Arthritis

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Patho 305

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  • OA
  • Bony bumps on the finger joint closest to the fingernail are called Heberden's nodes. Bony bumps on the middle joint of the finger are known as Bouchard's nodes.
  • http://www.wormsandgermsblog.com/2010/09/articles/diseases/other-diseases/lyme-disease-in-australia/
  • Introduction of foreign proteins
    Ag-Ab complexes form
    Deposited & trapped in tissues
    kidneys, lungs, skin, joints, or blood vessels
    normally removed from blood
    results in inflammatory response
    Complement
    Neutrophils- lysosomes
    Tissue destruction
    Human Leukocyte antigen (HLA)
  • Granulation occurs (Pannus)- nodules in tissue
  • Antinuclear antibodies
  • Arthritis of sacroiliac joints
  • Arthritis

    1. 1. Arthritis
    2. 2. Osteoarthritis (OA)  local degenerative joint disorder  rt aging & wear and tear from repetitive stress Patho  Proinflammatory Cytokines- TNF & IL1  Loss of articular cartilage  Wear of underlying bone  Formation of bone spurs  Weight-bearing joints often affected
    3. 3. Osteoarthritis S & S osteophytes & irregular cartilage surface cause  Localized joint pain  inc with wt bearing & activity  Crepitus Bone spurs cause  Heberden’s nodes  Joint near nail  Bouchard’s nodes  Middle joint
    4. 4. Infectious (septic) Arthritis  Joint infection due to bacteria usually via bloodstream  Lyme disease  deer tick-borne spirochete  produces red macule or papule, flulike S & S S & S  RT localized infection (one joint) & systemic inflammation
    5. 5. Autoimmunity Rheumatoid Arthritis (RA)  Type III -Immune Complex  Cell-mediated tissue destruction of connective tissues  Women  Cause multifactorial  genetics HLA-DR4  environment  hormones
    6. 6. RA Autoimmunity S & S Systemic  Anorexia  Fatigue  Weakness  Low grade fever  Rheumatoid Factors (RF)  Antibody against IgG & IgM Local  Bilat small joints  Swollen  Stiff  Pain  Red  Warm  At least 3 joints > 6 weeks
    7. 7. RA Long term S & S  Deformity of joint  Skeletal muscle atrophy  Joint fibrosis  Alt bone alignment
    8. 8. Juvenile Rheumatoid Arthritis [JRA] chronic inflammatory disease affecting synovium – Acute onset RF NOT present ANA present 3 subtypes JRA 1. Systemic onset- Stills disease 2. Polyarticular arthritis  localized to 5 or more joints 3. Pauciarticular arthritis  affecting 4 or fewer joints  Uveitis- iris inflamm
    9. 9. Adult-Onset Still Disease  Seronegative polyarthritis Same S & S of JRA  High-spiking fever  Rash on trunk & extremities  Possible sore throat  Hand joints  Visceral involvement
    10. 10. Ankylosing Spondylitis Autoimmune HLA-B27 S & S  Low back pain  Severe am stiffness  Limited ROM (rigidity) Complication  Postural changes  Osteoporosis
    11. 11. Acute Gouty Arthritis deposits of uric acid crystals & urate salts (purine waste product) in tissue Etiology  Dec excretion by kidneys  Genetic- lack of uricase S & S  Elev uric acid  Joint warm, red, & tender  great toe MTP joint  Tophi (lg hard nodule) ~ 10 years later  Ears, eyes, cardiac & renal
    12. 12. Fibromyalgia Syndrome  Cause remains unknown Primary Symptom  Widespread pain in all quadrants of body  18 specific trigger points for pain & tenderness  additional symptoms  Fatigue  Insomnia  Depression  Concentration problems

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