Joint Types and Arthritis Overview

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Questions and Answers

Which condition can lead to secondary gout due to increased cell turnover?

Leukemia (correct)

Psoriasis

Renal failure

Lesch-Nyhan syndrome

What is the characteristic feature of acute gout presented in clinical symptoms?

Exquisitely painful arthritis of the great toe (correct)

Systemic febrile illness

Painful swelling of the knee

Painless nodules in the joints

Which of the following is a consequence of chronic gout?

Development of tophi (correct)

Increased bone density

Enhanced renal excretion of uric acid

Reduced joint mobility

What characteristic laboratory finding is associated with gout?

Negative birefringence of needle-shaped crystals (C) Signup and view all the answers

What substance is associated with pseudogout, contrasting it with gout?

Calcium pyrophosphate dihydrate (A) Signup and view all the answers

What is a characteristic feature of rheumatoid arthritis that differentiates it from osteoarthritis?

Symmetric involvement of joints (B) Signup and view all the answers

In osteoarthritis, which pathological feature is characterized by fragments of cartilage floating in the joint space?

Joint mice (A) Signup and view all the answers

Which of the following is NOT a common site affected by osteoarthritis?

Shoulders (A) Signup and view all the answers

What major risk factor is associated with the development of osteoarthritis?

Age (B) Signup and view all the answers

Which component of a synovial joint is responsible for secreting fluid that lubricates the joint?

Synovium (C) Signup and view all the answers

What is the hallmark clinical feature of rheumatoid arthritis seen in the joints?

Symmetric joint involvement and morning stiffness that improves with activity (D) Signup and view all the answers

Which of the following is a common characteristic of osteophytes in osteoarthritis?

They are reactive bony outgrowths found at DIP joints. (B) Signup and view all the answers

What type of cartilage is predominantly found at the articular surface of synovial joints?

Hyaline cartilage (D) Signup and view all the answers

Which of the following is NOT typically associated with ankylosing spondyloarthritis?

Characterized by the presence of rheumatoid factor (B) Signup and view all the answers

What is a common extra-articular manifestation of reactive arthritis?

Uveitis (A) Signup and view all the answers

What is the primary cause of infectious arthritis in young adults?

N. gonorrhoeae (A) Signup and view all the answers

Which laboratory finding is NOT typically seen in gout?

High levels of rheumatoid factor (B) Signup and view all the answers

In psoriatic arthritis, which joints are most commonly affected?

DIP joints of the hands and feet (A) Signup and view all the answers

Which of the following complications is associated with chronic inflammatory states like rheumatoid arthritis?

Anemia of chronic disease (C) Signup and view all the answers

What is the hallmark of seronegative spondyloarthropathies?

Axial skeleton involvement (A) Signup and view all the answers

Which clinical finding is most associated with gout?

Lower extremity joint pain (C) Signup and view all the answers

Study Notes

Joint Types

Joints connect bones, providing structural strength or motion
Solid joints are tightly connected (e.g., cranial sutures).
Synovial joints have a space for motion.
- Articular surfaces are made of hyaline cartilage (type II collagen).
- The surfaces are surrounded by a joint capsule

Degenerative Joint Disease (Osteoarthritis)

Progressive degeneration of articular cartilage
Often due to wear and tear
Major risk factor is age (often after 60)
Other risk factors: obesity, trauma
Affects a limited number of joints (e.g., hips, lower lumbar spine, knees, DIP and PIP joints)
Morning stiffness, worsening throughout the day
Pathologic features include:
- Cartilage disruption and fragments within the joint space (“joint mice”)
- Eburnation of the subchondral bone
- Osteophyte formation (bony outgrowths), commonly at DIP and PIP joints (Heberden and Bouchard nodes)

Rheumatoid Arthritis

Chronic, systemic autoimmune disease
Classically affects women of childbearing age
Associated with HLA-DR4
Characterized by synovitis (inflammation of the joint lining), pannus (granulation tissue) formation
Leads to cartilage destruction and joint fusion (ankylosis)
Clinical features:
- Morning stiffness, improving with activity
- Symmetric involvement of joints (especially PIP joints) in fingers, wrists, elbows, ankles, and knees; DIP usually spared
- Joint space narrowing, cartilage loss, and osteopenia are common on X-rays
- Fever, malaise, weight loss, myalgias
- Rheumatoid nodules, vasculitis (inflammation in blood vessels), Baker cyst, and lung involvement

Seronegative Spondyloarthropathies

Group of joint disorders
Lack of rheumatoid factor
Axial skeleton involvement (spine and sacroiliac joints) and HLA-B27 association
Typical diseases: ankylosing spondylitis, reactive arthritis, psoriatic arthritis
- Ankylosing spondylitis: low back pain, vertebral fusion ("bamboo spine"), uveitis and aortitis; affects young adults mostly males
- Reactive arthritis: triad of arthritis, urethritis, and conjunctivitis, follows GI or Chlamydia trachomatis infection; affects young adults, mostly males
- Psoriatic arthritis: affects axial and peripheral joints (DIP joints), often occurs with psoriasis

Infectious Arthritis

Arthritis due to an infectious agent (typically bacterial)
Common causes: Neisseria gonorrhoeae (young adults), Staphylococcus aureus (older individuals)
Symptoms include warm joint, limited range of motion, fever, elevated WBC count, elevated ESR
Commonly affects one joint; usually the knee

Gout

Deposition of monosodium urate crystals in joints, typically in the great toe (podagra)
Due to hyperuricemia (high uric acid levels), either from overproduction or decreased excretion
Primary gout: most common form, cause unknown
Secondary gout: associated with conditions that cause increased cell turnover (e.g., leukemia)
Acute gout: sudden pain and inflammation
Chronic gout: tophi (urate crystals) formation in soft tissues, joint damage, and chronic renal disease

Pseudogout

Clinically similar to gout, but caused by calcium pyrophosphate dihydrate (CPPD) crystal deposition in joints
Synovial fluid shows rhomboid-shaped crystals with weakly positive birefringence

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Description

This quiz covers the various types of joints, including solid and synovial joints, and delves into common degenerative joint diseases like osteoarthritis and rheumatoid arthritis. Understand the characteristics, risk factors, and pathologic features associated with these conditions. Perfect for students studying anatomy or healthcare.