Osteoarthiritis And reactive Arthiritis

Question 1

Define reactive arthiritis

Answer 1

Sterile inflammation in joints following infection, especially urogenital and gastrointestinal infections and so Joint inflames after infection

Occurs mainly in young adults with predispostion of HLA - B27 class 1 allele.

Question 2

Describe the symptoms of reactive arthiritis

Answer 2

1. As symmetrical
2. oligoarthiritis <5 joints
3. Enthesis: heel pain And dactylitis (swollen finger)
4. Spondylitis
5. Ocular sterile conjunctivitis
6. Genito-urinary sterile urethritis
7. Psoriasis rash on hands and feet

Question 3

Describe the diagnosis and treatment of eactive arthritis

Answer 3

Clinical diagnosis, investigation to exclude septic arthritis, microbiology, immunology, synovial fluid examination

Treatment: articular: NSAIDs, extra articular: symptomatic therapy, refractory disease: oral glucocorticoid

Question 4

Define osteoarthritis and where it affects

Answer 4

Chronic self progressive disorder due to failure of articular cartilage that typically affects joints of the hands (especially pinch grip), spine, hips and knees —— not autoimmune and not inflammatory

Typically affects: hand then spine then knees then hips then big toe.

Question 5

What are the feature and pathogenesis

Answer 5

Features: bony swellings: osteophytes, osteophytes in DIP, osteophytes at PIP and many others.

Pathogenesis: defective and irreversible articular cartilage and damage to underlying bone due to excessive loading on joints of abnormal joint component

The articular cartilage : aggrecan - proteoglycan = made up of chondroiton and keratin sulphate (important for keeping water in articular cartilage - the GAG chain attracts H2O for integrity of articular cartilage.

Question 6

Describe the management.

Answer 6

Education
Physical therapy 
Occupations
Weight loss 
Joint replacement