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1. MSK > Other arthritis's > Flashcards

Other arthritis's Flashcards

1
Q

What is psoriatic arthritis?

A

inflammatory arhtritis that occurs mainly in people with arthritis, 10-15% dont have arthritis

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2
Q

Is psoriatic arthritis rheumatoid factor positive or negative?

A

negative

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3
Q

What are the different signs of psoriatic arthritis?

A

pitting and onchyloysis of nails
ankylosing spondylitis
dactylitis (sausage digit)
uveitis

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4
Q

What is the common presentation of PA?

A

asymmetric oligoarthritis with dactylitis

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5
Q

What is arthritis mutilans?

A

very aggressive form of psoriatic arthritis

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6
Q

What is the investigations for PA?

A

Bloods - RF (-ve), raised inflammatory markers

Xrays - marginal erosions, osteolysis, enthesitis

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7
Q

What is the non pharmacological treatment for PA?

A

physiotherapy

orthotics

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8
Q

What is the pharmacological treatment for PA?

A 
NSAIDs
Steroid injections
DMARDS
Anti TNF if very severe
Anti IL-17
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9
Q

What is reactive arthritis?

A

inflammatory arthritis following a systemic illness

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10
Q

What systemic illnesses can cause reactive arthritis?

A

Salmonella
Chlamidya
Shigella
Yersinea

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11
Q

What is reactive arthritis characterised by?

A

inflammatory synovitis fomr which viable microorganisms cannot be cultured

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12
Q

What is the peak population for reactive arthritis?

A

young adults 20-40

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13
Q

What is the investigations for reactive arthritis?

A 
Bloods - RF, increased inflammatory markers
HLA-B27 positive
Blood, urine and stool cultures
X ray of affected joint
joint fluid analysis
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14
Q

What is Reiters Syndrome?

A

Type of reactive arthritis characterised by uveitis/conjunctivitis, urethritis and arthritis

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15
Q

What are the common signs of reactive arthritis?

A

enthesitis
fever, malaise, fatigue
asymmetrical monoarthrtis or oligoarthritis
muscutaneous lesions - oral ulcers
visceral manifestations - mild renal disease, carditis
occular lesions - conjunctivitis and iritis

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16
Q

What is the treatment for reactive arthritis?

A 
90% resolve spontaneously - some become chronic
NSAIDs
antibiotics for underlying infection
DMARDs if chronic
Physio/Occupational Therapy
17
Q

How long after the initial disease/infection do symptoms start to show for RA?

A

1-4 weeks

18
Q

What is enteropathic arthritis associated with?

A

associated with IBD

19
Q

What is the presentation of EA?

A 
arthritis in several joints - commonly sacroilitis
weight loss
fever
uveitis
skin involvement
GI watery stools
enthesitis
oral ulcers
20
Q

What are the investigations for EA?

A 
upper and lower GI endoscopy showing IBD signs
joint aspirate
increased inflammatory markers
Xray/MRI showing sacroilitis
USS showing synovitis/tenosynovitis
21
Q

What is the treatment for EA?

A 
analgesia - paracetamol, cocodamol
DONT GIVE NSAIDS
Treat IBD
Steroids 
DMARDs
Anti-TNF
22
Q

What is septic arthritis?

A

high bacterial load causes sepsis

23
Q

What is the pathophysiology of spetic arthritis?

A

proteolytic enzymes degrade hyaline cartilage and destroy the joint, may cause osteonecrosis of the hip

24
Q

What is the presentation of septic arthritis?

A 
unable to weight bear
hip/groin pain
HIP FLEXED AND EXTERNALLY ROTATED
severe hip pain on passive movement
usually pyrexial
25
Q

What causes septic arthritis in neonates?

A

strep and gram -ve

26
Q

What causes septic arthritis in infants to adults?

A

staph aureus

27
Q

What causes septic arthritis in IV drug users?

A

pseudomonas

atypical organisms

28
Q

How is septic arthritis investigated?

A 
blood tests - FBC, CRP 
blood cultures
kochers criteria
ultrasound +- aspiration
Xrays
29
Q

How is septic arthritis treated?

A

URGENT
open surgical washout
antibiotics

30
Q

How can septic arthritis happen? (where can the organisms get in from?)

A

direct innoculation from trauma/surgery
carried through blood
can travel from adjacent bone e.g. osteomyelitis
spreads from the metaphysis

31
Q

What is reactive synovitis?

A

inflammation of the synovium secondary to illness

32
Q

What is the presentation of reactive synovitis?

A

HIP FLEXED AND EXTERNALLY ROTATED
groin/hip pain and limp
pyrexial

33
Q

What distinguishes between reactive synovitis and septic arthritis?

A

Kochers criteria

  • fever
  • refusing to bear weight
  • serum WBC >12,000
  • CRP >20
34
Q

How is reactive synovitis investigated?

A

Ultrasound

Kochers criteria

35
Q

How is reactive synovitis treated?

A

self limiting

analgesia and NSAIDs

1. MSK (36 decks)

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