This document provides information about different types of arthritis. It discusses osteoarthritis, rheumatoid arthritis, and gout/gouty arthritis. For osteoarthritis, it describes the pathological changes that occur in the articular cartilage, adjacent bone, and synovium. These include loss of cartilage, bone spurs, and low-grade chronic synovitis. Rheumatoid arthritis is characterized by diffuse proliferative synovitis and pannus formation, which destroy cartilage and bone. Gouty arthritis occurs when uric acid crystals form in the joints, triggering acute synovitis and inflammation. If left untreated, gout can damage joints and kidneys over time.

1. ARTHRITIS
By BURAID MAQBOOL WANI

2. Introduction:
Arthritis is a disease where animal or human body
jionts are damaged
Arthritis is from the greek word
Arthra_jiont
Itis_inflammation
Therefore we say arthritis is the inflamation of
JIONTS
arthritis is painful and causes stiffness of JIONTS

3. Types of Jionts…
Diarthadial/synovial
Jionts connected by jiont capsule inside which synovial membrane is
present which contains synoviocytes… .
Synovial membrane is Specalized connective tissue
Synoviocytes are of two types
Type A synoviocytes_they are like macrophages helps in wear and tear
and remove debris
Type B synoviocytes_synthesizes hyaluronic acid help in growth and
development of cartilage and also help in reducing joint inflammation
Synarthadial/non synovial
Jionts are connected by thick fibrous hard tissue… as
shows zero movement or very less moment
(Cartilage is smooth elastic tissue that covers and
protects ends of long bones at JIONTS

4. SYNOVIAL JIONT

5. TYPES OF ARTHRITIS
There are more than 200 types of arthritis
But the most common forms of arthritis we will be
studying are
1 osteo arthritis
2 Rheumatoid arthritis
3 Gout/Gouty arthritis

6. Osteoarthritis
Most common form of arthritis.
It can effect both smaller and larger JIONTS
It mainly effects the weight bearing JIONTS like hands wrist feet ankle knees
back hips
Mainly effects the women after the age of 45
In osteoarthritis bone degradation occurs
Osteoarthritis is further classified into primary osteoarthritis (POA)
And secondary osteoarthritis (SOA)

7. …
#PRIMARY OSTEO ARTHRITIS
Most common form of OA
CAUSED DUE TO AGEING OF CARTILAGE
It's believed if we live long everybody will have
primary osteoarthritis
Cause; longetivity of use
Wear and tear with repeated minor trauma
Heridity(but pattern unknown)
FRZB GENE mutation also known as toy frisbee
(It regulates cartilage growth)
#SCONDARY OSTEO ARTHRITIS
Less common caused due to trauma injury or
pathogens
Rhematiod arthritis may be cause
Cause;
Break down of collagen type2 by interlukin_1
,TNF,NO2
(CT2 GIVES TENSILE STRENGTH,
ELASTICITY AND SUPPORT JOINTS)

8. MORPHOLOGICAL CHANGES OF
OSTEOARTHRITIS OR PATHOLOGY OF OA.
The pathological changes occur in *articular cartilage, *adjacent bone and* synovium
1 Articular cartilage;
*Regressive changes are marked at weight bearing cartilage
There is loss of matrix ( proteoglycans )
Loss of chondrocyte
Loss of normal metachromasia
Proliferation of chondrocytes forming either clusters ,lossens and flacking occur
Fissuring of cartilage resulting in exposing of subchondral bone
RADILOGICALLY; PROGRESSIVE LOSS OF CARTILAGE
NARROWED JOINT SPACE

9. BONE;
subchondral bone looks like polished
ivory
Death of superficial osteocytes
Increased osteoclastic activities
Osteocyte or spur formation
Joint mice ( by losen osteophyte)

10. SYNOVIUM,
Intially no pathological changes seen
Later low grade chonic synovitis
Villous hypertrophy ( increased csf if it
occurs in back region)
Some amount of synovial effusion

12. 2 RHEUMATOID ARTHRITIS
RA. is a disorder in which body own immune system starts to attack body joints or tissues
It's a multisystem inflammatory disease primarily effects synovium and most damage occur to
joint linning and cartilage which eventually results in erosion of two opposing bones
RA. Effects symetrically
It can lead to permanent deformity of joint if not treated in few years

13. Cause:
It's believed it occurs by the combination of
Genetic factor. And environmental factors
Human leukocyte antigen. ❌ Cigarette, pathogen.bacteria
HLA_DR1. HLA_DR4
WHEN THEY MIX THEY MODIFY OUR OWN BODY PROTEINS
MAINLY IgG ANTIBODIES ,. TYPE 1 COLLAGEN ,. VIMENTIN WHICH ARE PRESENT IN SYNOVIUM
ALSO
ANTIBODY MECHANISM GETS ACTIVATED ALSO Tumor necrosis FACTOR ACTIVATED CAUSING
INFLAMMATION AND RUPTURING AND DAMAGE
This process results in rheumatoid arthritis

14. MORPHOLOGICAL features or pathological
changes of rhematiod arthritis
*predominant pathological lessions are found in joints
Characteristic feature is diffused proliferative synovitis with formation of pannus(abnormal
layer of fibrovascular tissue is formed beneath joint capsule)the pannus progressively destroy
the underlying cartilage and subchondral bone
#microscopically numerous folds of large villi of synovium
Marked thickening of synovial membrane due to edema, congestion and multilayering of
Synoviocytes
#intense inflammatory cell infiltration in synovium

16. Gout)GOUTY ARTHRITIS
Another form of arthritis characterized by severe pain redness
and tenderness in joints caused by uric acid crystals in the joint
causing INFLAMMATION AND joints loose function
#if Gout occur by rhomboid crystals ( calcium pyrophosphate)=
pseudojiont or false Gout

17. Cause;
Dietary purine load (more than 400 mg) and endogenous purine synthesis
Under excretion ( ineffective metabolism) and overproduction of uric acid leads to urate crystal
formation
They interact with inflammatory system causes Gout

18. PATHOLOGICAL AND MORPHOLOGICAL
CHANGES OF GOUTY ARTHRITIS
# ACUTE GOUTY ARTHRITIS
characterized by acute synovitis triggered by precipitation of sufficient amount of
needle_shaped crystals of monosodium urate from serum or synovial fluid
#CHORONIC TOPACEOUS ARTHRITIS
recurrent attack of acute GOUTY arthritis results in choronic arthritis characterized by
Presence of synovial proliferation
Pannus formation
Progressive distruction of articular cartilage and subchondral bone
Deposition of urates in form of tophi ( porous stone) in peri articular tissue

19. Tophi in soft tissue:
Tophus means porous stone (few mm to cm)
It may be located in peri articular tissues of toe
and hands
Tophi is surrounded by macrophages,
lymphocytes, fibroblasts, foreign body cells
RENAL SCARS AND DAMAGE
Gout if untreated can damage to kidney

20. SIGNS AND SYMPTOMS
#STIFFNESS
#INABILITY TO USE THE JOINT
#MALAISE ( FEELING DISCOMFORT)
#FATIGUE
#WEIGHT LOSS
#POOR SLEEP
#MUSCLE ACHE
#LOSS IF FLEXIBILITY
#PAIN

21. Diagnosis
#pain pattern on arthadial location
2 HISTORY EVALUATION
GENETIC FACTOR
MALNUTRITION
OCCUPATION
AGE
3PHYSICAL EXAMINATION
S/S ASSESSMENT
BLOOD TESTS... screening blood tests may include rhematiod factors ,antinutritive factors,other ANTIBODIES
#X_RAY