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Jason's Locomotor > Joint Pathology > Flashcards

Joint Pathology Flashcards

1
Q

bony congruence allows?

A

even distribution of pressure

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2
Q

3 layers of articular cartilage

A

superficial: parallel fibers
middle: random fibers
deep: perpendicular fiberes

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3
Q

what do GAGs do in articular cartilage?

A

draws in water

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4
Q

what does collagen and chondrocytes and GAGs do in articular cartilage?

A

water drawn in by GAGs, held together by collagen II, and maintained by chondrocytes

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5
Q

blood vessels in aritcular cartilage?

A

Nope

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6
Q

capsule, tendons, ligaments purpose?

A

stability and movement

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7
Q

synovial fluid contains?

A
  • plasma filtrate

- extra slippery hyaluronic acid

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8
Q

2 cells in synovium ?

A

Type A: macrophage-like

Type B: fibroblast-like (make hyaluronic acid)

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9
Q

OA presentation?

A
  1. Chronic, few joint
  2. weight bearing or prev. injured
  3. worse with use
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10
Q

RA presentation?

A
  1. inflamm, systemic
  2. symmetrical, small joints
  3. morning stiffness
  4. better with use
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11
Q

Gout presentation?

A
  1. paroxysmal acute inflammation

2. uric acid crystallisation

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12
Q

what is gout in big toe called?

A

Podagra

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13
Q

Damage precipitates what 3 things in OA?

A
  1. chondrocyte proliferation
  2. cytokine release
  3. matrix depletion
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14
Q

matrix depletion or unravelling releases what things?

A

enzymes (collagenases, MMPs)

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15
Q

what bony changes in OA?

A

thickening and microfractures,

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16
Q

what is shedding of cartilage called?

A

fibrillation “shredded appearance”

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17
Q

bone on bone causes 3 things:

A
  1. eburnation
  2. cysts
  3. osteophytes
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18
Q

3 big things in morphology of OA?

A
  1. non-uniform less of cartilage
  2. subchondral thickening
  3. osteophytes
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19
Q

signs of OA: 3

A
  1. reduced ROM
  2. crepitus
  3. osteophytes
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20
Q

onset of OA?

A

insidious

21
Q

pain type in OA?

A

deep achey

worse after use

22
Q

Heberden’s Nodes?

A

DIP

23
Q

Bouchard Nodes?

A

PIP

24
Q

X-rays dx OA?

A

Nope, little correlation

25
Q

5 OA risk factors:

A
  1. age
  2. obesity
  3. prev. injury
  4. heavy use of joint
  5. genetic
26
Q

OA not common in which joint?

A

shoulder

elbow

27
Q

RA affects not just joint but:

A

skin
blood vessels
heart
lungs

28
Q

RA pathogenesis which t-helper cells?

A

Th1, Th17

29
Q

RA pathogenesis which cytokines releases? 4:

A

IL-1,6,17

TNF-a

30
Q

RA pathogenesis T-cells activate what 4 things?

A

fibroblasts
macros
osteoclasts
B-cells

31
Q

RA pathogenesis what is formed in joint?

A

granulation tissues-like pannus due to breakdown of cartilage and bone

32
Q

what happens in synovium of RA pathogenesis ?

A
  1. germinal centres
  2. mononuclear infiltrate
  3. hyperplasia with villus formation = pannus
33
Q

what does pannus lead to eventually in RA pathogenesis ?

A

fibrosis and bony union of joints

34
Q

signs of RA?

A
  1. warm swollen joints

2. rheumatoid nodules

35
Q

symptoms of RA?

A
  1. morning stiffness - eases with activity

2. symmetric polyarthritis -starts at hands then feet

36
Q

what is a rheumatoid nodule?

A

granulomatous inflammation

with central necrosis

37
Q

how is joint space loss in RA?

A

uniform loss

38
Q

Risk factors for RA? 4 things:

A
  1. genetic
  2. women
  3. age: 25-55
  4. smoking
39
Q

When do you get systemic gout?

A

after 20-30 years of increasing uric acid levels, then precipitates into crystals

40
Q

uric acid crystals like to precipitate where?

A

in cool areas with low pH and nucleating agents: eg. big toe

41
Q

uric acid crystals do what do cause pain?

A

activate inflammation,
synovial cells
complement
neutrophil lysis

42
Q

what are tophi?

A

uric acid crystal deposition in soft tissue: articular cartilage and capsule

43
Q

gout and kidneys?

A

kidney stones

gouty nephropathy

44
Q

what is a gouty tophi?

A

granulomatous inflammation (foreign type body)

45
Q

gold standard for gout test?

A

joint aspiration: crystals

46
Q

serum urate in gout?

A

not reliable

47
Q

x-ray findings for gout?

A
  1. punched out erosions

2. overhanging edges

48
Q

gout risk factors: 4

A
  1. male
  2. uric acid metabolism
  3. genetics
  4. metabolic syndrome
49
Q

high uric acid is related to what things that would help upright human evolutionarily:

A
  1. Na+ retention
  2. hypertension
  3. insulin resistance

Jason's Locomotor (36 decks)

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