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Joint Disorders Clinical Features

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fuckdaveliu's version from 2018-05-18 22:43

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Degenerative Joint Disease (Osteoarthritis)Affects limited number of joints (hips,lower lumbar spine,knees,DIP, PIP,base of thumb), Joint stiffess in the morning that worsens during the day, Disruption of the cartilage that lines the articular surface(fragements of cartilage floating in the joint space called 'joint mice'), eburnation of the subchondral bone, Osteophyte formation (Heberden nodes, and Bouchard nodes)
Rheumatoid ArthritisSynovitis leading to formation of a pannus(inflammed granulation tissue), leads to destruction of cartilage and ankylosis of the joint. Arthritis with morning stiffness that improves with activity. Affects the PIP, writs, elbows, ankles, knees, DIP spared. Fever Malaise, weight loss, and myalgias. Rheumatoid nodules, vasculitis, baker cyst, Pleural effusions, lymphadenopathy, interstitial lung fibrosis. IgM autoantibody against Fc portion of IgG(rheumatoid factor) marker of tissue damage and disease activity. Neutrophils and high protein in synovial fluid
Ankylosing SpondylarthritisLack of rheumatoid factor, Axial Skeleton Involvement. Presents as low back pain, involvement of vertebral bodies eventually arises, leading to fusion of the vertebrae(bamboo spine). Uveitis, Aortosis(leading to aortic regurgitaion)
Reiter SyndromeTriad of arthritis, uethritis, and conjuctivitis
Psoriatic ArthritisAxial and peripheral joints, DIP joints of the hands, and feet are most commonly affected, leading to sausage fingers or toes
Infectious ArthritisInvolves single joints(knee). Warm joint with limited range of motion, fever, increased white count, elevated ESR
Acute GoutPainful arthritis of the great toe(podagra)
Chronic GoutDevelopement of tophi(white, chalky aggregates of ruic acud crystals with firbosis and giant cell reaction in the soft tissue and joints), Renal Failure (Urate Crystals may deposit in kidney tubules(urate nephropathy). L
GoutLabratory findings show hyperuricemia, synovial fluid shows needle-shaped crystals with negative birefringence under polarized light
PseudogoutRhomboid-shaped crystals with weakly positive birefringence under polarized light
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