Joints

Question 0

What are some immune-mediated joint conditions?

Answer 0

Rheumatoid arthritis and ankylosis spondylitis

Question 1

What are some degenerative joint disorders?

Answer 1

Osteoarthritis aka degenerative joint disease

Question 2

What is the most common joint disorder?

Answer 2

Osteoarthritis

Question 3

What is affected with osteoarthritis?

Answer 3

Degeneration of articular cartilage occurs (collagen)

Question 4

What substance is decreased in OA and what is the result of that reduction?

Answer 4

Decreased proteoglycans leading to matrix breakdown

Question 5

Is OA largely inflammatory?

Answer 5

Not necessarily (“itis”

Question 6

What causes OA?

Answer 6

Both mechanical wear and tear from aging along with a genetic influence

Question 7

Which type of OA occurs without trauma and is common among adults?

Answer 7

Primary

Question 8

Which type of OA is insidious in onset and is oligocarticular in nature?

Answer 8

Primary

Question 9

Which type of OA is associated with trauma or obesity, deformity, or a systemic disease?

Answer 9

Secondary

Question 10

Which type of OA involves a predisposing injury or deformity?

Answer 10

Secondary

Question 11

What are the common specific locations for OA?

Answer 11

Spine (cervical, lumbar), DIP joints, 1st metacarpal joint, 1st tarsal metatarsal joint

Question 12

What is the most common location for OA in females?

Answer 12

Knees and hands

Question 13

What is the most common location for OA in males?

Answer 13

Hips

Question 14

What occurs to the intervertebral discs and is seen on X-ray during OA?

Answer 14

Dehydration of discs

Question 15

When can inflammation in OA develop?

Answer 15

After full blown degeneration

Question 16

What are the functions of articular cartilage?

Answer 16

Decrease friction and shock allow load absorption

Question 17

OA disrupts the function of what cells?

Answer 17

Chondrocytes

Question 18

What are risks for OA?

Answer 18

Mechanical stress, age 50s-60s, genetics, increased bone density, increased circulating estrogen

Question 19

Insidious onset, deep/achy pain, crepitus, decreased range of motion, and worse pain the morning are all associated with what joint condition?

Answer 19

OA

Question 20

What affect can osteophytes in OA have on nerves?

Answer 20

Possible impingement of nerve roots

Question 21

What is the treatment for OA?

Answer 21

Palliative: ice, heat, NSAIDs, adjust, joint replacement

Question 22

What is ankylosis?

Answer 22

Abnormal fusion of joints

Question 23

Is ankylosis present in OA?

Answer 23

No no no no no no noooooo

Question 24

Is ankylosis present in rheumatoid arthritis?

Answer 24

Yes

Question 25

OA is more common among which gender?

Answer 25

Females

Question 26

What is the name for the enlargement of the DIP joints?

Answer 26

Heberden's nodes

Question 27

What is the name for the visual enlargement of the PIP joints?

Answer 27

Bouchard's nodes

Question 28

Which joint disease is a systemic, chronic autoimmune disease?

Answer 28

RA

Question 29

RA results in what effect on the joints?

Answer 29

Increased collagenase and osteoclast activity

Question 30

The biomarker, HLA-DRB1, is a risk factor for what joint issue?

Answer 30

RA

Question 31

What two things are commonly tested for when checking for RA?

Answer 31

Anti-CCP antibodies and rheumatoid factor (RF)

Question 32

In 70% of cases, RA patients test positive for what?

Answer 32

Anti-CCP antibodies

Question 33

What is another cause of testing positive for anti-CCP antibodies?

Answer 33

Inflammation due to smoking or infection

Question 34

80% of people, with RA will test positive for what test?

Answer 34

Rheumatoid factor

Question 35

What are the most common specific locations for RA?

Answer 35

MCP and PIP joints (Bouchard's nodes)

Question 36

What is the name for the visual swelling in the fingers seen with RA?

Answer 36

Fusiform swelling

Question 37

What is significant about the patients with RA and their C1/C2 region?

Answer 37

30% demonstrate atlanto-axial instability

Question 38

Pannus is associated with what joint condition?

Answer 38

RA

Question 39

Swan neck deformity and ulnar deviation are associated with what joint condition?

Answer 39

RA

Question 40

Which joint condition has relatively symmetric defects?

Answer 40

RA

Question 41

What is a condition that is similar to RA but shows up negative for RF and positive for HLA-B27 (seronegative)?

Answer 41

Seronegative spondyloarthropathies

Question 42

What is the unique location for the inflammation seen with seronegative spondyloarthropathies?

Answer 42

Sacroiliitis, spinal ligaments (syndesmophytes)

Question 43

What are the categories of seronegative arthropathies?

Answer 43

Psoriatic arthritis (psoriasis), enteropathic arthritis (IBD), ankylosing spondylitis, reactive arthritis

Question 44

What is the most common diagnosis when a negative test for RF is seen?

Answer 44

Juvenile rheumatoid arthritis

Question 45

What gender is more likely to develop juvenile rheumatoid arthritis?

Answer 45

Female

Question 46

What is the most common age for juvenile rheumatoid arthritis to be causing pain?

Answer 46

1-6

Question 47

What is Still's disease?

Answer 47

Spiking fever, rash, pericarditis

Question 48

In what location does inflammation typically occur with juvenile rheumatoid arthritis?

Answer 48

Large joints like the knee and hip leading to dysfunction

Question 49

What is the other name for ankylosing spondylitis (AS)?

Answer 49

Marie-Strumpell disease

Question 50

What part of the skeleton is affected by ankylosing spondylitis?

Answer 50

Axial skeleton

Question 51

Where do you see referred pain with ankylosing spondylitis?

Answer 51

Gluteal region

Question 52

What is the actual pain in ankylosing spondylitis?

Answer 52

Sacro iliac joint

Question 53

Bamboo spine is associated with what joint condition?

Answer 53

Ankylosing spondylitis

Question 54

What is the typical onset age for ankylosing spondylitis?

Answer 54

Before the age of 40

Question 55

Characteristic morning stiffness after thirty minutes of being awake is associated with what joint condition?

Answer 55

Ankylosing spondylitis

Question 56

Nocturnal low back pain that is unrelieved when lying down is associated with what joint condition?

Answer 56

Ankylosing spondylitis

Question 57

95% of ankylosing spondylitis cases test positive for what test?

Answer 57

HLA-B27

Question 58

Where is a secondary location for ankylosis in patients with ankylosing spondylitis?

Answer 58

Rib joints

Question 59

Syndesmophytes are indicative of what general joint condition?

Answer 59

Seronegative spondyloarthropathies

Question 60

Trolley track sign and dagger sign on X-ray is indicative of what condition?

Answer 60

Ankylosing spondylitis

Question 61

What are the effects of ankylosing spondylitis?

Answer 61

Decreased flexion and lordosis leaded to a hunched appearance