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DI 3203- Mod 9 > RA, Juvenile arthritis, SLE, Scleroderma > Flashcards

RA, Juvenile arthritis, SLE, Scleroderma Flashcards

1
Q

what is the target of rheumatoid arthritis

A

Synobial tissue + jts

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2
Q

What is the most common inflammatory arthritide

A

Rheumatoid athritis

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3
Q

Age of onset, gender RA

A

20-60

Higher prevelence in women (evens out after 40)

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4
Q

What is considered juvenil idioathic arthritis

A

before 16

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5
Q

S+S of RA

A

fusiform swelling
stiffness in morning
bilateral bursitis
eventual deformities

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6
Q

What are the 2 abnormal blood markers you will see in RA

A

Rheumatoid factor- 70-95%

Anti CCP

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7
Q

What is Anti CCP

A

measures levels of specific antibodies against CCP

-more specific than RA factor

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8
Q

What is the pathological progression of RA (3)

A
  1. acute synovitis
  2. synovial effusion + hyperemia
  3. Synovial proliferation/grandulation tissues (pannus formation)
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9
Q

What is the bare area

A

intracapsular bone not protected by articular cartilage

-inflammatory process (pannus formation) erodes unprotected bone

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10
Q

Target sites in hands/wrist and hallmark finding

A

MCPs
PIPs
Carpals
(spares DIPs)

Bilaterally symmetrical!!

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11
Q

what is a good hand vew to visualize RA

A

ballcatchers

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12
Q

What are the signs of RA in the hand (6)

A
  • Uniform jt space loss
  • Marginal erossions
  • fusiform swelling
  • periarticular osteopenia
  • subchondral cysts
  • subluxations
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13
Q

What is periarticular osteopenia

A

osteopenia in the jt capsul

abrupt density change

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14
Q

what causes ulnar styloid erosions

A

RA that originally in the extensor carpi ulnaris will start to eat at ulnar syloid

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15
Q

What are the types of hand deformities seen in RA

A
  • Ulnar deviation
  • Swan neck defomities
  • Zig zag deformity (ulnar dev of MCPs and radial dev of radiocarpal)
  • athritis mutilans
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16
Q

What is swan neck def

A

flex of dip
ext of pip
flex of mcp

17
Q

What is boutonnieres deformity

A

ext of dip
flex of pip
ext of mcp

18
Q

What are some imaging signs in the carpals in RA

A
  • Spotty carpal sign
  • Squashed carpal sign
  • Terry thomas sign (scapholunate dissociation)
  • bony ankylosis
19
Q

What are the imaging findings for RA in the foot

A

same findings as hand

uniform loss of jt space, marginal erosions, swelling, periarticular osteopenia, subluxations

20
Q

what are the xray signs of RA in the hip

A

Uniform loss of jt space
erosions
femoral head destruction
bilateral acetabular protrusion

21
Q

what causes bilateral protrusio acetabuli compared to unilateral

A

bilateral- RA (mc)

Unilat- Pagets, trauma, idiopathic females

22
Q

X ray signs of RA in the cervical spine (5)

A
  • Dens erosions
  • Occipital condyle/lat mass erosions (causes basilar impression)
  • Tepered spinous process (triangle shape)
  • eroded and fused factets
  • disc space narrowing
23
Q

DDx of bilateral osteolysis of distal clavicle

A

Slceroderma
hyperparathyrodism
RA

24
Q

Tx of RA and mc

A

Methotrexate Mc
NSAIDs
Corticosteroids
Jt replacements

25
Q

Differences bw osteoarthritis and RA

A

RA- symetrical, morning stiff >30, spares dips

OA- asymetrical, morning stiff <30, spares MCPs

26
Q

What is SLE- age, gender

A

chronic autoimmune disease
7:1 F:M
childbearing age

27
Q

SLE clinical features (5)

A
  • Constitutional Symptoms
  • Polyarthralgia (jt pains)
  • Skin rash (malar rash)
  • Renal Failure
  • Raynauds
28
Q

Imaging features of SLE (sides, S+S)

A
  • bilateral + symetric
  • Reversible hand deformities **
  • increased incidence of AVN

ERROSIONS NOT COMMON (differentiator from RA)

29
Q

What are the abnormal lab tests in SLE (3)

A
  • Le cells
  • Antinuclear antibodies
  • Abnormal plasma proteins
30
Q

Scleroderma ratio, age of onset

A

F:M 3:1

onse age 30-50

31
Q

overall scleroderma clinical features

A
  • Skin changes mc
  • raynauds phenomenon
  • Telangiectasia (spider veins)
  • dysphagia (esophageal probs common)
32
Q

Scleroderma of the hands findings (3)

A
  • loss of skin folds
  • rigidity
  • tapering of finger tips
33
Q

Scleroderma imaging findings

A
  • Acro-osteolysis (distal erosion)
  • atrophy of soft tissue/skin retraction
  • Soft tissue calcifications
  • well preserved jt spaces

DI 3203- Mod 9 (10 decks)

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