W30-L1: Joint Pathology Flashcards
(22 cards)
What are the two types of cell in the synovium?
Type A cell: Macrophage like
Type B cell: Fibroblast like
What is the basis of osteoarthritis?
Wear and tear, presents as chronic degeneration of a few joints
What are symptoms of osteoarthritis?
deep pain, worse with use
What is the basis of rheumatoid arthritis?
An autoimmune inflammatory arthritis with systemic involvement
Where does rheumatoid arthritis start?
symmetrically in small joints of hands and/or feet, and proceeds to destroy them
What are the symptoms of rheumatoid arthritis?
Morning stiffness, systemic symptoms
What is the basis of gout?
Incredibly painful acute inflammation in a single joint due to crystallisation of uric acid
What is the underlying pathological process of osteoarthritis?
Damage stimulates chondrocyte proliferation, enzyme/cytokine action, and matrix depletion which causes changes in bones, shedding of cartilage and bone on bone action
What is the morphology of damage to cartilage in osteoarthritis?
- Non-uniform loss of cartilage
- Subchondral thickening
- Osteophytes
What signs of osteoarthritis?
- Reduced range of motion
- Crepitus (grinding)
- Osteophytes
What is the onset of osteoarthritis?
Insidious
What are some possible X-ray findings in osteoarthritis?
- Loss of load bearing space
- Osteophytes
- Subchondral sclerosis
- Subchondral cysts
What are some risk factors for osteoarthritis?
- Increasing age
- Obesity
- Previous injury
- Repeated heavy use
- Genetic
What is the underlying pathology of Rheumatoid arthritis?
T Helper cells as well as fibroblasts, macrophages that causes granulation like tissue
What are the inflammatory changes in rheumatoid arthritis?
Mononuclear infilitrate in synovium, hyperplastic synovium with villus formation, germinal centres
What are signs of rheumatoid arthritis?
- Warm, swollen joints
- Rheumatoid nodules
- Destruction and deformity of joints
What are some X-ray findings in rheumatoid arthritis?
1st: Thin bone around joints (Juxta-articular osteopaenia)
2nd: Uniform joint space loss (different from OA as its uniform, not weight bearing)
3rd: Subchondral erosions (pannus which is abnormal granulation tissue erodes everything)
What are the risk factors for rheumatoid arthritis?
- Genetic
- Female
- Increasing age (25-55)
- Smoking
What is the underlying pathological process of gout?
Too much uric acid in the body that eventually precipitates in cool areas with low pH, crystals then active inflammatory cells
What is the histology of gout?
Granulomatous inflammation (foreign body) which shows epithelioid macrophages, fibrosis, multinucleate giant cells
What are the X-ray findings in gout?
Late stage findings only which are punched out erosions with sclerotic, overhanging
edges
What are the risk factors for gout?
- Male
- Increasing age
- Genetics
- Uric acid metabolism
- Obesity etc.
