Flashcards in Arthritis Deck (61)
A chronic joint disorder characterised by degeneration of joint cartilage and adjacent bone that can cause joint pain and stiffness
The most common form of arthritis is ...
Prevalence of osteoarthritis ... with age
Which joints does osteoarthritis commonly affect?
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
Clinical features of osteoarthritis
Fusiform swelling of joints (Bouchard's nodes)
Rheumatoid arthritis is an ... disease affecting the ... ...
Rheumatoid arthritis affects ... of the population
RhA is ... times more common in ...
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
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)
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)
RhA usually affects joints ...
Joints commonly affected in RhA
Major aetiology of RhA
60% genetic plus environmental involvement
Non-genetic factors causing RhA
What does ankylosing spondylitis cause?
Acute spinal pain and stiffness without significant decrease in mobility
Why is osteoarthritis joint specific but RhA whole body?
RhA is an autoimmune disease so affects multiple organs
Why do ligaments become lax in later stage arthritis?
Chronic inflammation causes over-stretching
What is TNF-alpha?
An inflammatory cytokines produced my macrophages
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
Why is there increased prevalence of arthritis in older people?
Natural decline in glucosamine and chondroitin sulphate production (so less durable cartilage is produced)
Men have more ... OA
Women have more .../... OA
In general ... develop RhA more frequently than ...
What hormone is protective of OA?
Oestrogen - increased OA prevalence post menopause
Weakness of which muscle is a risk factor for OA?
Quadriceps (from inactivity)
Top ... for BM increases risk of hip and knee OA by ... times
Modest weight loss ... OA