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Common Arthritic Disorders
Terms in this set (22)
progressive loss of articular cartilage and new bone formation consisting of osteophytes (hypertrophic bone growth at the articular surface).
Causes of OA
primary OA: Primary osteoarthritis is mostly related to aging and the natural "Wear and Tear" on the joints. Secondary OA: major joint trauma; obesity; surgery; congenital joint abnormalities; gout; or diabetes
Classic bony enlargement of the distal interphalangeal (DIP) joints of the hand.
proximal interphalangeal (PIP) joints can be affected, and these bony prominences.
Joint space narrowing
OA commonly effected joints
Osteoarthritis commonly affects the hands, feet, spine, and the large weight-bearing joints, such as the hips and knees. Notice that the wrists and ankles are spared.
Runners and OA
Studies have not shown that runners (repetitive use) are at any increased risk for developing osteoarthritis, especially if weekly mileage is kept < 40 miles.
OA and steroids
There is no use for oral steroids, such as prednisone, in the plan for OA.
multiple joints are affected and that the distribution is typically symmetrical. The wrists and ankles can be affected and show ulnar deviation, whereas the ankles and wrists are spared in OA.
Ulnar deviation of the hands and wrist.
Arthritis of the hand joints with classic deformities of the PIP joints "swan-neck" deformities and the DIP joints "boutonniere" deformities.
swan neck deformity
hyperextension of the proximal interphalangeal joints (PIPs), and flexion of the distal interphalangeal joints (DIPs)
defined as a flexion deformity of the PIPs with extension of the DIPs
disease-modifying antirheumatic drugs
monoarticular arthritis of the big toe
tophi or tophitic gout
urate deposits in subcutaneous tissue that form nodules called
The only definitive diagnostic test for gout is...
synovial fluid aspiration of the affected joint. Looking for uric acid crystals.
indomethacin(Indacin)-no ASA b/c contraindicated w/ Indacin and Gout
Septic joint in PEDs and Adolesants
In children think Staph aureus (Otitis Media); in sexually active young people Neisseria gonorrhoeae should be suspected.
unilateral joint pain, stiffness following lack of activity goes away in less than 30 min, lack of inflammation, bony prominences noted, tender to palpation, decreased range of motion, X-ray shows narrowing joint spaces
pain, swelling, and stiffness of the joints. The pain is usually bilateral and aggravated by movement. Morning stiffness often lasts at least 30 minutes. Low-grade fever, early afternoon fatigue, malaise, weakness, anorexia and weight loss. "Swan neck" deformity of the proximal interphalangeal joint (caused by hyperextension of the PIP joint, and flexed DIP joint). +Rheum Factor, elev ESR
abrupt onset of a monoarticular arthritis (Podagra) of the big toe, subcutaneous tissue nodules, inflammation intense as to suggest a septic joint or cellutlitis, hyperuricemia, X-rays may show punched-out lesions in subcondral bone in the first metatarsophalangeal joint, elevated ESR/WBC
FLS, painful, warm, erythematous joint
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