RHEUMATOLOGY Flashcards
Reactive Arthrtiis
How does reactive arthritis develop?
After an infection where the organism cannot be recovered from the joint- sterile arthritis triggered by distant GI or Urogential infections
Reactive Arthritis
Describe the clinical triad of symptoms for Reactive Arthritis, in what gene does it mostly occur and what are precipitating factors?
- Polyarticular Arthralgia
- Urethritis
- Uveitis
CAN’T SEE, PEE or CLIMB A TREE
+ for HLA-B27- seronegative spondyloarthropathies
* common preciptating infections: Salmonella, Shigella, Yersinia and Campylobacter
* people can develop symptoms after a STI ionfection- SARA (sexually axquired reactive arthritis)
Reactive Arthritis
Describe 2 many causes of reactive arthritis and the commonly associated organisms?
Post-STI (common in men)- Chlamydia
Post-Dsyenteric- Shigella, Salmonella, Yersinia and Campylobacter
Reactive Arthritis
Describe the management of Reactive Arthritis?
Symptomatic: analgesia, NSAIDs and Intrarticular steroids
Sulfasalazine and Methotrexate (persitent disease)
Symptoms rarely last more than 12 months
Describe Bechets Disease-clinical triad?
- Oral ulcers
- Genital ulcers
- Uveitis
Septic Arthritis
Desribe Septic Arthritis?
- cause of joint swelling and should be considered in acutely painful joint
- unlikely to affect several joints
- may present with other signs like fever and inability to bear weight
*Organism may be cultured in joint aspiration of a joint affected by septic arthritis
KOCHER CRITERIA: determine probability of septic arthritis- 4 parts criteria
1. High WCC>12,000
2. High ESR (>40mm/hr)
3. inability to weight bear
4. presence of temp>38.5
Juvenile Idiopathic Arthritis
Describe features of systemic juvenile idiopathic arthritis??
- gradual onset
- morning stiffness
- spiking fevers
- history of school absences or avoidance of physical activities
- Flat, pale pink rash may appear
Systemic Lupus Erythematosus (SLE)
Describe the clinical features of SLE?
- autoimmune disorder-following a relapsing-remittting course
- most frequently occurs in women of child-bearing age
Classic triad:
1. Fever
2. Joint Pain
3. Rash in women of child-bearing age
Systemic Lupus Erythematosus (SLE)
What is the treatment of choice for SLE?
Hydroxychloroquine- anchor drug for long-term maintenance therapy of SLE
Systemic Lupus Erythematosus (SLE)
Describe SLE-clinical features?
- Malar flush
- Arthritis
- Thrombocytopenia
- Leukopenia
- Positive ANA (antinuclear antibody)
Systemic Lupus Erythematosus (SLE)
Describe the management of SLE?
- Basics: NSAIDs and sun-block
- Hydroxychloroquine: treatment of choice for SLE
- internal organ involvement: renal, neuro or eye: then consider prednisolone or cyclophosphamide
OA
Define OA and give the causes?
OA: chronic, degenerative joint disease involving the breakdown and eventual loss of the articular cartilage in the joints
associated with ageing but can also be caused by other factors such as obesity, joint injury, and genetics. It is the most common form of arthritis and a leading cause of disability among the elderly.
Causes: The pathophysiology of osteoarthritis involves:
- Age-related degeneration of articular cartilage.
- Mechanical stress on the joints due to obesity or injury.
- Genetic predisposition.
Risk factors contributing to the development of osteoarthritis include:
- Age
- Obesity
- Previous joint injury
- Overuse of the joint
- Genetics
- Bone deformities
OA
Give the signs and symptoms associated with OA?
SIGNS AND SYMPTOMS
Osteoarthritis is characterized by:
- Pain in the joint during or after use
- Stiffness, especially in the morning or after a period of inactivity
- Loss of flexibility and range of motion
- Grating sensation or the feeling of bone rubbing on bone
- Formation of bone spurs around the affected joint
OA
Describe the investigations used to diagnose OA?
Predominately based on clinical presentation and imaging
Imaging: LOSS
Loss of joint space: This reflects cartilage thinning, which is a hallmark of osteoarthritis.
Osteophytes: Also known as bone spurs, these are new bone formations at the joint margins.
Subchondral sclerosis: This refers to increased bone density beneath the cartilage, visible as areas of increased whiteness on the X-ray.
Subchondral cysts: These are fluid-filled sacs that form in the marrow of the bones adjacent to the joint.
magnetic resonance imaging (MRI) can provide a more detailed view of the joint and reveal changes in the early stages of the disease. MRI can also help visualize soft tissue structures, cartilage, and bone marrow changes.
