Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Medicine Podiatric > wk 7- joint pain > Flashcards

wk 7- joint pain Flashcards

1
Q

what make up the synovial joint

A

bone
cartilage covering articular surfaces
synovial fluid
synovial joint capsule

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q
A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what is OA

A

a chronic, degenerative synovial joint condition which is characterised by loss of articular cartilage and periarticular bone response

more common in women

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

patho of OA

A

has both mechanical and biological factors to it

mechanical: abnormal loading/wear such as injury, instability, hypermobility, joint dysplasia play a role, deformity, sport, obesity

biological: genetic predisposition, age related changes to cartilage metabolism

  1. transmission of inflammatory mediators from synovial fluid into cartilage causing an inflammatory reaction/damage
  2. progressive chondrocyte death and cartilage destruction occur
  3. subchondral bone undergoes infarction forming bone cysts
  4. attempts of repair to stabilse the joint cause subchondral sclerosis and marginal osteophytes
  5. inflammation of synovium and periarticular soft tissues
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what can reduce OA of knee

A

weight loss
by 33% if they drop down a weight class for women
by 25.4% for men

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

features of OA

A

pain by activity and relieved by rest

rest stiffness developed over time

joint tenderness

swelling

crepitus

restriction ROM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

radiographic features

A
  • non uniform joint space narrowing
    -osteophytes
    -subchondral sclerosis
    -subchondral cysts
    -loose bodies
    -sublaxation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

OA management

A
  1. exercise -maintains ROM and strengthens muscles
  2. footwear/ assistive devices- cranes, brace, splints, footwear
  3. weight loss (esp knee)

pharma
1. NSAIDs non selecitve or cox2 with or without SSRI/SNRI
2. opiods for short term use
3. corticosteroid/hyaluronic acid injections for short term use

  1. surgery: joint replacement
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what is synovial chondromatosis

A

synovium grows abnormally and produces nodules made of cartilage . nodules can sometimes break off and become loose bodies inside the joint which can damage the smooth articular cartilage

rare condition that can lead to OA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what is RA

A

systemic, inflammatory, autoimmune disease

more common in females, with a reduction in life expectency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

RA patho

A

Triggered by a genetic and environment factor

  1. synovial plasma cells produce antibodies that form immune complexes and stimulate leucocyte proliferation
  2. T cells infiltrate the synovium and secrete cytokines which recruits more inflammatory cells like macrophages into the joint which secrete more cytokines
  3. This stimulates pannus formation of the synovial membrane which causes destruction of cartilage, bone and soft tissue
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what causes RA to occur

A

cause is unknown but there are

  1. genetic (50% of risk)
  2. environmental risk factors
    - smoking
    -infections
    -diet
    -air pollution
    -silica exposure
    -alcohol
    -obesity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

clinical features of RA

A

symmetrical
presents insidiously
multiple joints
joint swelling
warmth
stiffness after inacitvity
pain
prolonged morning stiffness )>60mins)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

complications of foot for RA

A

Common deformities: pes planus, plantar fasciopathy, tib post/achilles tendonitis , hallux valgus, hammer toes

rheumatoid nodules at sites of pressure in 30% of patients

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

complications of RA extra articular

A
  • vascular complications
    -neuropathy in half the cases
    -nodules
    -ulcers
    -infection
    -eye complications
    -anaemia/iron deficiency
    -muscle disorders
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

how do you detect an active disease in RA

A
  1. lateral squeeze test
  2. swollen joint count
  3. exam and palpation of tendons and bursae
17
Q

early referral for RA criteria

A
  1. 3+ swollen joints
  2. squeeze test positive for MTP and or MCP
  3. morning stiffness 30mins or more
18
Q

RA management

A
  1. referral to rheumatologist - early diagnosis improves outcomes

pharma: conventional synthetic disease modifying anti rheumatic drugs

  1. methotrexate oral or subcutaneous injection once weekly
    2.Leflunomide, sulfasalzine and hydroxychloroquine may be used alone or in combination
  2. corticosteroids are used to manage symptoms until antirheumatic drugs begin
    • biological disease modifying anti rheumatic drugs (infliximab)
      - increased risk of infections
  4. immunisations
19
Q

gout what is it

A

inflammatory arthritis associated with hyperuricaemia and uric acid crystals

common in men at the 1MTPJ

20
Q

risk factors for gout

A
  • alcohol
    -diet of purines (red meat, seafood)
    -aspirin, diuretics, cytotoxic drugs (that raise plasma urate levels)
    -fam history
    -conditions
21
Q

gout patho

A

hyperuricaemia occurs through
1. decreased renal urate excretion- alcohol
2. increased urate production
3. or increased intake - purine rich foods

monosodium urate crystals may occur in response to an event

22
Q

diagnosis of gout

A
  • serum urate (not reliable because levels may be dropping after attack)
    -US imaging
23
Q

features of gout

A
  • 1st mTPJ
    -Swollen, hot, red joint
    -tender
    -tophi (chronic)
    -unable to weightbare
    -loss of ROM
24
Q

management for gout

A
  1. rule out septic arthritis
  2. NSAIDs/prednisone/local corticosteroid injection
  3. urate lowering medication if 2+ attacks within a year
  4. bloods checked every 4-6 weeks after attack
25
Q

pseudogout what is it

A

build up of calcium pyrophosphate crystals in joints

26
Q

what is septic arthritis

A

bacterial invasion of the synovial space, common in 1st MTPJ

diabetics, RA, prosthetics, joint surgery at a higher risk

fatal

27
Q

diagnose septic arthritis

A

arthrocentesis and synovial culture

28
Q

symptoms of septic arthritis

A

red hot swollen joint
fever
pain

29
Q

predisposing factors for septic arthritis

A

-RA
-DM
-prosthetic
-joint surgery/injection

30
Q
A

Medicine Podiatric (13 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions