Joints

Question 1

Phases of osteoarthritis (3):

Answer 1

1. Chondrocyte injury
2. Chondrocytes proliferate
3. Chondrocyte drop out with loss of cartilage

Question 2

Bone eburnation:

Answer 2

Seen in osteoarthritis: bone on bone movement causes polished look with sclerosis beneath

Question 3

Osteophytes:

Answer 3

Seen in osteoarthritis: bone spur at joint edge

Question 4

Osteoarthritis symptoms (5):

Answer 4

• Deep achy pain
• Morning stiffness
• Worse with use
• Crepitus of joint
• Limited range of motion

Question 5

Heberden nodes:

Answer 5

Osteophytes at DIP in women

Question 6

Osteoarthritis spares (3):

Answer 6

• Wrists
• Elbows
• Shoulders

Question 7

Pannus (4):

Answer 7

Rheumatoid arthritis

• Exuberant inflamed synovium
• Chronic inflammation with T cells
• Granulation tissue with hemosiderin
• Erodes articular cartilage

Question 8

Hand deformities in RA (3):

Answer 8

• Radial deviation of wrist
• Ulnar deviation of fingers
• Flexion-hyperextension of fingers (swan neck; boutonniere)

Question 9

Seronegative spondyloarthropathies (4):

Answer 9

• Pathology in ligamentous attachments
• Immune mediated
• No specific autoantibody
• HLA-B27

Question 10

Ankylosing spondyloarthritis (3):

Answer 10

• Young adults
• HLA-B27
• Axial joints

Question 11

Reactive arthritis (3):

Answer 11

Reiter Syndrome:

• Appendicular noninfectious arthritis
• < 1 month after primary infection
• Triad (see, pee, tree):
  
  • Arthritis
  • Urethritis
  • Conjunctivitis

Question 12

Psoratic arthritis (3):

Answer 12

• HLA-B27 and HLA-Cw6
• Insidious
• Pencil in cup deformity in DIP

Question 13

Tophi:

Answer 13

Mass deposits of urates in gout.

Question 14

Gout phases (4):

Answer 14

1. Asymptomatic hyperuricemia
2. Acute arthritis
3. Intercritical gout (no symptoms)
4. Chronic tophaceous gout

Question 15

Ganglion cyst (3):

Answer 15

• Cyst near joint or tendon sheath
• Wrist is most common
• No communication with joint space

Question 16

Synovial cyst (2):

Answer 16

• Connected to a joint or bursa

- Baker cyst: popliteal synovial cyst