Flashcards in Seminar A arthritis Deck (26)
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1
Types of arthritis and rheumatism
Soft tissue rheumatism →
Localised rheumatoid
Fibromyalgia
Polymayalgia rheuamatica
Bone disease
Osteoporosis
Metabolic
Other arthritis
Other diseases
No disease
Osteoarthritis
Inflammatory polyarthritis
Rheumatoid Arthritis
SLE
Spondyloarthropathies
Other CTD
Crystal arthropathy
Gout
Pseudogout
Spinal pain
2
Soft tissue rheumatism →
Pain and stiffness from structures outside joints
3
Localised rheumatoid
Pain and stiffness from specific structures such as the ileo-lumbar ligament
4
Fibromyalgia
A term loosely used to describe patients with a syndrome of pain and tenderness in multiple sites. There is a strict definition but it is rarely used
5
Polymayalgia rheuamatica
A specific disease causing early morning proximal muscle stiffness but not arthritis. It occurs in people over 60, and sometimes in associsation with temporal (or giant cell) arteritis (when younger people might be affected)
6
Osteoporosis
Reduction in all bone tissues
7
Metabolic
For example, osteomalacia, when bone calcification but not bone protein is reduced.
8
Other arthritis
There are over 200 recognised types of arthritis and rheumatism
9
Other diseases
Many other diseases cause aches and pain in muscles and joints. Hypothyroidism and diabetes are good examples
10
No disease
Everyday aches and pains can be interpreted as indicating a serious illness in those with worries or concerns
11
Osteoarthritis
Patchy cartilage death and local bony overgrowth
12
Inflammatory polyarthritis
Inflammation inside many joints
13
Rheumatoid Arthritis
Synovial hyperplasia and inflammation
14
SLE
Deposition of immune complexes in many organ systems leading to local inflammation
15
Spondyloarthropathies
Inflammation of entheses with subsequent new bone formation principally in the spine, as in ankylosing spondylitis
16
Other CTD
Such as scleroderma or Raynaud’s disease
17
Crystal arthropathy
Inflammation caused by the precipitation of crystals within joints
18
Gout
Sodium urate crystals causing inflammation in joints
19
Pseudogout
Calcium pyrophosphate crystals causing inflammation in joints
20
Spinal pain
Not including inflammatory pain from spondyloarthropathies
21
Cartilage death (OA)
1. Joint space narrowing
2. Subchondral sclerosis
3. Osteophytes
4. Thickening capsule becomes thickened and fibrotic
5. Additional synovial fluid produced
6. Women >50
22
Synovial inflammation and overgrowth (RA)
Synovitis
Joint space narrowing
Erosions
1. Persistent inflammation causes generalised cartilage loss (resulting in joint space narrowing) and also thinning (osteoporosis) of the bone close to the joint (juxta-articular osteoporosis)
2. Synovial cells themselves become overgrown and invasive, and eat into the corners of the ones, forming ‘erosion’.
3. Women (30-50 yrs)
23
Inflammation and new bone formation at enthuse (places where ligaments and tendons join on to bone) (Ankylosing spondylitis)
• Main site is the spine (enthuses bound).
• New bone forms little spurs (called syndesmophytes in the spine) – grow out into area of ligaments.
• Loss of range of motion
• Synovitis
• More common in men (15-30)
24
Crystals in synovial fluid (gout)
First joint involved (50% of pop)→ Proxiaml interphalanageal joint of big toe (podagra)
Does not happen in women or children before menopause
Men>40yrs
25
Joint infection associated symptoms
Inflammations
Systems symptoms – nights sweats or pyrexia
Raised white blood cell count
26
