Arthritis, Rheumatology Flashcards Preview

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Flashcards in Arthritis, Rheumatology Deck (44):
1

Name 5 main types of arthritis

- osteoarthritis
- rheumatoid arthritis
- ankylosing spondylitis
- gout
- septic arthritis (infection)

2

What does arthritis mean?

inflam of bone

3

What is rheumatology?

study of locatmotive system
- joints, muscles, ligaments

4

Name 3 main subtypes of rheumatic disease and list diseases within these subtypes

1. Degenerative
- osteoarthritis
- cervical spondylitis

2. Inflammatory
- rheumatoid arthritis
- crystal arthropathies - gout / pseudo-gout
- septic arthritis
- connective tissue disease
- Seronegative SpA (spondyloarthritis) - eg - ankylosing spondylitis

3. Soft tissue
- tennis elbow
- golfer's elbow
- mechanical back pain
- repetitive strain

4. Other
- fibromyalgia
- osteoporosis

5

What are risk factors for osteoarthritis?

age
trauma
osteoporosis
obesity

6

What is fibromyalgia?

rheumatic condition characterized by muscular or musculoskeletal pain with stiffness and localized tenderness at specific points on the body

7

Name 4 Seronegative Spondylarthropathies

1. ankylosing spondylitis
2. reactive arthritis
3. psoriatic arthritis
4. enteropathic arthritis

Common for young men to get them
Lots of joints can be affected
Rheumatoid factor not present (therefore seronegative)
Where ligaments enter joints = issue (not synovial fluid)

8

What is reactive arthritis?

inflam caused by an infection - eg UTI, sore throat
can occur anywhere
No treatment
Usually self limiting

9

What is psoriatic arthritis?

inflam of any joint
associated with psoriosis (scaly skin)

10

What is enteropathic arthritis?

inflam of joints
linked to Crohn's or ulcerative colitis

11

What gender / age often get Seronegative Spondylarthropathies?

young men

12

Why are they called Seronegative Spondylarthropathies?

Rheumatoid factor not present (therefore seronegative)

13

What part of joint is affected by Seronegative Spondylarthropathies?

Where ligaments enter joints = issue (not synovial fluid)

14

Name 6 connective tissue disorders

1. SLE - lupus
2. Sjogren's syndrome
3. Scleroderma
4. polymyositis
5. dermatomyositis
6. Vascularitis
- giant cell arteritis
- PMR - polymyalgia rheumatica
- Takayasu's arteritis
- polyarteritis nodosa
- Wedener's granulomatisis
- Behcet's syndrome

15

What is main area affected by giant cell arteritis?

temples are sore because carotid a. inflam

16

What is scleroderma?

all organs become fibrous
therefore tighter
eg harder to open mouth

17

What is polymyositis and dermatomyositis?

attack on striated muscle, esp thighs
Dermatomyositis = panda eyes

18

What is polymyalgia rheumatica?

Vasculitis
inflam of medium to large arteries

19

What is Takayasu's arteritis?

Vasculitis
inflam of aorta

20

What is affected in Wegener's granulomatisis?

Vasculitis
inflam of small arteries
kidney issues

21

What are symptoms of Behcet's syndrome?

Vasculitis
- miscarriages
- oral ulcers
- genital ulcers

22

Name components of a normal joint

bone
cartilage
capsule (ligament)
synovium
synovial fluid
enthesis

23

How think is cartilage in a healthy joint?

1-3mm

24

What does the synovium do?

produces synovial fluid
passes on nutrients from blood to cartilage

25

Is blood and / or nerves present in cartilage?

Neither

26

What is the enthesis?

Where ligaments/tendons joins bone
part of joint

27

What are causes of 5 main types of arthritis?

1. osteoarthritis - cartilage death
2. rheumatoid arthritis - inflam of synovium
3. ankylosing spondylosis - inflam of enthesis, new bone formation (syndesmophytes)
4. septic arthritis - infection
5. gout - crystal formation (sodium urate = gout, calcium pyrophospate = pseudogout)

28

What is osteoarthritis?

asymmetrical loading of joint
reduced cartilage - in patches
subchondral bone thickens / sclerosis- to protect itself
capsule thickens
maybe increase in synovial fluid
osteophytes form

29

Why does subchondral bone thicken / sclerose in osteoarthritis?

to protect itself and cartilage dies

30

What happens to joint space in osteoarthritis?

It narrows
NB may have increase in synovial fluid

31

What are two bony reactions of osteoarthritis?

- osteophytes form
- subchondral thickening

32

What happens to capsule in osteoarthritis?

It thickens, becomes fibrotic

33

What happens to synovium in osteoarthritis?

may become inflam
may produce more synovial fluid

34

If patient stays they have arthritis, what is best question to ask to determine type?

Do you see a rheumatologist?
If no = osteoarthritis
If yes = rheumatoid arthritis

35

What are swellings on finger joints called in osteoarthritis?

main knuckle = Bouchard's node
top knuckle = Heberden's node

36

What do swellings on finger joints feel like in osteoarthritis?

Feel hard and painless

37

What can be seen in xrays with osteoarthritis?

joint space narrowing
subchondral bone thickening / sclerosis
osteophytes

38

Who is more prone to osteoarthritis?

women
>50yrs

39

What is rheumatoid arthritis?

Inflam and overgrowth of synovium
- mixture of acute and chronic changes (synovitis)
synovial cells enlarge and 'eat' bone = bone erosions

40

What are systemic symptoms of rheumatoid arthritis?

fever, malaise, low BMI, reduced weight
increased risk ischemic heart disease

41

What are local symptoms of rheumatoid arthritis?

Pain
stiffness

42

How will the joints feel if acute or chronic rheumatoid arthritis?

acute = squishy joints
chronic = joints look deformed

43

What happens to cartilage in rheumatoid arthritis?

generalised loss
NB osteoarthritis = patchy loss of cartilage

44

Where is more most likely to thin in rheumatoid arthritis? What is this called?

juxta-articular osteoporosis