CP 57 - Disease of MSK Part 1 Flashcards
(38 cards)
what is arthritides?
- Pain and stiffness of a joint
- Inflammation of the joint
- Not a single disease
- Hundreds of diseases- causing pain and stiffness of the musculoskeletal system `
what are the 2 common types of arthritides
acute arthritis - pain, heat, redness and swelling
chronic arthritis - commonest types - osteoarthritis & rheumatoid arthritis
what is the actual name for degenerative joint arthritis?
osteoarthritis - progressive erosion of articular cartilage, results in the formation of bony spurs and cyst at the margins of joints
what is the pathogenesis of osteoarthritis?
- Deterioration or loss of cartilage that acts as a protective cushion in between bones
- as the cartilage is worn away - bone forms spurs
- fluid filled cysts in the marrow - subchondral cysts
- results in pain and limitation of movements
what is chondrocyte?
a cell which has secreted the matrix of cartilage and become embedded in it.
what is the basis of OA?
chondocytes - cellular basis
what does chondrocytes produce?
interleukin 1 - initiates matrix breakdown
which other hormone is released to complete the breakdown of the matrix?
prostaglandin - induces the releases of lytic enzymes - prevent matrix synthesis
what are some of the clinical features for primary OA?
Herberden’s (distal interphalanges joint) /Bouchard’s (proximal interphalanges joint) Nodes
what is rheumatoid arthritis
Producing a non suppurative proliferative synovitis- destruction of articular cartilage and ankylosis of joints
what is a pannus?
mixture of inflammatory stuff and production of Polypoid fibrovascular thickening of the synovium with synoviocyte hyperplasia
what does pannus do?
it invades the cartilage
penetrate into the subchondral bone and cyst formation
filling of joint space with pannus producing ankylosis of joint space
what are some clinical features for RA?
Malaise, fatigue and generalised musculoskeletal pain to start of.
involved joints are swollen, warm, painful and stiff in the more or after activity
what is the pathogenesis of RA?
genetic 65-80% - autoimmune reaction within the synovial membranes - CD4 +ve T cells
what are the diagnostic criteria for RA?
Morning stiffness Arthritis in 3 or more joint areas Arthritis of hand joints Symmetric arthritis Rheumatoid nodules – later stages Serum Rheumatoid factor
radiological changes - narrowing of the joint space, loss of articular cartilage
4 of the above criteria
what are the 2 tests which one can use to diagnose RA?
Rheumatoid factors - present in most
analysis of synovial fluid - confirms presence of neutrophils (inflammatory pictures)
what are other systems within the body which are affected by RA?
skin-rheumatoid nodules - commonest cutaneoues manifestation
lungs, spleen, heart etc
what is sero-ve arthritides?
conditions which have similar features to RA but lack of rheumatoid factors
what are some examples of sero-ve arthritides?
ankylosing spondylitis
psoriatic arthritis etc
what is Gout?
End point of a group of disorders producing hyperuricemia
what does purine metabolism produce?
uric acid
what are some of the clinical features of Gout?
acute arthritis, chronic arthritis, tophi (deposition of uric acid in joints), gouty nephropathy
What is pyogenic osteomyelitis?
Systemic illness-fever, malaise, chills and marked pain over the affected region
what are some clinical features for pyogenic osteomyelitis?
X-ray lytic focus of bone destruction surrounded by zone of sclerosis
