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Flashcards in 6. Degenerative Arthritis Deck (41)
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1

What are the three types of arthritis?

Degenerative
Inflammatory
Metabolic

2

What are the 4 kinds of degenerative arthritis?

1- Degenerative joint disease (DJD)
2- Diffuse idiopathic skeletal hyperostosis (DISH)
3- Synoviochondrometaplasia
4- Neuropathic arthropathy

3

What are the 5 kinds of inflammatory arthritis?

1- rheumatoid arthritis
2- ankylosis spondylitis
3- psoriatic arthritis
4- reactive arthritis (Reuter)
5- enteropathic arthropathy

4

What are the 3 kinds of metabolic /crystal arthritis?

1- gout
2- CPPD
3- HADD

5

What is the Hx for inflammatory arthritis vs. non-inflammatory arthritis?

inflammatory arthritis
• Morning stiffness >1 hour
• Low-grade temp
• Fatigue
• Rash

Non-inflammatory
• morning stiffness <1 hour

6

What is the PE for inflammatory arthritis vs. non-inflammatory arthritis?

inflammatory arthritis
• rubor - erythema
• color - warmth
• tumor- swelling
• dolor - tenderness
• loss of function

Non-inflammatory
• bony proliferation in osteoarthritis

7

What is the labs for inflammatory arthritis vs. non-inflammatory arthritis?

Inflammatory arthritis
• (+)ve ESR, CRP
• anemia of chronic disease
• (+)ve rheumatoid or anti-CCP antibodies

Non-inflamm
• WNL

8

What is the radiographs for inflammatory arthritis vs. non-inflammatory arthritis?

Inflamm
• erosions
• periostitis
• joint-space narrowing

Non-inflamm
• joint-space narrowing
• osteophytes
• subchondral sclerosis

9

What is the synovial fluid for inflammatory arthritis (infectious, non infectious) vs. non-inflammatory arthritis?

NON-INFECTIOUS inflam
• leukocyte count >2k
(Mostly neutrophils)

INFECTIOUS inflamm
• leukocyte count >50K

Non-inflamm
• leukocyte count <2k
(Less than 50% are neutrophils)

10

What is the MC joint disease?

Degenerative Joint Disease (AKA osteoarthritis)

11

Describe the pathology that is DJD?

Focal cartilage degen that gradually involves larger areas
Synovial hypertrophy
Growth of subchondral bone
Microfractures of subchondral bone
Deformity of articular surface

12

What is the clinical presentation of DJD?

Insidious onset with intermittent exacerbation
Achin P
Stiffness that decreases w/30 min activity
Swelling
Crepitus
Decreased ROM
Palpable excrescences
Adjacencies mm atrophy

NO lab changes

13

What are the possible locations for DJD?

Small joints of hands, feet
What bearing joints
A-C joint

ANY JOINT

14

What are 4 main radiographic features of DJD?

[insert slide 17 photo]

Non-uniform joint space loss
Osteophytes
Subchondral sclerosis
Subchondral cysts

15

Spinal DJD is MC in what part of the spine?

Lower Cx and Lx

16

Sharpening of the uncinates (uncovertebral joints) and then hypertrophic changes are usually associated with what disease?

IVD DJD

17

What are the causes of neurologic compromises 2˚ to DJD in the spine (causes of spinal stenosis)?

Osteophytes
Ligament hypertrophy
Listhesis
Disc herniation

18

What is “kissing spine” syndrome?

Baastrup syndrome

19

Describe Baastrup syndrome

Signs of DJD at opposing SP surfaces
- remodeling of cortical surface
- osteophytes
- sclerosis

Associated with extremes lordosis

20

What part of the SI joint is most affected in SI joint DJD

Mid and lower thirds

21

What is the “tooth” sign related to?

The "tooth" sign represents the relief of severe osteophyte formation in the bundle of the quadriceps tendon at its insertion into the patella.

22

Treatment (4) for DJD?

Maintain/restore mobility
Nutritional support
NSAIDS
Surgery maybe eventually to replace the joint

23

What is erosive osteoarthritis?

It has features of DJD + inflammatory arthritis

Acute, inflammatory onset and episodes

24

Describe the DIP and PIP involvement of erosive osteoarthritis

Bilateral, symmetric DIP and PIP

25

Who gets erosive OA?

Females
30-50 yo

And 15% of these people will develope RA

26

What is “gull wing” sign associated with?

Severe DJD plus erosions

27

What does DISH stand for? And what is DISH?

Diffuse Idiopathic Skeletal Hyperostosis

Spinal, esp ALL, and extra spinal ligamentous and tendinous calcification and ossification. NOTE: NORMAL DISC SPACES

ALL = anterior longitudinal ligament

28

Where is DISH most commonly located? (3)

Thoracic spine
Lower cervical
Upper lumbar

29

What is visualized extraspinal in DISH?

Enthesopathy / whiskering in the pelvis, patella, calcaneus, elbow

30

On radiograph, what is seen with DISH?

[insert photo]

Thick, flowing hyperostosis anterior to spine for about 4 contiguous levels.