Summary Flashcards
Autoimmune attack of synovial pannus
Inflammatory
Symmetric polyarthropathy
Morning stiff >30 min
RA
Men > 30 Prolonged hyperuricemia of joints (6.7+ crystals cannot be seen on radiograph) Inflammatory Asymmetric polyarthropathy Bilateral symmetry
Gout
Young adults, M> Inflammatory Asymmetric Oligoarthropathy (RF negative, HLA-B27) Inflammation at bony insertions of tendons Ligaments and fascia
Seronegative
45-85 (2:1 M>F) Osteoproliferative arthropathy Symmetric Progressive restrictive ROM Morning stiffness Dysphagia (fusion of 4+ cervical vertebrae by protruding syndesmophytes)
DISH
1st MPJ (hallucal sesamoids) Medial column- lisfranc's joint Lesser IPJ
OA
5th MPJ-med, lat
1st IPJ- med, sesamoids
Lesser MPJ- med
Chopart , TCN joint
Fibular notch
RA
1st MPJ 1st IPJ Lisfranc n chopart Ankle Not fib notch Can attack any site in foot
(MPJ, Midfoot, IPJ)
Gout
1st IPJ - most destructive MPJ, PIP, DIP Ray-like digits Calcaneius sites 2-5 Hallucal sesamoids Ankle
Seronegative
Calcaneus sites 3-6 Spine Dorsal talus n midfoot Base of 5th met(styloid process) Anteromedial navicular Medial 1st cuneiform Deltoid ligament Hallucal sesamoids
DISH
Knee
Hip
Hands(DIP n PIP)
OA
Spinal predilection
Sacroilitis n spondylitis
Enthesopathuc
Syndesmophytes w erosive changes at corners of vertebral bodies
Seronegative
Cervical vertebrae
Shoulder
Knees
Elbows “tennis elbow”
DISH
Uncommon:
Ankle, STJ and lateral column (chopart’s)- associa w trauma, tarsal coalition, AVN or CPPD
OA
Uncommon:
Ankle (except distal fibular notch)
RA
Joint space:
Subchondral chondrolysis
Primary- focal
Secondary- concentric
Wear n tear- focal (medial>lateral)
Gull-wing deformity
OA
Early concentric chondrolysis
(Pannus extension across joint)
End stage fibrous ankylosis- bone in socket
Loss of joint concentrically
RA
Joint space largely preserved
(Can note some widening of joint space)
Late joint space loss
Gout
Early concentric chondrolysis
Joint space narrowing w whiskered oeriostitis (new bone formation at margins) -pencil in cup deformity(not pathogonomic)
30% of joints fuse by bony ankylosis
End stage intra-articular bony ankylosis and/or contracture- mouse ear appearance
Seronegative
Joint space widening
DISH
> 50 yrs Wear and tear Non inflammatory Asymmetric Morning stiff
Focal joint space loss-> gradual
OA
Symmetry
RA
Asymmetric enthesopathy
Seronegative
Pain
OA
NSAID initially works
Crepitis w palpation
OA
Enthesopathy
Not a true arthropathy
Stiffness- early, late, cold
DISH
1 cause of aggressive benign
30-50% of bone loss must occur to be seen
OM
Inflammatory arthritis
Class II inflammation
RA
Asymptomatic polyarthritis
Class II inflammation
Bilat, sym is not uncommon
Gout
Non-inflammatory
Class I
OA
Bone biopsy for definite Dx
Class II inflammation
OM
