Osteoarthritis vs RA Flashcards
osteoarthritis: pathogenesis?
mechanical: wear and tear destroys cartilage
osteoarthritis: which cells are involved in pathogenesis? what do these cells mediate?
chondrocytes mediate degradation and inadequate repair
which one (osteoarthritis or RA) is a degenerative joint disorder?
osteoarthritis
Osteoarthritis: predisposing factors?
age
female
obesity
joint trauma
age, female, obesity and joint trauma. predisposing for what?
osteoarthritis
in which disease do chondrocytes mediate degradation and inadequate repair?
osteoarthritis
osteoarthritis: presentation?
pain in weight-bearing joints after use (end of the day), improves with rest
assymetric
no systemic symptoms
which disease causes pain in weight-bearing joint at the end of the day, and improves with rest
osteoarthritis
osteoarthritis: knee cartilage loss begins medially or laterally?
medially (bow-legged/genu varum/’O’)
does osteoarthritis cause systemic symptoms?
no
osteoarthritis: joint involvement symmetric or asymmetric?
asymmetric
osteoarthritis: joint findings x-ray
(4 total)
osteophytes (bone spurs)
joint space narrowing (asymmetric)
subchondral sclerosis
cysts
x-ray findings: osteophytes, joint space narrowing, subchondral sclerosis and cysts. suggestive of?
osteoarthritis
osteoarthritis: synovial fluid findings?
non-inflammatory
WBC < 2000/mm3
osteoarthritis: findings hands?
Heberden nodes at DIP
Bouchard nodes at PIP
Nodes at 1st cmc (thumb)
osteoarthritis: which fingers joints are involved?
DIP, PIP, CMC (thumb base)
DIP: heberden
PIP: bouchard
Heberden nodes: where?
DIP (in osteoarthritis)
Bouchard nodes: where?
PIP (in osteoarthritis)
What are nodes at DIP called in osteoarthritis?
Heberden nodes
What are nodes at PIP called in osteoarthritis?
Bouchard
Are MCP involved in osteoarthritis?
no
which fingers joints are NOT involved in osteoarthritis?
MCP
osteoarthritis: treatment?
activity modification
NSAID, acetaminophen
intra-articular glucocorticosteroids
RA: pathogenesis?
Autoimmune and inflammation causes formation of pannus which erodes articular cartilage and joints
(pannus: proliferative granulation tissue)
what is pannus?
proliferative granulation tissue
formation of pannus which erodes articular cartilage. which disease?
RA
RA: predisposing factors?
Female
HLA-DR4
tobacco smoking
which disease is associated with HLA-DR4?
RA
RA is associated with which HLA type?
HLA-DR4
female, HL-DR4, tobacco smoking. predisposing factors for what?
RA
Which antibodies are associated with RA?
Rheumatic factor
anti-cyclic citrullinated peptide
which is more specific for RA: RF or anti-cyclic citrullinated peptide?
anti-cyclic citrullinated peptide
which antibody is most specific for RA?
anti-cyclic citrullinated peptide
which percentage of RA cases is positive for RF?
80%
what kind of antibody is RF?
IgM
targets IgG Fc region
RA: presentation?
pain, swelling and morning stiffness lasting >1hr, improving with use
systemic symptoms
extraarticular manifestations
how long does the morning stiffness in RA last?
> 1 hr
how do RA symptoms improve in the morning?
with use
pain, swelling and morning stiffness lasting >1hr, improving with use. suggestive of?
RA
does RA have systemic symptoms?
yes
what are the systemic symptoms in RA
fever, fatigue, weight loss
RA: joint findings on x-ray
erosions
osteopenia (juxta-articular)
joint space narrowing (symmetric)
cysts
x-ray findings:
erosions
osteopenia (juxta-articular)
joint space narrowing (symmetric)
cysts
suggestive of what?
RA
RA: which part of the body can be subluxated?
cervical spine
cervical subluxation. suggestive of what?
RA
RA: deformities?
cervical subluxation
ulnar finger deviation
swan neck (DIP flexed)
boutonniere (PIP flexed)
ulnar finger deviation. suggestive of what?
RA
swan neck deformities. suggestive of what?
RA
boutonniere deformities. suggestive of what?
RA
which joint is flexed in a swan neck deformity?
DIP
which joint is flexed in a boutonniere deformity?
PIP
which finger joint are involved in RA?
MCP, PIP
which finger joints are NOT involed in RA?
DIP, CMC (thumb base)
treatment RA?
NSAIDs
glucocorticosteroids
disease modifying agents: methotrexate, sulfasalazine
biological agents: TNF-a inhibitors
biological agent used for RA?
TNF-a inhibitor
disease modifying agents used for RA?
methotrexate (chemo/immuno-surpressive)
sulfasalazine (anti-inflammatoru)
extra-articular manifestations RA?
(10 total)
rheumatoid nodules (skin and lung)
Interstitial lung disease
pleuritis
pericarditis
anemia
neutropenia + splenomegaly
amyloidosis
sjogren
scleritis
CTS
