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MSK Pathology > Arthritis > Flashcards

Arthritis Flashcards

1
Q

What is the most common form of arthritis?

A

osteoarthritis

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2
Q

What type of disorder is OA?d

A

degenerative due to imbalance between wear and repair of cartilage

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3
Q

What may put people at a higher risk of OA?

A 
previous fractures
Perthes disease
SUFE (slipped capital femoral epiphysis )
congenital disclocation of hip
cartilage injury
crystal arthropathy
Inflammatory arthritis
Meniscal tears
Genu varum or valgum
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4
Q

Name the 4 typical radiographic findings of an osteoarthritic joint. (LOSS)

A

Loss of joint space
Osteophytes
Sclerosis
Subchondral cysts

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5
Q

What is the most common seropositive inflammatory arthropathy?

A

RA

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6
Q

What does RA most commonly affected?

A

small joints of hands and feet as well as cervical spine

Hipes, kneses shoulders and elbows can also be affected

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7
Q

Is RA more common in men or women and by how much?

A

women are 2-3 times more likely

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8
Q

What are CRP and ESR usually in RA?

A

raised

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9
Q

List clinical features of RA.

A 
morning stiffness
synovitis (doughy swelling)
pain
deformity
loss of function
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10
Q

What can occur on the skin in RA?

A

cutaneous rheumatoid nodules

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11
Q

How can internal organs be affected in RA?

A

rheumatoid lung, ischaemic heart disease

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12
Q

What do X rays show in RA?

A

hypotrophic artritis:
no osteophytes, sclerosis or bone cysts
Instead - PERIARTICULAR EROSIONS

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13
Q

What is seen on X ray in OA (what is the pictre type called)?

A

hypertrophic

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14
Q

What operations may be performed for rheumatoid arthritis?

A 
synovectomy
joint replacement
joint excision
tendon transfers
arthrodesis (fusion)
cervical spine stabilisation
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15
Q

Which joints tend to be affected in SLE?

A

hands and knees

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16
Q

What type of arthritis are spongyloarthropathies?

A

seronegative

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17
Q

In what are patients often HLA-B27 positive on serological testing?

A

spongyloarthropathies

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18
Q

What is ankylosing spondylitis?

A

chronic inflammatory disease of spine and sacro-iliac joints leading to eventual fusion of intervertebral joints and Sacro iliac joints

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19
Q

Who is more likely be affected by AnkSpon, men or women?

A

men (3:1)

20
Q

What conditions are associated with AnkSpon?

A

aortitis, pulmonary fibrosis and amyloidosis

21
Q

What do X rays show in AnkSPon?

A

bony spures known as syndesmophytes which can make a bridge over the intervertebral disc, resulting in fusion, known as BAMBOO SPINE

22
Q

Is surgery commonly used in AnkSpon?

A

NO

23
Q

Is kyphoplasy to straighten the spine in AnkSpon commonly used?

A

No - iss controversial and carries considerable risk

24
Q

How common is psoriactic arthritis in people with skin psoriasis?

A

30%

25
Q

In what type of arthritis are there normally nail changes including pitting and onycholysis?

A

psoriatic

26
Q

What is the very aggressive type of psoriatic arthritis that 5% of patients have?

A

arthritis mutilans

27
Q

What does enteropathic arthritis involve?

A

spine and peripheral joints, occurring in patients with IBD, coeliac, bowel resections and some GI infections

28
Q

How many IBD sufferers will get enteropathic arthritis?

A

10-20%

29
Q

What is reactive arthritis?

A

occurs in response to infection in other part of body, eg GI or genitourinary
Large joints around the KNEE become inflamed 1-3 weeks after the infection

30
Q

What is the triad of symptoms which may occur in reactive arthritis?

A

Reiter’s syndrome:

  1. urethritis
  2. uveitis
  3. arthritis
31
Q

What is gout?

A

a crystal arthropathy caused by deposition of urate crystals within a joint, usually due to hyperuricaemia

32
Q

What is uric acid the final compound in the breakdown of?

A

purines in DNA metabolism

33
Q

What may cause the yperuricaemia in gout?

A 
renal underexcretion (eg caused by diuretics/renal failure)
seafood, red meat, alcohol
34
Q

What can trigger the formation of uric acid crystals?

A

dehydration, trauma, surgery, chemotherapy

35
Q

What is the classic site of gout?

A

first MTP joint (known as Podagra)

36
Q

What are the two next most common sites of gout?

A

ankle and knee

37
Q

How does gout present?

A

intensely painful red hot swollen joint

38
Q

What are gouty tophi?

A

painless white accumulations of uric acid occurring in soft tissues and erupting through skin

39
Q

What can chronic gout result in?

A

destructive erosive arthritis

40
Q

What is the treatment for gout?

A

NSAIDs, corticosteroids, apioid analgesics and colchicine (if you can’t tolerate NSAIDs)

41
Q

How is a definitive diagnosis of gout made?

A 
polarized microscopy
(uric acid crystals are needle shaped and display negative birefringence - change from yellow to blue)
42
Q

What can prevent recurrent attacks in gout?

A

allopurinol or probenecid (don’t start until acute attack has settled)

43
Q

What is pseudogout?

A

crystal arthropathy causing acute arthritis caused by CALCIUM PYROPHOSPHATE crystals

44
Q

What term is used when calcium pyrophosphate deposition occurs in cartilage and other soft tissues in absence of acute inflammation?

A

chondrocalcinosis

45
Q

What is the umbrella term for chrondocalcinosis and pseudogout?

A

CPPD

46
Q

What does CPPD tend to affect?

A

knee, wrist and ankle

47
Q

What are the treatments for pseudogout?

A

NSAIDs, steroids, occassionly colchicine

MSK Pathology (17 decks)

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