint PIP proximal interphalangeal joint first carpometacarpal joint hips knees spine
symptoms of osteoarthritis?
joint pain- worse with activity
joint crepitus- creaking, cracking sound
joint instability
joint enlargement/ boney swelling (eg. heberden’s nodes)
joint stiffness
limitation of movement
what are some radiological abnormalities of osteoarthritis
loss of joint space
subchondral (under cartilage) bony sclerosis
osteophytes
subchondral cysts
what do you see happen in the joint of someone of osteoarthritis?
smooth layer of cartilage, synovial membrane and synovial fluid breakdown
atrophy of muscular joints
what is the synovial fluid rich in?
hyaluronic acid which gives it its viscosity
how do you treat/manage osteoarthritis?
physical therapy weight loss where appropriate exercise paracetamol, NSAIDS, intra articular corticosteroid injection joint replacement
