Arthritis

Question 1

What are the 2 main joint examinations?

Answer 1

• GALS

- REMS

Question 2

What does GALS stand for?

Answer 2

Gait, Arms, Legs and Spine.

Question 3

What does REMS stand for?

Answer 3

Regional Examination of the Musculoskeletal System.

Question 4

Which joint examination is more thorough?

Answer 4

REMS.

Question 5

What is rheumatoid arthritis?

Answer 5

Chronic inflammation of joints.

Question 6

What proportion of the population are affected by rheumatoid arthritis?

Answer 6

1%.

Question 7

What deformities does rheumatoid arthritis lead to? (2)

Answer 7

• Joint deformity (swan neck)

- Rheumatoid nodules (over bony prominences)

Question 8

Why are rheumatoid nodules very rare now?

Answer 8

Due to improved treatments.

Question 9

What is the pattern of rheumatoid arthritis deformities?

Answer 9

Occurs symmetrically, mainly proximal phalangeal joints.

Question 10

What vascular problem can rheumatoid arthritis lead to?

Answer 10

Vasculitis.

-inflammation of the vascular system

Question 11

What joints are mainly affected by rheumatoid arthritis?

Answer 11

Fingers
Feet
Elbows

Question 12

What is osteoarthritis?

Answer 12

Degeneration of synovial joints and underlying bone&raquo_space; progressive destruction of hyaline cartilage.
-‘wear and tear’

Question 13

What makes osteoarthritis so painful?

Answer 13

Cartilage is destroyed&raquo_space; bones rub together.

Question 14

What joints are mainly affected by osteoarthritis?

Answer 14

Weight-bearing joints/digits.

-hip, knee, thumb

Question 15

What nodes form due to osteoarthritis? (2)

Answer 15

• Heberden’s nodes

- Bouchard’s nodes

Question 16

What position did osteoarthritis used to lead to?

Answer 16

‘Windswept’ position.

Question 17

What is primary osteoarthritis?

Answer 17

Osteoarthritis without a known cause.

Question 18

What proportion of 75-79 year olds are affected by osteoarthritis?

Answer 18

85%.

Question 19

Which gender is osteoarthritis more common in in

Answer 19

More common in males.

Question 20

What is the familial pattern found in some cases of osteoarthritis?

Answer 20

Mutation of type II collagen.

Question 21

What is secondary osteoarthritis?

Answer 21

Osteoarthritis that is caused by another disease/condition.

-e.g. obesity, trauma, surgery

Question 22

What causes secondary arthritis?

Answer 22

Injury to the joint.

-e.g. bleeding, stress, inflammation

Question 23

What causes psoriatic arthritis?

Answer 23

PSORIASIS; skin condition&raquo_space; red patches on skin with silvery flakes.

Question 24

Which areas of the body does psoriasis commonly affect?

Answer 24

Elbows, knees, bottom.

Question 25

Which joints does psoriatic arthritis normally affect?

Answer 25

Any joint in the hand.

Question 26

What deformity does psoriatic arthritis lead to?

Answer 26

Dactylitis. - 'sausage digit' - inflammation of the digit - shortened digits

Question 27

What is gout?

Answer 27

Defective metabolism of uric acid >> arthritis and chalk-stone deposits.

Question 28

What joints are most commonly affected by gout?

Answer 28

Smaller joints in the feet.

Question 29

What are the 2 main types of gout?

Answer 29

- Acute podagra | - Chronic tophaceous gout

Question 30

What is acute podagra?

Answer 30

Very painful arthritis due to gout. | -usually affects 1-2 joints

Question 31

What is chronic tophaceous gout?

Answer 31

Nodular tophi (uric acid crystals) are deposited in soft tissue areas.

Question 32

What is another name for Still's disease?

Answer 32

Juvenile chronic arthritis.

Question 33

What are the main effects/symptoms of Still's disease? (3)

Answer 33

- Joint inflammation - Rash (lasting ~1/2 an hour) - Splenomegaly

Question 34

What condition is 'prayer sign' present in?

Answer 34

Diabetes mellitus. | -cannot straighten fingers when hands are together

Question 35

What is rheumatology?

Answer 35

The study of arthritis and other disorders of joint/muscles/ligaments.

Question 36

List some other rheumatological conditions.

Answer 36

- Hypercholesterolaemia - Ankylosing spondylitis - Ricketts - Scurvy - Dermatomyositis - Marfans - Pseudo-gout - Milwaukee shoulder - Acromegaly - Vasculitis

Question 37

What problem does hypercholesterolaemia lead to in the heels?

Answer 37

Xanthelasma on the heel (yellow plaques). | -cannot straighten heel properly

Question 38

What is ankylosing spondylitis?

Answer 38

Arthritis of the spine. | -joints fuse if untreated >> stiffened spine

Question 39

What used to be the treatment for ankylosing spondylitis?

Answer 39

Radiotherapy. | -but lead to leukaemia and skin cancer

Question 40

What is Ricketts?

Answer 40

Vitamin D deficiency. | -leads to swelling on chest wall, decreased growth and knees bow out (>> osteoarthritis)

Question 41

What is the main source of vitamin D?

Answer 41

Sunlight.

Question 42

What is scurvy?

Answer 42

Vitamin C deficiency. | >> spontaneous bleeding from skin and joints

Question 43

What are the main signs of dermatomyositis? (2)

Answer 43

- Heliotropic rash around eyes/knuckles | - Muscle inflammation

Question 44

How is dermatomyositis treated?

Answer 44

Steroids and immunosuppressants.

Question 45

What is Marfans?

Answer 45

Defect in fibrinogen (collagen component) .>> longer, hypermobile limbs, eye lens dislocation, aortic aneurysm. -affects all collagen

Question 46

What is pseudo gout?

Answer 46

Inflammation of joints due to deposits of calcium pyrophosphate crystals. -not uric acid

Question 47

What crystals are deposited to cause Milwaukee shoulder?

Answer 47

Calcium hydroxyaptite crystals.

Question 48

What is acromegaly?

Answer 48

Increased growth hormone >> increased growth of body tissue and larger hands/feet. -leads to 2* osteoarthritis

Question 49

Name 3 types of vasculitis.

Answer 49

- Henoch-Schoenlein purpura - Erythema nodosum - Lupus pernio