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34 Cards in this Set

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Osteoarthritis
"degenerative joint disease"
Cause
Wear and tear of joints leading to destruction of articular cartilage
Signs of osteoarthritis
Subchondral cysts, osteophyts, eburnation, Heberdens nodes, Bouchards nodes
Heberden's nodes
DIP bony swelling
Bouchard's nodes
PIP bony swelling
Predisposing factors for osteoarthritis
Age, obesity, joint deformity
Osteoarthritis x ray findings
Narrowing of joint space due to loss of cartilage and osteosclerosis
Joint fluid in osteoarthritis
Few cells and normal mucin
Most commonly affected joints in osteoarthritis
Vertebra, hips, knees, DIPS
Classic presentation of osteoarthritis
Pain in weight bearing joints after use (end of day)
Pain improves with rest
Rheumatoid arthritis etiology
Inflammatory disorder affecting synovial joints w/pannus formation
Signs/symptoms of rheumatoid arthritis
Starts in small joints of hands/feet but may involve any joint (usually symmetric)
Joint swelling, redness, warmth
Subq rheumatoid nodules, ulnar deviation, subluxation, Baker's cyst
Most common affected joints in rheumatoid arthritis
MCP, PIP (not DIPS)
Classic presentation of rheumatoid arthritis
Morning stiffness improving with use
Symmetric joint involvement
Systemic symptoms (fever, fatigue, pleuritis, pericarditis)
X ray findings in rheumatoid arthritis
Erosions and osteoperosis
Synovial fluid in rheumatoid arthritis
Increased cells (usually neutrophils), poor mucin
Classic triad of sjogren's syndrome
(1) xeropthalmia (dry eyes, conjunctivitis, "sand in my eye")
(2) xerostoma (dry mouth, dysphagia)
(3) arthritis
Associations of Sjogren's syndrome
Assoc w/RA
Incr risk of B cell lymphoma
Parotid enlargement, dental caries
Epidemiology of Sjogren's syndrome
Mainly F 40-60YO
Autoantibodies in Sjogren's
SSA (Ro)
SSB (la)
Joint symptoms in gout
Asymmetric distribution
Joint is swollen, red, and painful
Usually MTP joint (big toe)
Associated presentation of gout
Tophus formation (often on extrenal ear or achiles tendon)
Why is gout attack precipitated by alcohol or after a large meal
Alcohol metabolites compete for same excretion site in kidney as uric acid causing buildup of uric acid in blood
Etiologies of gout
Caused by precipitation of monosodium urate crystals in joint space (hyperuricemia)
-Inborn error of purine metabolism usually from an unknown deficiency
(Except Lesche Nyhan syndrome (HGPRT deficiency))
-incr cell turnover
-Von Gierke's disease
Diagnosis of gout
Tap joint
Crystals are needle shaped and negatively birefiringent
Yellow when parallel and blue when perpendicular to light
Treatment of gout
Colchicine
NSAIDs
Probenecid
Allopurinol
Pseudogout cause
Deposition of calcium pytophosphate crystals in joint space
Diagnosis of pseudogout
Rhomboid cystals that are weakly positively birifringent
Yellow when perpendicular and blue when parallel
Felty Syndrome
Polyarticular rheumatoid arthritis associated with HLA B27
Splenomegaly and leukopenia
Chronic infectious arthritis: causative microbes
TB
Lyme disease
Septic arthritis presentation
Monoarthritis w/asymmetrical pattern. Pain, redness, low grade fever, tenderness, swelling, reduced joint mobility
Septic arthritis: #1 overall (causative agent/mech of pathogenesis and treatment)
Staph aureus/coagulase inhibits phagocytosis (nafcillin)
Septic arthritis: 15-40YO mono or polyarticular (causative agent/mech of pathogenesis and treatment)
Neisseria gonorrhea/pilimediate adherence and inhibit phagocytosis (ceftriaxone)
Septic arthritis: prosthetic joint (causative agent/mechanism of pathogenesis)
Coag negative staph /biofilm allow adherence to teflon
Septic arthritis: viral (causative agents/mechanism of pathogenesis)
Rubella, hepB, parvovirus/immune complex mediated