R/O - Osteoarthritis Flashcards
what type of arthritis is osteoarthritis?
hypertrophic
what is the most common form of arthritis?**
osteoarthritis
what are the two subtypes of primary OA?
- localized
- generalized
what are the subtypes of generalized primary OA?
- nodal
- erosive
- inflammatory
OA / DJD definition:
degeneration of cartilage and its underlying bone within a joint as well as bony overgrowth
what are the radiographic signs of OA / DJD?**
- joint space narrowing
- subchondral sclerosis
- ostephyte formation
pathology of OA / DJD
- articular cartilage loss
- osteophyte and bony sclerosis development
- inflammatory infiltrates in the synovium
- lax ligaments
- weak muscles
symmetric polyarthritis - likely diagnosis?
OA
how is OA different from RA?
- inolvement DIP, PIP, IP, first MP, CMC
- bony enlargement (bouchards nodes) - RA is doughy when squeezed
what is the pharmacological therapy for OA?
ORAL:
- acetaminophen
- oral NSAIDs
- topical NSAIDs
- tramadol
- duloxetine (NR)
- opioids (NR)
INTRA-ARTICULAR:
- hyaluronates
- glucocorticoids
TOPICAL:
- capsaicin (hand only)
- diclofenac (NSAID)
what is one advantage of COX-2 specific NSAIDs over normal NSAIDs?
lower risk of GI adverse effects than NSAIDs
RA general features**
- multisystem, autoimmune disease
- NOT a benign “joint disease”
- high rates of diability
- increased early mortality
diagnostic classification of RA:
- morning stiffness
- arthritis of 3 or more joint areas
- arthritis of hand joints
- symmetric arthritis
- rheumatoid nodules
- serum rheumatoid factor
- radiographic changes
morning stiffness in inflammatory arthritis (such as RA) lasts for how long?
at least an hour
what marker is specific but not sensitive for RA?
- anti-CCP (anti-cyclic citrillinated peptide) antibody
what are the lab findings in RA?
- Rf
- anti CCP
- acute phase reactants
- ANA
what are the joint morphology changes in RA?
- synovitis
- bone erosion
- pannus
- cartilage degradation (joint space narrowing)
what is the pathologic hallmark of RA?
rheumatoid erosions
periarticular osteopenia is seen in which type of arthritis?
RA
what is Caplan’s syndrome?
rheumatoid nodules PLUS pneumoconiosis
what is the role of NSAIDs in RA?
symptomatic relief ONLY (pain and stiffness)
what is the gold standard treatment for RA?
methotrexate
what are the adverse effects of methotrexate?
- hepatic fibrosis
- bone marrow toxicity
- pulmonary toxicity
- nuisance side effects
what are the TNFa biologics for RA?
- infliximab
- etanercept
- adalimumab
- certolizumab
- golimumab
what is the T cell activity biologic drug?
abatacept
what is the B cell activity biologic drug?
rituximab
what is the IL-1 activity biologic drug?
anakinra
what is the IL-6 activity biologic drug?
tocilizumab
what is the JAK activity biologic drug?
tofacitinib
what is the most POTENT medication for RA? they are usually used in combination with what other drugs?
- anti TNFa therapies
- methotrexate
