Arthritis

Question 1

Aetiology of acute septic

Answer 1

Staph aureus mainly and less frequently strept

Question 2

Source of infection

Answer 2

Direct
Following penetrating injury
By blood

Question 3

Pathology of acute septic

Answer 3

Characteristized by pain tenderness redness swelling and warmth , marked restrictions of movements and purulent fluid exudate fills the joint space are present , destruction of articular cartilage may occur followed by joint ankylosis

Question 4

Def of rheumatoid arthritis

Answer 4

Chronic multisystem disease with stmetric inflammation of small joints, extra articular manifestations are common

Question 5

Aetiology of RA

Answer 5

it is a member of collagen diseases , the current theory that it occurs in imunogentically predisposed person due to microbial agent as a trigger antigen

Question 6

Incidence of RA

Answer 6

Peak incidence occurs in middle age with predominance of females

Question 7

Pathology of RA

Answer 7

Symmetric inflammation of small joints especially PIP ( swan neck deformity) wrist ( radial deviation) and elbow and knee is also characteristic

Question 8

Microscopic picture of RA

Answer 8

Articular lesions
1- prolefritive synovitis forming large villi of synovium
2- formation of pannus ( special type of granulation tissue ) what makes this disease aggressive
3- thickening of synovial membrane due to oedema congestion and multilayering of synoviocytes
4- infiltration of synovial membrane by chronic inflammatory cells especially lymphocytes and plasma cells and macrophages that lead to forming lymphoid follicle
5- foci of fibrinoid necrosis

Extra articular lesions : non specific inflammatory manifestations in blood vessels in pleura or lung but there is characteristic subcutaneous rheumatoid nodules in over pressure points as knee and sacrum

Question 9

Def of osteoarthritis

Answer 9

The most common chronic disease of synovial joint, it is characteristized by degeneration of articular cartilage over years

Question 10

Names of osteoarthritis

Answer 10

Osteoarthrosis
DJD ( degenerative joint disease)

Question 11

Common sites of osteoarthritis

Answer 11

Weight bearing joints and spine

Question 12

Types of osteoarthritis

Answer 12

Primary: in old people as a result of tear and wear of the joint
Secondary: in old or young people due to
1- chronic stress on joint as in obesity
2- abnormal joint mechanics : in cases of defective nerve supply to a joint as in ( charcot joint ) and in cases of spinal cord lesions ( tabes dorsalis of syphilis )
3- traumatic injury in articular cartilage due to fracture or repair of repeated minor trauma

Question 13

Pathology of osteoarthritis

Answer 13

1- degeneration and softening of the central part
2- the bones look like polished ivory
3- death of osteocytes and increased osteoclastic activity forming rarefactions and microcyst formation and micro fractures
4- proliferation of the peripheral part leading to forming of cartilaginous lipping
5- ossification of cartilaginous lipping forming boney projections ( osteophytes )
6- fracture of these osteophytes forming intra articular loose bodies
7- mild chronic inflammation in synovial membrane and osteocartilgineous metaplasia