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2 MSK > Osteoarthritis and Crystal Arthropathies > Flashcards

Osteoarthritis and Crystal Arthropathies Flashcards

1
Q

most common form of arthritis?

A

osteoarthritis

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2
Q

pathogenic effects of osteoarthritis on bone?

A

formation of osteocytes
loss of joint space
thinning of cartilage
bony swelling

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3
Q

does cartilage grow back?

A

no

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4
Q

how does cartilage thin?

A

loses its matrix

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5
Q

why are osteocytes present?

A

in an attempt to repair broken down cartilage

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6
Q

what kind of pain does osteoarthritis present with?

A

mechanical pain i.e worse on activity, worse at end of day

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7
Q

is osteoarthritic pain relieved by rest or exercise?

A

rest

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8
Q

how long are joints typically stiff for?

A

<30 mins

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9
Q

most common areas affected by osteoarthritis?

A 
neck
lower back 
ends of fingers
base of thumb
base of big toe
hips
knees
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10
Q

which part of the hands are most affected by osteoarthritis?

A

DIP
PIP
1st CMC
base of thumb

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11
Q

what are bony enlargements affecting the DIP joint called?

A

heberdens nodes

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12
Q

what are bony enlargements affected PIP joint called?

A

bouchards nodes

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13
Q

manifestations of osteoarthritis on the leg?

A

bakers cyst

genu varus

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14
Q

where can hip pain typically be felt?

A

groin
hip
radiating knee

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15
Q

where can hip pain be a referred pain from?

A

lower back

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16
Q

what is a bakers cyst?

A

lump in popliteal fossa from drained effusion from joint

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17
Q

risk factors for OA

A 
age>40
female
genetic
job involving strain
previous injury
obesity
MSK comorbs
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18
Q

what joints does RA tend to affect?

A

MCP

PIP joints

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19
Q

how do the joint characteristics of RA differ from OA

A 
RA= soft, warm, tender
OA= cold, hard, bony
20
Q

what would be the result of ESR and CRP for OA

A

normal

21
Q

what would the anti CCP antibody result be for OA

A

negative

22
Q

what would the result of ESR and CRP be for RA

A

raised

23
Q

what would the anti CCP antibody result be for RA

A

positive

24
Q

is the treatment for OA curative?

A

no

25
Q

treatment for OA?

A

analgesics
NSAIDs (careful)
pain modulators eg amitriptyline/gabapentin
steroids short term (intraarticular)

26
Q

2 main crystal arthropathy conditions?

A

gout

pseudogout

27
Q

what salt deposition goes on in gout?

A

monosodium urate crystals

28
Q

is gout more common in women or men

A

men

29
Q

what can increase purine production and thus increase uric acid?

A 
red meats
shellfish
legumes
protein supplements
genetics
underexcretion
rapid cell breakdown eg psoriasis
30
Q

what value indicates hyperuricaemia?

A

> 7mg/dL

31
Q

what things would cause underexcretion of uric acid?

A 
starvation
dehydration
hypothyroidism
hyperparathyroidism
diuretics
renal insufficiency
32
Q

best time to measure serum urate in a suspected gout patient

A

2 weeks after acute attack

33
Q

what is the first metacarpal phalangeal joint?

A

big toe

34
Q

clinical presentation of gout

A

unilateral hot, red, swollen area that is very painful on either big toe, ankle, knee, upper limb, spine

35
Q

differential diagnoses for gout

A

septic arthritis
trauma
psoriatic arthritis

36
Q

what is chronic polyarticular gout?

A

chronic joint inflammation as a result of recurrent gout attacks over 10+ years

37
Q

investigations for gout

A

joint aspirate
inflammatory markers
x ray

38
Q

buzzword for gout findings on joint aspirate

A

needle shaped crystals

negative birefringence

39
Q

treatment for gout

A

NSAIDs
colchicine
corticosteroids
analgesia

40
Q

cause of pseudogout?

A

calcification of cartilage

41
Q

who gets pseudogout?

A

elderly

42
Q

most common areas affected by pseudogout

A

knees, wrist, ankles

43
Q

how does allopurinol help in gout

A

prevents uric acid production

44
Q

risk factors for pseudogout

A 
age
trauma
gout
hypercalcaemia
hypothyroidism
45
Q

treatment for pseudogout?

A

NSAIDs
colchicine
steroids
rehydration

(same as gout)

46
Q

what condition would you suspect if you saw red clumps on the microscope in a 50 year old female complaining of shoulder pain?

A

hydroxyapatite crystal deposition

2 MSK (61 decks)

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