osteoarthritis vs rheumatoid arthritis Flashcards
Pathogenesis of osteoarthritis
Wear and tear destroys articular cartilage, leading to inflammation. Chrondrocytes attempt repair but repair is inadequate.
Pathogenesis of rheumatoid arthritis
Autoimmune - inflammation induces formation of pannus (proliferative granulation tissue) which erodes articular cartilage and bone
Predisposing factors for OA
Female, age, obesity, joint trauma
Predisposing factors for RA
Female, HLA-DR4, smoking
Which proteins are positive in RA?
Rheumatoid factor
Anti-cyclic citrullinated peptide antibody (more specific)
Presentation of OA
pain in weight-bearing joints after use, and improves with rest
Asymmetric joint involvement
Presentation of RA
Pain, swelling and morning stiffness that improves with use
Symmetric joint involvement
Systemic symptoms (fever, fatigue, weight loss)
What extraarticular manifestations may be seen in RA?
Rheumatoid nodules (fibrinoid necrosis with palisading histiocytes) - in subcutaneous tissue and lung Pneumoconiosis, interstitial lung disease, pleuritis, pericarditis, anemia of chronic disease, neutropenia, splenomegaly
What is Caplan syndrome?
seropositive rheumatoid arthritis and a characteristic pattern of fibrosis in the lung
What is felty syndrome?
splenomegaly, neutropenia and RA
Joint findings of OA
osteophytes, joint space narrowing, subchondral sclerosis and cysts. Synovial fluid is non inflammatory (<2000).
Herberden nodes and Bouchard nodes.
which joints are effected in OA of the hands?
DIP and PIP
first CMC
Where do herberden nodules occur?
DIP
Where do bouchard nodes occur?
PIP
joint findings in RA
erosions, juxta-articular osteopenia, soft tissue swelling, subchondral cysts, joint space narrowing.
Synovial fluid inflammatory
