Joint Flashcards
Which type of collagen serves as an articular surface of adjoining bones?
Hyaline cartilage (type II collagen)
Which susbtance lubricates the synovium lining the joint capsule?
Hyaluronic acid
What is the most common type of arthritis and what causes it? What is a major risk factor?
Degenerative joint disease (osteoarthritis) which is a progressive degeneration of articular cartilage most often due to wear and tear. Age (common after 60), obesity and trauma
Which joints are affected by osteoarthritis?
Hips, lower lumbar spine, knees, distal interphalangeal joints (DIP), and proximal interphalangeal joints (PIP) of fingers
A 76 year old retired veternerian comes to your office complaining of joint stiffness that worsens during the day. What does he have?
Osteoarthritis
What are the three pathologic features of osteoarthritis
- Disruption of the cartilage that lines the articular surfaces and fragments of cartilage floating in the joint space called “joint mice”
- Eburnation of teh subchondral bone
- Osteophyte formation (reactive bony outgrowth) in DIP and PIP
What is Rheumatoid arthritis, who does it target and what is it associated with?
Chronic systemic autoimmune disease that arises in women of late child bearing age. Associated with HLA-DR4.
What structures are affected in Rheumatoid arthritis , what structure does it form and what kind of damage can it inflict?
Characterized by involvement of joints. Hallmark is synovitis leading to formation of a pannus (inflamed granulation tissue). Leads to destruction of cartilage and ankyloss (fusion) of the joint
What are the 6 clinical features of Rheumatoid Arthritis?
- Arthritis with morning stiffness that improves with activity
- Fever, malaise, weight loss and myalgias
- Rheumatoid nodules
- Vasculitis
- Baker cyst
- Pleural effusions, lymphadenopathy, and interstitial lung fibrosis
Which joints are invovled in rheumatoid arthritis and what is seen on xray? Is it unilateral or bilateral?
Symmetric inovlement of PIP joints (swan neck deformtity), wrists (radial deviation), elbows, knees, ankles.
Xray shows joint space narrowing, loss of cartilage and osteopenia
What are the laboratory findings in rheumatoid arthritis? Which antibodies are involved? What is found in synovial fluid? What are some complications of RA?
IgM autoantibody against Fc porition of IgG (rheumatoid factor) which marks tissue damage and disease activity
Neutrophils and high protein in synovial fluid.
Complications include anemia of chronic disease and secondary amyloidosis
What are the three properties of seronegative spondyloarthropathies?
- Lack of rheumatoid factor
- Axial skeleton involvement
- HLA B-27 association
Which population does ankylosing spondyloarthritis involve? How does it present and what are some extra-articular manifestations?
Arises in young MALE adults. Presents with low back pain with eventual fusion of vertebral bodies (bamboo spine). Extra articular manifestations include uveitis and aortitis (leading to aortic regurgitation).
A 27 year old graduate student had a CHlamidya trachomatis infection. What other symptoms can accompany his presentation as a result of Reiter syndrome?
Triad of arthritis, urethritis and conjuctivitis
A patient comes to your rheumatology clinic with complaints of joint pain and a skin like presentation. Her toes looked like sausages. What does she have? Which joints are invovled?
She has psoriatic arthritis which is in 10% of psoriasis cases. Invovles axial and peripheral joints. DIP joints of the hands and feet are most commonly affected.
