Pathoma - Joint Disorders Flashcards
Osteoarthritis - what is it?
progressive degeneration of articular cartilage
Osteoarthritis - cause
“wear and tear” (mechanical)
Osteoarthritis- risk factors
Age, obesity, trauma
Osteoarthritis - pathobiology
disruption of cartilage lining articular surface
Osteoarthritis - joint findings
osteophyte formation Herber/Bouchard nodes (DIP/PIP involvement) eburnation sclerosis joint space narrowing
Osteoarthritis - treatment
NSAIDS, corticosteroids
Rheumatoid arthritis - cause
chronic autoimmune dz
Rheumatoid arthritis - risk factors
HLA-DR4
Osteoarthritis - Clinical presentation
pain that gets worse at end of day/with use
Rheumatoid arthritis -joint findings
Pannus
increased synovial fluid
MCP/DIP joints involvement
joint deviation
Rheumatoid arthritis- pathobiology
inflammatory destruction of synovial joints
What type of hypersensitivity is RA?
Type III
What is pannus?
inflamed granulation tissue
Rheumatoid arthritis- clinical presentation
Morning stiffness symmetric joint involvement systemic symptoms (fever, malaise,etc)
Rheumatoid arthritis- treatment
NSAIDS, corticosteroids, disease modifying agents (methotrexate, sulfasalazine, TNF-alpha inhibitors)
Rheumatoid arthritis - associated
vasculitis
Baker’s cyst
pleural effusions
Rheumatoid arthritis - labs
IgM autoantibody against Fc portion of IgG (RF)
Seronegative spondyloarthropathies
arthritis with lack of rheumatoid factor
SNSAs - location and risk factors
axial skeleton
HLA-B27
SNSAs - diseases
PAIR: Psoriatic arthritis Ankylosing spondylitis Inflammatory bowel disease Reactive arthritis (Reiter's syndrome)
Ankylosing spondylitis - population
young adults, mostly male
Ankylosing spondylitis - clinical presentation
low back pain, bamboo spine (joints fuse)
Ankylosing spondylitis - associated
uveitis and aortitis
Psoriatic arthritis - involved joints
DIP of hands/feet (asymmetric involvement)
Psoriatic arthritis - clinical presentation
“sausage fingers/toes”
Psoriatic arthritis - x-ray
“pencil in cup” deformity
Reactive arthritis (Reiter’s) - clinical presentation
arthritis, urethritis, conjunctivitis
(“can’t see, can’t pee, can”t climb a tree”
Reactive arthritis (Reiter’s) - associated
post GI or C. trachomatis (chlamydia) infection
Infectious arthritis - common causes
N. gonorrheae (#1)
S. aureus
Infectious arthritis - clinical presentation
single joint
fever, increase WBCs
Gout - cause
hyperuricemia
Gout - crystals
Monosodium urate (MSU)
Causes of secondary hyperuricemia
leukemia, myeloproliferative disorders
renal insufficiency
Lesch-Nyhan syndrome
Gout- clinical presentation (acute)
incredibly painful great toe
alcohol/meat consumption exacerbate
Gout - clinical presentation (chronic)
tophi (white, chalky uric acid cystals)
renal failure
Gout - labs
hyperuricemia
needle shaped crystals (negative birefringence) (yellow)
Pseudogout - crystals
calcium pyrophosphate
Pseudogout - labs
rhomboid shaped crystals (weakly + birefringence)
Pseudogout - clinical presentation
large joints (knee)
Gout - tx
acute- NSAIDs/corticosteroids
chronic xanathine oxidase inhibitors (allopurinol, febuxostat)
