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Flashcards in Arthritis Deck (61)
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1

Define arthritis

A chronic joint disorder characterised by degeneration of joint cartilage and adjacent bone that can cause joint pain and stiffness

2

The most common form of arthritis is ...

Osteoarthritis

3

Prevalence of osteoarthritis ... with age

Increases

4

Which joints does osteoarthritis commonly affect?

Knees
Hips
Hands

5

Describe process of osteoarthritis

1. Collagen/proteoglycan producing cells become abnormal
2. An increase in cartilage growth initially and bone density (osteosclerosis) reducing joint space
3. Cartilage thins and cracks, roughening causes pain during movement
4. Bone erosion with bone on bone movement
5. Compensation occurs with development of bone spurs leading to deformation and pain
6. Inflammation thickens synovium
7. Increase in synovial fluid --> joint swells --> overstretching of muscles causes weakness

6

Clinical features of osteoarthritis

Bone hypertrophy
Bone spurring
Fusiform swelling of joints (Bouchard's nodes)
Heberdens nodes

7

Rheumatoid arthritis is an ... disease affecting the ... ...

Autoimmune
Whole body

8

Rheumatoid arthritis affects ... of the population

1%

9

RhA is ... times more common in ...

3
Women

10

Process of RhA

1. T-cells in synovial fluid become unable to distinguish between foreign and normal body cells
2. Excessive production of immunoglobulins and inflammatory cytokines (TnF alpha)
3. Excessive Ig causes abnormal division and growth of synovial cells
4. Leukocytes migrate to joints, release enzymes causing synovitis --> increases swelling, stretching of ligaments, enzyme release attacks hyaline cartilage

11

4 stages of RhA

1. Synovitis (synovial membrane inflammation)
2. Pan us (extensive cartilage loss, exposed and pitted bones)
3. Fibrous ankylosis (invasion of joint with fibrous connective tissue)
4. Bony ankylosis (fusion of bones)

12

What may blood tests reveal in RhA? Why does this happen?

Presence of rheumatoid factor (RF) antibody (80% sensitivity)

RF is produced to try and lower levels of other antibodies

(However some people with RF don't have RhA and vice versa)

13

RhA usually affects joints ...

Symmetrically

14

Joints commonly affected in RhA

Wrists
Hands
Knees
Elbows
Shoulders
Ankles

15

Major aetiology of RhA

60% genetic plus environmental involvement

16

Non-genetic factors causing RhA

Age
Hormonal factors
Infection
Smoking
Obesity

17

What does ankylosing spondylitis cause?

Acute spinal pain and stiffness without significant decrease in mobility

18

Why is osteoarthritis joint specific but RhA whole body?

RhA is an autoimmune disease so affects multiple organs

19

Why do ligaments become lax in later stage arthritis?

Chronic inflammation causes over-stretching

20

What is TNF-alpha?

An inflammatory cytokines produced my macrophages

21

Name some extra-articular manifestations of RhA

TNF-alpha causes weakness, fatigue, loss of appetite, muscle pain, weight loss

Myocardial damage and pericarditis

Pleural fluid accumulation in lungs

In 1 out of 6 people can shorten life

22

Why is there increased prevalence of arthritis in older people?

Natural decline in glucosamine and chondroitin sulphate production (so less durable cartilage is produced)

23

Men have more ... OA

Hip

24

Women have more .../... OA

Hand/knee

25

In general ... develop RhA more frequently than ...

Women
Men

26

What hormone is protective of OA?

Oestrogen - increased OA prevalence post menopause

27

Weakness of which muscle is a risk factor for OA?

Quadriceps (from inactivity)

28

Top ... for BM increases risk of hip and knee OA by ... times

20%
7-10

29

Modest weight loss ... OA

Reduces

30

History of joint damage ... to OA

Predisposes