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34 Cards in this Set
- Front
- Back
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Define effusion.
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An increased amount of joint fluid.
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What percent of white cells may be polymorphonuclear before suspecting infection?
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94%
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What is the most prevalent form of arthritis?
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Osteoarthritis
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How is osteoarthritis distinguished?
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By its lack of inflammatory cells in the synovium and synovial fluid.
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What are other names for osteoarthritis?
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Degenerative Joint Disease (DJD) or osteoarthrosis (OA).
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Where are the most common locations of OA?
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Weight-bearing joints and in distal finger joints.
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What would you expect to see in a radiographic image of a joint with OA?
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Narrowing of the "joint space," sclerosis of subchondral bone, osteophyte formation, and subchondral cysts.
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What is Rheumatoid Arthritis?
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An inflammatory, autoimmune arthritis of uncertain etiology.
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Changes to which gene are thought to produce a genetic predisposition to the disease?
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HLA-DRB1
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How is Rheumatoid Arthritis characterized?
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By the development of a profuse and erosive synovitis that destroys joints.
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How is Rheumatoid Arthritis early disease thought to progress?
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It is thought to produce injury to synovial microvasculature, resulting in larger regions of synovial tissue injury and exacerbation of the inflammatory response.
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What initiates the immune actions in the rheumatoid joint, and what actually causes the damage?
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T-cells initiate immune actions, but neutrophil activation results in the release of multiple enzymatic facgtors and proteases, which begin the degradation of the joint surfaces and the surrounding ligaments and tendons.
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What makes up the majority of the cells present in the synovium of the rheumatoid joint?
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Activated fibroblasts.
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What is pannus?
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It is the aggressive granulation tissue formed of fibroblasts that erodes the surrounding cartilage surfaces and subchondral bone within joints.
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What are some clinical features of Rheumatoid Arthritis?
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Persistent polyarthritis, symmetric involvement, morning stuffness, painful joint motion, and muscle wasting.
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What are DMARDs?
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Disease-Modifying AntiRheumatic Drugs
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What causes septic arthritis?
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bacteria, viruses, spirochetes, mycobacteria, and fungi, which as a group tend to be mono- or pauciarticular with the exception of parovirus which usually causes polyarticular arthritis and resembles rheumatoid arthritis.
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Define iatrogenic.
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iatrogenesis and iatrogenic artifact refer to adverse effects or complications caused by or resulting from medical treatment or advice
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What is the treatment for suspected septic arthritis?
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Aspiration of the joints.
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Which joints does gonococcal arthritis generally affect?
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Knees, elbows and ankles, and the small joints of the hand and wrist, and the sternoclavicular joints.
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Discuss viral arthritis.
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The hepatitis virus and rubella virus (or vaccine) may cause an immune-complex-mediated arthritis that is usually self-limited and not destructive.
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Discuss arthritis caused by Lyme disease.
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Lyme disease is caused by Borrelia burgdorferi, which is a tick-borne spirochete. In its late stages, it presents with intermittent migratory polyarthritis.
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Discuss arthritis caused by mycobacteria and fungus.
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Usually only in immunosuppressed individuals. Monoarticular arthritis in hips and knees is most common. Mild inflammation, slow-to-no destruction.
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What are the most common types of crystals in crystalline arthritis?
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Urate, calcium pyrophasphate, and apatite.
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What is the common name for monosodium urate crystalline arthritis?
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Gout.
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What are spondyloarthropathies?
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A collection of arthritic disorders that tend to present with asymmetrical arthritis, involvement of the sacroiliac joints and spine, and enthesitis (inflammation where a tendon attaches to a bone).
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Describe Ankylosing spondylitis.
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Clinical features include the insidious onset of low back pain, usually before 40yrs, improving with exercise. Sacroilitis is virtually always seen, but the amount of spinal arthritis varies.
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What is the radiographical feature of ankylosing spondylitis?
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"Bamboo" spine, due to ossification of the annulus fibrosus and intervertebral ligaments, and ultimately obliteration of the sacroiliac joints.
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What are the 4 types of spondyloarthropathies?
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Ankylosing spondylitis
Reiter's Syndrome Psoriatic Arthritis Enteropathic Arthritis |
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What are the names of the bones in the proximal row of carpal bones?
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From radial to ulnar:
Scaphoid Lunate Triquetrum Pisiform |
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What are the names of the bones in the distal row of carpal bones?
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Radial to Ulnar:
Trapezium Trapezoid Capitate Hamate |
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What are the boundaries of the cubital fossa?
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It is an inverted triangle.
Base: transverse line through supracondylar ridge Lateral side: brachioradialis muscle and wrist extensor group Medial: pronator teres and flexor group Floor: brachialis, biceps, supinator, anterior capsule of elbow joint Roof: bicipital aponeurosis and deep fascia of forearm |
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What are the contents of the cubital fossa?
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Brachial artery, vein and median nerve (lying medial to biceps tendon), lateral cutaneous nerve of the forearm (lying lateral to the biceps tendon), and the radial nerve dividing into deep and supervicial radial nerves (lying deep to the brachioradialis).
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Describe the position within the cubital fossa of the cephalic, median cubital, and basilic veins.
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They lie in contact with the roof of the cubital fossa, but are technically are not within the fossa. On the medial aspect of the roof of the fossa, the medial cutaneous nerve of the forearm continues its subcutaneous path from the arm to the forearm.
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