Flashcards in 7. Inflammatory Arthritis Deck (101)
What is synovial chondromatosis aka osteochondromatosis, synoviochondrometaplasia?
Metaplastic changes in synovium produce cartilaginous bodies.
1 - These cartilaginous bodies may (or may not) calcify or ossify.
2 - they may (or may not) be free within joint capsule
What is seen on radiograph with synovial chondromatosis?
Multiple round / oval and well-defined osseous or cartilaginous densities within joint capsule
It will not be visualized on plain film if it isn’t calcified or ossified
Who gets synovial chondromatosis?
Where is the MC location for synovial chondromatosis?
Elbow, hip 20%
It can form at any site with synovium
What are symptoms of synovial chondromatosis?
Chronic, slow, progressive
If there is just one osteochondritis body plus a defect in the host bone, what is DDX instead of synovial chondromatosis?
What is the prognosis for synovial chondromatosis?
Risk of 2˚ DJD
Malignant transformation reported, but extremely rare
Tax for synovial chondromatosis?
Though recurrence is not uncommon
What are the 3 inflammatory arthropathies?
Juvenile Idiopathic Arthritis
What is the MC inflammatory arthritis?
Rheumatoid Arthritis (RA)
What is RA?
Multisystem AI that targets synovial tissues and joints. Progressive, bilateral symmetry.
Locations of RA?
Wrist and hands
Shoulder, hip, knee
What is the pathologic process of RA?
Antigen-antibody complex deposited in synovium with resulting inflammatory cascade
A synovial proliferation = pan USA
What does pannus do and what is it associated with?
Erodes bone and articular cartilage
How do you diagnose RA?
What do you expect to see for RA lab test?
RF (+)ve in 70% (2-3% are (+)ve w/o RA)
Anti-CCP in addition to RF increases sen + spec
In acute cases:
- increased ESR
- increased CRP
Anemia (normocytic normochromic)
Synovial fluid eval + biopsy
Know the ACR - EULAR classification criteria?
[see notepacket slide 17)
Age of onset of RA?
Sex of RA?
F:M 3:1 until age 60
1:1 after 60 yo
What joints are MC for RA to start?
Larger joints and spine later
What systemic sx show up in RA?
PE for RA?
Morning stiffness >1 hour
Pain with motion or tenderness
Soft tissue swelling or joint effusion but NO REDNESS
Bilateral symmetrical joint swelling (except DIP)
Where are boutonnière deformities located?
Where are swan neck deformities located?
Where are hitchhiker thumb deformities located?
In RA, what is the earliest change and where is it located?
What are other changes in the same area?
Tendinopathy around the wrist
Ulnar and radial styloid erosion
What sign is visible in RA wrist?
“Spotty carpal” sign
Cervical spine involvement happens in ___% of RA patients
Foot is the initial site of involvement in ___% of RA patients