Pathology of arthritis for medical students.

1. “ Never let the competition define you. Instead, you have to define yourself based on a point of view you care deeply about.” – Tom Chappel

3. COMMON CLINICAL PROBLEMS OF ARTHRITIS

5. "Thinking is progress. Non-thinking is stagnation of the individual, organisation and the country. Thinking leads to right action. Knowledge without action is useless and irrelevant. Knowledge with action, converts adversity into prosperity.” - - APJ Abdul Kalam, President of India.

6. Pathology of Arthritis Dr. Venkatesh M. Shashidhar. Associate Professor & Head of Pathology

12. Rheumatoid Arthritis

18. Early Destruction in RA:

19. Cartilage Destruction in RA:

21. Normal - Synovium - R.A

22. RA-Pannus: Head of femur

23. RA - Pannus:

24. RA - Pannus:

25. RA - Pannus: Hyperplastic inflammed synovium

27. Skin RA Nodule:

28. Skin RA Nodule:

29. Rheumatoid Nodule (skin): Palisading Macrophages Central Fibrinoid Necrosis

31. Joint involvement in RA:

32. Swan Neck Deformity in RA:

33. Swan Neck Deformity in RA:

34. Joint Destruction in RA: Swan Neck Deformity

35. RA Joint destruction, ankylosis:

36. RA Joint destruction, ankylosis: Subluxation deformities and severe osteopenia in chronic rheumatoid arthritis treated with corticosteroids

37. RA Muscle wasting. Polyarthritis and muscle atrophy in chronic juvenile rheumatoid arthritis.

38. Osteoarthritis Degenerative arthr osis . (Osteoarthrosis)

40. Factors affecting Osteoarthritis:

41. Normal -- Femur Head -- OA Normal Osteoarthritis

42. Osteoarthritis: 1- Eburnation of bone 2- Subchondral cyst 3- Residual cartilage

43. Osteoarthritis:Cartilage deg.

44. OA: Ebernation & Osteophytes Exposed bone Osteophytes

45. Femur Osteroarthritis: Bone exposure Cartilage degeneration

46. Spine OA: Osteophytes:

49. Osteophyte formation:

50. Bone cysts in OA:

54. OA Fingers:

55. OA Fingers:

56. OA Hip:

57. OA Hip: 1997, bilateral, joint space narrowing (arrows) at the hips that is worse on the left side

58. OA Hip: Subchondral sclerosis (solid arrowhead) and cyst (arrow) formation are also noted on the left side

59. OA Hip:left hip arthroplasty

63. RA OA

64. "Powered by intellect, Driven by Values..!” Life motto of Infosys founder and Chairman, Narayana Murthy. INDIA Tip for Success in life….!

65. "When you speak, speak the truth; perform when you promise; discharge your trust... Withhold your hands from striking, and from taking that which is unlawful and bad...“ - - APJ Abdul Kalam, President of India.

66. Arthritis Other Infective, traumatic, secondary to systemic diseases.

68. Septic Arthritis: ORGANISM PEAK AGE INCIDENCE GRAM STAIN Hemophilus influenzae Children Gram negative coccobacilli Neisseria gonorrheae Young adults Gram negative diplococci Salmonella young with Sickle Cell An. Gram negative rods Staph. aureus Adults Gram positive cocci in clusters Escherichia coli Adults Gram negative rods Pseudomonas Adults Gram negative rods

69. Gonococcal Arthritis:

71. Big Toe in Gout:

72. Fingers in Acute Gout:

73. Fingers in Gout: Acute Gout  Chronic Gout 

74. Joint destruction in Gout:

75. Gout Tophii (amputated toe)

76. Gout Tophi: Microscopy

77. Gouty Tophus – Giant cell granuloma

78. Urate Crystals (Birefringense):

81. CPPD-Arthritis (pseudo gout): Crystal deposition within cartilage, tendons and ligaments

82. Pseudo Gout – Calcium pyrophoshate

84. AS-Fusion of vertebrale (syndesmophytes)

85. Scoliosis in Ankylosing Spondylitis

86. Seronegative Arthritis Reiter’s, Psoriasis, Ulcerative colitis, Crohn’s disease etc.

88. Arthritis Comparison:

89. "The gem cannot be polished without friction, nor man perfected without trials or problems (or exams) …!." --Chinese proverb

104. "Thinking should become your capital asset, no matter whatever ups and downs you come across in your life.“ - - APJ Abdul Kalam, President of India.

105. Arthritis Case Studies:

113. Syndesmophytes Osteitis SIJ-arthritis

114. Syndesmophytes (Bamboo spine) Osteitis (Shiny corners)

118. Disorders of Bone Paget’s Disease

119. Paget’s Disease