Flashcards in Diseases of MSK 1 Deck (54):
1
The group of diseases causing pain, stiffness and inflammation of the MSK system
Arthritides
2
2 different types of arthritides
Acute and Chronic
3
2 different types of chronic arthritis
Osteoarthritis
Rheumatoid arthritis
4
Commoneste type of joint disease aka degenerative joint disease, Progressive erosion of articular cartilage.
Osteoarthritis
5
What forms at the margins of joints in osteoarthritis
Bony spurs and cysts
6
Underlying systemic diseases in OA
Diabetes
Obesity
7
Which joints are affected by OA in men and women?
Men-hip
Women- knees and hands
8
Pathogenesis of OA
Deterioration or loss of cartilage
Bone forms spurs and cysts
Results in pain and limitaiton of movements
9
Cells which form the cartilage around bone
Chondrocytes
10
How do chondrocytes contribute to OA
-Produce interleukin 1- initiates matrix breakdown. -Prostaglandin derivative induces the release of lytic enzymess- prevents matrix synthesis
11
Abnormal stresses in weight bearing joints
Primary OA
12
What joints are commonly affected in OA
Fingers, knees and cervical and lumbar spines
13
What forms in the fingers in primary OA
Herbeden's or Bouchard's nodes
14
Chronic systemic disorder-principally affecting the joints
Rheumatoid arthritis
15
Pathogenesis of RB
Production of a non suppurative proliferative synovitis-destruction of articular cartilage and ankylosis of joints
16
Who is more at risk of RA- emn or women?
Women
17
What happens to the synovium in RB
Polypoid fibrovascular thickening of the synovium, forms a pannus that invades into the articular cartilage- penetrates subchondral bone and cyst formation
18
Clinical features of RB
Malaise, fatigue and generalised MSK pain
Joints are swollen, warm, painful and stiff in the morning or after activity
Small joints of the hands and feet are frequently affected
19
Mutations in which genes predispose you to RA
HLA
DR4
DR1
20
Name 2 primary exogenous arthritogens
EBV
Borrelia
21
Describe the pathogenesis of RA
Autoimmune reaction within the synovial membranes- CD4 positive T cells.
Release of cytokines- IL1,6, TNF alpha and beta
22
Criteria for diagnosis
Morning stiffness
Arthritis in 3 or more joint areas
Arthritis of hand joints
Symmetric arthritis
Rheumatoid nodules
Serum Rheumatoid factor
Typical radiographic changes-narrowing of joint space, loss of articular cartilage
23
What 2 main things are required for the diagnosis of RB
Rheumatoid factor- present in most
Analysis of synovial fluid- presence of neutrophils
24
RA- other systems involvement
Skin- rheumatoid nodules
Lung, spleen, heart and other viscera
25
What do you call arthitis which lacks rheumatoid factor
Sero-negative arthritides
26
4 sero negative arthritides
Ankylosing spondylitis
Reiter's syndrome
Psoriatic arthritis
Enteropathic arthritis
27
End point of a group of disorders producing hyperuricaemia- uric acid is the end product of purine metabolism
Gout
28
4 clinical features of gout
Acute arthritis
Chronic arthritis
Tophi in various sites
Gouty nephropathy
29
Pathogenesis of gout
Transient attacks of acute arthritis- crystallization of urates within and about joints, leading to chronic gouty arthritis and deposition of masses of urates in joints and other sites - tophi
30
deposition of masses of urates in joints and other sites
Tophi
31
Sytemic illness and marked pain over the affected region is typical of what condition?
Pyogenic (bacterial) osteomyelitis
32
What shows up on the X-ray for pyogenic osteomyelitis
Lytic focus of bone destruction surrounded by zone of sclerosis
33
3 mechanisms of cause of pyogenic osteomyelitis
Haematogenous
Contiguous
Direct implantation
34
Acutely painful and swollen joints with restricted movements, with fever, leucocytosis and elevated ESR
Infective arthritis
35
Common bacterial causes of infective arthritis
Staph, strep, gonococcus, mycobacteria
36
Predisposing conditions for infective arthritis
Trauma
IVDU
debilitating illness
37
What are the d2 types of osteoporosis
Primary or secondary
38
Primary osteoporosis risk factors
Age and postmenopausal
39
Increased porosity of the skeleton, reduction in bone mass, localised or entire skeleton
Osteoporosis
40
3 clinical features of osteoporosis
Vertebral fractures
Kyphosis
Scoliosis
41
3 causes of secondary osteoporosis
Endocrine disorders
neoplasm e.g. multiple myeloma
Malnutrition
42
2 examples of ednocrine disorders that predispose you to secondary osteoporosis
Hyperparathyroidism, Type 1 diabetes
43
Paget's disease
Osteoclast dysfunction- matrix madness. Histological hallmark-mosaic pattern
44
Cause of paget's disease
Paramyxovirus
45
Pathogeneisis of osteoclast dysfunction e.g. paget's disease
Pred. osteoblastic activity- gain in bone mass. Newly formed bone is disordered and architecturally unsound
46
Who is most at risk of Paget's disease
5th decade, males
47
What bones are most commonly affected by paget's disease
Axial skeleton and proximal skeleton
48
Most common symptom of pagets
Pain
49
What type of fractures do you get in Paget's disease?
Chalk stick type fractures
50
3 causes of paget's disease
Giant cell tumour- benign
Malignant-osteosarcoma, chondrosarcoma, malignant fibrous histiocytoma
51
Defects in matrix mineralisation, related to lack of vit. D.
Ostomalacia
52
Decreased bone density
Osteopenia
53
Are skeletal deformities seen in osteomalacia?
No
54