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MSK > Joint Disorders > Flashcards

Joint Disorders Flashcards

1
Q

A process of rapid cartilage degeneration resulting in narrowing of the joint space and loss of motion

A

Chondrolysis

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2
Q

Chondrolysis degeneration is associated with ______, ______, ______.

A
  • infection
  • trauma (orthopedic procedures like arthroscopic meniscectomy, shoulder arthroscopy, ACL reconstruction)
  • prolonged immobilization
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3
Q

What is a common hip occurrence associated with Chondrolysis? What population is more commonly affected?

A

SCFE (slipped capital femoral epiphysis)

females in adolescence (onset of menses)

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4
Q

What demonstrates as progressive joint stiffness with progressive loss of motion and pain?

A

Chondrolysis

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5
Q

Chondrolysis has a ______ etiology and an unclear pathogenesis

A

unknown

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6
Q

in chondrolysis, what is one cause for apparent leg-length discrepancy?

A

soft tissue contracture

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7
Q

treatment for chondrolysis includes what 3 things?

A
  1. NSAIDs (inflammation)
  2. Protected Weight Bearing and maintenance of joint motion
  3. surgery
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8
Q

____ is a degenerative joint disease, slow evolving, originates in the cartilage, and affects the bone, soft tissues, and synovial fluid

A

OA

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9
Q

cause of primary OA?
secondary?

A

unknown

trauma, infection, hemarthrosis, osteonecrosis

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10
Q

whats the most common joint disease? percent of men? women?

A

OA

60% M and 70% FE after age 65

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11
Q

T or F: the development of OA is a risk factor for also developing cardiovascular disease

A

true

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12
Q

T or F: numerous genotypes have been ID and determined the progression of OA

A

F phenotypes

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13
Q

T or F: tearing ligaments or menisci, or femoroacetabular impingement is a risk factor for OA

A

T

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14
Q

participating in sports, having _____ joint syndrome, or being in occupations of high joint stress are all risk factors of OA along with certain phenotypes and muscle weakness.

A

hypermobility

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15
Q

inflammatory and procatabolic mediators affect the chondrocytes in the _____ _____ creating hypertrophic differentiation and _________________.

A

articular cartilage

early cell death.

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16
Q

in OA the patient may experience a loss of _______, synovial _____, focal _______ of the cartilage, ______ overgrowth.

A

hyaline cartilage
inflammation
calcifications
bony

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17
Q

in OA _____ and ______ appear in the cartilage with is a thinning of the articular cartilage and exposure of the subchondral bone.

A

fissuring and eburnation

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18
Q

onset occurs _______ in OA and are _____ with activity and _____ after rest

A

suddenly
worse
better

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19
Q

in OA joints may be….

A

warm and tender

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20
Q

heberden nodes are what

A

osteophyte formation at the DIP

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21
Q

bouchard nodes are what

A

osteophytes affecting the PIP

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22
Q

in OA joint space _____ early on and _____ at the end stages

A

widening
narrowing

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23
Q

what grade OA?
possible osteophytes; possible narrowing of joint space

A

1

24
Q

what grade OA?
definite osteophytes; possible narrowing of joint space

A

2

25
Q

what grade OA?
moderate multiple osteophytes; definite joint space narrowing; some sclerosis and possible deformity of bone ends

A

3

26
Q

what grade OA?
large osteophytes; marked joint space narrowing; sever sclerosis and definite deformity of bone ends

A

4

27
Q

conservative treatment of OA includes

A

education
behavioral interventions
diet
weight loss
low-impact exercise
orthotics
meds
complementary, alternative, and integrative therapy approaches

28
Q

manual therapy and supervise exercise techniques for OA

A

ROM
eccentric contraction
closed chain kinetic strengthening

29
Q

these are systemic disorders that can affect all body systems

A

Rheumatic Diseases

30
Q

Rheumatic Diseases are often marked by periods of _______ and _______

A

exacerbation and remission

31
Q

RA is a chronic systemic inflammatory disease that manifests with a wide range of ________ and _________ findings

A

articular and extraarticular

32
Q

what two diseases are associated with RA

A

Graves and Hashimoto thyroiditis

33
Q

pathogenesis of RA is unknown, but there are an infiltration of _____ cells into the synovial fluid

A

immune cells (T lymphocytes)

34
Q

approximately 80% of people with RA test positive for

A

rheumatoid factors

35
Q

___________ are autoantibodies that react with immunoglobin antibodies in the blood.

A

Rheumatoid Factors

note, they are found in synovial fluid and synovial membranes also

36
Q

what is it called when the synovial lining thickens resulting in the clinical synovitis that is seen so often in RA

A

edematous

37
Q

a destructive granulation tissue seen in joints for patients with RA is called__________

A

pannus

38
Q

what is special about the pattern of RA in the joints that’s different from OA

A

it can also attack the joint from the side

39
Q

in RA elevated __________ inhibit bone growth and induce bone reabsorption via activating ______

A

cytokines
osteoclasts

40
Q

adhesions and fibrous fusion at the joint is called

A

ankylosis

41
Q

the most common joints affected by RA are

A

wrist
knee
fingers
hands
feet

42
Q

what is flexion at DIP and hyperextension at the PIP

A

Swan Neck Deformity

43
Q

hyperextension at the PIP is characteristic of

A

Boutonniere Deformity

44
Q

the longer the person has RA the greater the likelihood of the person having

A

cervical spine disease
(active irritation of C2 can also occur)

45
Q

in RA a person my have a Positive Lhermitte sign which means they…

A

have shock-like sensations of the torso or extremities with neck flexion

46
Q

T or F:urinary and fecal incontinence and paralysis can occur in RA

A

T

47
Q

T or F: Rheumatoid nodules are only present in the joints

A

F, they are also in lungs and heart and other organs

48
Q

Stocking-Glove Peripheral Neuropathy is …

A

caused by small vessel vasculitis

49
Q

mononeuritis multiplex is caused by

A

rheumatoid vasculitis involving medium sized arteries

note, one sign of R vasculitis secondary to RA are small brown infarcts found between the palms and fingers

50
Q

lab values that indicate RA

A

WBC in synovial fluid
decrease in fluid volume and viscosity
C-reactive protein (an acute phase reactant)

51
Q

onset for RA vs OA

A

RA- 25 and 50; sudden or several weeks to months with intermittent exacerbation
OA - 40; gradual over years

52
Q

incidence of OA vs RA

A

OA- 12% of US adults over 65
RA- 1% of UA adults

53
Q

gender for RA vs OA

A

RA- women 3x more but more disabling in men
OA- more common in men prior 45 and women after 45

54
Q

etiology of RA vs OA

A

OA- unknown
RA - multifactorial

55
Q

manifestation of RA vs OA

A

RA- symmetric, any joint, inflammation, prolonged >1 hr stiffness
OA- one side, LE and hands, inflammation is 10% of cases, morning stiffness decreased with PA

56
Q

lab values for OA

A

effusions and low WBC
ESR increased
uCTX-II and sCOMP

MSK (19 decks)

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