Seminar A arthritis Flashcards
Types of arthritis and rheumatism
Soft tissue rheumatism →
Localised rheumatoid
Fibromyalgia Polymayalgia rheuamatica Bone disease Osteoporosis Metabolic Other arthritis Other diseases No disease Osteoarthritis Inflammatory polyarthritis Rheumatoid Arthritis SLE Spondyloarthropathies Other CTD Crystal arthropathy Gout Pseudogout Spinal pain
Soft tissue rheumatism →
Pain and stiffness from structures outside joints
Localised rheumatoid
Pain and stiffness from specific structures such as the ileo-lumbar ligament
Fibromyalgia
A term loosely used to describe patients with a syndrome of pain and tenderness in multiple sites. There is a strict definition but it is rarely used
Polymayalgia rheuamatica
A specific disease causing early morning proximal muscle stiffness but not arthritis. It occurs in people over 60, and sometimes in associsation with temporal (or giant cell) arteritis (when younger people might be affected)
Osteoporosis
Reduction in all bone tissues
Metabolic
For example, osteomalacia, when bone calcification but not bone protein is reduced.
Other arthritis
There are over 200 recognised types of arthritis and rheumatism
Other diseases
Many other diseases cause aches and pain in muscles and joints. Hypothyroidism and diabetes are good examples
No disease
Everyday aches and pains can be interpreted as indicating a serious illness in those with worries or concerns
Osteoarthritis
Patchy cartilage death and local bony overgrowth
Inflammatory polyarthritis
Inflammation inside many joints
Rheumatoid Arthritis
Synovial hyperplasia and inflammation
SLE
Deposition of immune complexes in many organ systems leading to local inflammation
Spondyloarthropathies
Inflammation of entheses with subsequent new bone formation principally in the spine, as in ankylosing spondylitis
Other CTD
Such as scleroderma or Raynaud’s disease
Crystal arthropathy
Inflammation caused by the precipitation of crystals within joints
Gout
Sodium urate crystals causing inflammation in joints
Pseudogout
Calcium pyrophosphate crystals causing inflammation in joints
Spinal pain
Not including inflammatory pain from spondyloarthropathies
Cartilage death (OA)
- Joint space narrowing
- Subchondral sclerosis
- Osteophytes
- Thickening capsule becomes thickened and fibrotic
- Additional synovial fluid produced
- Women >50
Synovial inflammation and overgrowth (RA)
Synovitis
Joint space narrowing
Erosions
1. Persistent inflammation causes generalised cartilage loss (resulting in joint space narrowing) and also thinning (osteoporosis) of the bone close to the joint (juxta-articular osteoporosis)
2. Synovial cells themselves become overgrown and invasive, and eat into the corners of the ones, forming ‘erosion’.
3. Women (30-50 yrs)
Inflammation and new bone formation at enthuse (places where ligaments and tendons join on to bone) (Ankylosing spondylitis)
- Main site is the spine (enthuses bound).
- New bone forms little spurs (called syndesmophytes in the spine) – grow out into area of ligaments.
- Loss of range of motion
- Synovitis
- More common in men (15-30)
Crystals in synovial fluid (gout)
First joint involved (50% of pop)→ Proxiaml interphalanageal joint of big toe (podagra)
Does not happen in women or children before menopause
Men>40yrs
Joint infection associated symptoms
Inflammations
Systems symptoms – nights sweats or pyrexia
Raised white blood cell count
UK joint infections commons cause
Staphylococci
Streptococci
