Osteoarthritis and Septic Arthritis Flashcards
(20 cards)
What is the mechanism behind osteoarthritis?
- cartilage loss is the end stage process
- complex process invligin mechanic-sensitive cells
- elements of inflammation/synovitis
- poor correlation between damage and pain
What are the radiological features of osteoarthritis?
Loss of joint space
Osteophytes
Subchondral sclerosis
Subchondral cysts
What are the treatments for osteoarthritis?
- weight loss
- muscle strengthening
- analgesia - keep it simple, think topical
- surgery
What are the surgical options for osteoarthritis?
- joint replacement
- joint relalignment as prevention
What are the differential diagnoses for acute mono arthritis?
septic arthritis crystal arthritis trauma reactive arthritis haemoarthosis
What crystal causes gout?
monosodium urate
Who is susceptible to septic arthritis?
- young/old
- underlying arthritis/trauma
- cutaneous ulcers
- prosthetic joints
- IV drug use
- diabetes
What are the classical features of septic arthritis?
knees, hips
20% more than one joint
fever in majory
raised CRP and ESR
What organisms cause septic arthritis?
staph 50%
strep 33%
gram -ve 10%
What is the consequence of untreated septic arthritis?
rapid joint destruction
Uric acid is the end product of…..
purine degradation
Most uric acid is excreted by..
the renal proximal tubule
What is the typical presentation of gout
- middle aged man
- 1st MTP
- rapid onset
- erythema/warmth
- obestiy/metabolic sundrome
- osteoarthritis
- alcohol/red meat
What 2 drugs can cause gout?
- cytotoxic and diuretics
What crystal causes pseudogout?
calcium pyrophosphate dihydrate
What are the triggers for pseudo gout?
- intercurrent illness
- trauma
- surgery
Which joints are affected by pseudo gout usually?
- elderly patients knee wrist shoulder
What is the work up for joint swelling?
- history
- examine
- aspirate
What is the appearance of aspirates from the following:
- osteoarthritis
- inflammatory arthritis
- crystal arthritis
- septic arthritis
Osteoarthritis - clear Inflammatory arthritis - straw hello Crystal arthritis - cloudy Septic arthritis - turbid
What is the difference in WBC in Osteoarthritis Inflammatory arthritis Crystal arthritis Septic arthritis
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