Flashcards in Investigating joint disease Deck (39)
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1
What are the 2 types of joint synoviocyte?
- A (like macrophage)
- B (like epithelial cell)
2
What are the 2 filters for joint fluid?
- vascular endothelium
- synovial interstitium
3
Joint fluid - contents
- proteins
- electrolytes
- enzymes
- water
- HA
- cells: synovial lining cells
4
What is the first main catergory of canine arthritis?
- Non- inflammatory (3000 WBC, PMNs e.g. neutrophils)
5
Categories of non-inflammatory arthritis?
- traumatic
- DJD
- hemarthrosis
6
Categories of inflammatory arthritis.
- infectious
- non-infectious
7
What are the categories of inflammatory, non-infectious canine arthrtiis?
- immune-based
- non-immune based (rare)
8
Name 2 types fo non-immune based arthritis
- crystal
- neoplastic
- both rare
9
Name 2 categories of immune-based arthritis
- erosive
- non-erosive
10
Examples - inflammatory, non-infectious, immune-based, erosive arthritis
* rheumatoid arthritis (RA)
- polyarthritis (PA) of greyhound
- feline progressive PA
11
Examples - inflammatory, non-infectious, immune-based, NON-erosive arthritis
* SLE
* Idiopathic PA
- PA/PM syndrome
- PA meningitis syndrome
- PA akitas
12
Age presentation of arthritis
- puppies (unstable)
- senior (OA)
13
What breed predispositions are there?
- GSD
- lab
- greyhound
- GAS: hip dysplasia
- Lab: elbow dysplasia (also cruciate dz)
- Greyhounds: erosive
14
Aspects of hx to include in workup
- # limbs affected
- relation to exercise/ intermiited
- exercise tolerance
- travel hx
- parasites
- systemic dz (IMHA, ITP etc)
15
Define ITP
Idiopathic thrombocytopenic purpura
16
Aspects of lameness to consider
- # limbs
- severity
- specific postures /mvts
17
Systemic signs of arthritis
- variable
- fever
- lethargy, aanorexia
- collapse
18
How can endocarditis lead to polyarthritis (PA)?
can lead to immune-mediated polyarthritis
19
How can tumours cause arthritis?
can lead to immune-mediated polyarthritis
20
What to look for on PE with suspect arthritis?
- fever
- heart murmur
- masses
21
Aspects of orthopaedic exam for suspect arthritis
- joint effusion, buttress, mm atrophy
- pain/ heat/ decreased ROM
- Instability (CCLR, CHD = Canine Hip Dysplasia), crepitus
22
What should you determine on neuro exam of suspect arthritis?
whether there are deficits or not
23
What areas to look for on radiograph when looking for arthritis
- joint capsule
- joint space
- bony relationships
- bone density
- subchondral bone
- calcification
- osteophytes and enthesiophytes
24
Where to perform arthrocentesis
- affected joint (single arthropathy)
- at least 3 joints (suspected polyarthropathy)
25
Method - arthrocentesis
- sedation/ GA
- landmarks
- sterile (gloves, clip and scrub)
- small syringe and needle
- slides, EDTA tube, blood culture media
26
Most common joints to tap for arthrocentesis - 3
- carpus
- tarsus
- stifle
- (elbow and hips possible but more difficult)
27
Aspects of joint fluid analysis
- cell count
- cytology
- chemical analysis (TP, glu)
- culture (if suspect septic)
28
What does joint fluid analysis allow you to differentiate?
Non-inflammatory (DJD) vs. inflammatory (infectious vs/ non-infectious)
29
What do different cells on cytology suggest?
- synoviocytes - normal
- neutrophils - inflammatory (degenerate vs. non-degenerate)
- macrophages = non-inflammatory
- bacteria/fungi = septic
30
