Osteoarthritis and Joint Health Quiz

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Questions and Answers

What role do chondrocytes play in the maintenance of articular cartilage?

They degrade all matrix components without any synthesis.

They only respond to external mechanical loading.

They synthesize matrix and regulate both anabolic and catabolic activities. (correct)

They solely secrete matrix-degrading enzymes.

After the age of 65, what is the estimated prevalence of osteoarthritis in women?

70% (correct)

60%

50%

80%

How does damaged collagen affect joint integrity compared to healthy collagen?

Damaged collagen restrains joint movement more effectively.

Damaged collagen does not restrain as effectively as healthy collagen. (correct)

Healthy collagen increases repulsive forces between joints.

Healthy collagen has no impact on joint integrity.

Which statement about osteoarthritis (OA) is true regarding its prevalence based on age and sex?

OA affects men and women equally up to age 55. Signup and view all the answers

What effect does mechanical loading have on chondrocyte metabolism in normal cartilage?

It modulates chondrocyte metabolism. Signup and view all the answers

What is the primary function of ligaments in a synovial joint?

Hold bones together and prevent undesirable motion Signup and view all the answers

What is one characteristic joint change seen in rheumatoid arthritis?

Decreased joint space Signup and view all the answers

What is the role of Type A cells in the synovial membrane?

Remove bacteria and debris Signup and view all the answers

Which of the following components contributes to the viscous quality of synovial fluid?

Hyaluronate secreted by Type B cells Signup and view all the answers

What deformity involves PIP flexion and DIP extension?

Boutonniere deformity Signup and view all the answers

Which of the following is an early joint affected in rheumatoid arthritis?

MCP and PIP joints Signup and view all the answers

What condition can manifest as a result of rheumatoid arthritis?

Osteoporosis Signup and view all the answers

What type of tissue makes up articular hyaline cartilage in a synovial joint?

Chondrocytes embedded in an intercellular matrix Signup and view all the answers

What is a visible sign of rheumatoid arthritis in the fingers, hand, and wrist?

Joint deformities Signup and view all the answers

What leads to the Swan Neck deformity?

Initial synovitis at the MCP joint Signup and view all the answers

What is a key characteristic of the fibrous joint capsule?

Sensitizes nerves to tension and vibration Signup and view all the answers

What was the prevalence of rheumatoid arthritis in Canada in 2015?

Roughly 0.9% of the population Signup and view all the answers

Which condition may result from chronic synovitis of the PIP joint?

Swan Neck deformity Signup and view all the answers

What type of joint change can lead to permanent deformities in rheumatoid arthritis?

Joint changes over time Signup and view all the answers

Which type of joint is primarily discussed in the provided content?

Synovial joint Signup and view all the answers

What condition is characterized by ulnar deviation and loss of ulnar deviation at the wrist?

Volar subluxation Signup and view all the answers

What is a hallmark symptom of rheumatoid arthritis (RA) during the morning?

Prolonged morning stiffness lasting more than 1 hour Signup and view all the answers

What does ankylosis refer to in the context of RA?

Abnormal stiffening and immobility due to bone fusion Signup and view all the answers

Which of the following is NOT a cardinal sign of inflammation associated with RA?

Increased range of motion Signup and view all the answers

What triggers the pain in joints affected by RA?

Pressure from swelling and inflammation Signup and view all the answers

In which locations is RA most commonly observed?

Wrist, knee, and joints of the fingers, hands, and feet Signup and view all the answers

Which of the following statements regarding RA's progression is true?

Erosion of underlying bone occurs as the disease advances Signup and view all the answers

What contributes to symmetric involvement of joints in RA?

Increasing number of joints involved Signup and view all the answers

What might be observed with increased joint swelling in RA?

Widespread joint involvement Signup and view all the answers

Which combination of factors is considered to contribute to the intrinsic joint vulnerability?

Meniscal injury, Malalignment, Obesity Signup and view all the answers

What is a characteristic of smokers with knee osteoarthritis (OA) compared to non-smokers?

Greater cartilage loss Signup and view all the answers

What primarily leads to the development of osteoarthritis (OA) according to the pathogenesis?

Imbalance between anabolic and catabolic repair activity Signup and view all the answers

Which of the following scenarios can result in tissue failure leading to osteoarthritis?

Excessive joint loading Signup and view all the answers

What is the role of the collagen network in articular cartilage?

It provides structure and strength to the cartilage matrix Signup and view all the answers

How does physical activity impact the risk of osteoarthritis?

Higher risk is linked only to contact sports Signup and view all the answers

What condition could indicate the advancement of osteoarthritis in a patient?

Weakening of the collagen network Signup and view all the answers

Which of the following is considered an extrinsic factor influencing the risk of osteoarthritis?

Obesity Signup and view all the answers

What is the maximum number of points that can be earned from the joint involvement category in the classification criteria for RA?

5 points Signup and view all the answers

Which of the following components is a nonspecific indicator of general levels of inflammation?

Erythrocyte Sedimentation Rate Signup and view all the answers

Which imaging techniques can provide accurate diagnosis for joint changes associated with RA?

Conventional x-rays and MRI Signup and view all the answers

What condition is characterized by the presence of autoantibodies such as anti-citrullinated protein?

Rheumatoid arthritis Signup and view all the answers

How many total points are required to classify a diagnosis as rheumatoid arthritis?

6 points Signup and view all the answers

The presence of which factor supports the diagnosis of rheumatoid arthritis but can also be found in healthy individuals?

Serum rheumatoid factor Signup and view all the answers

Which category in the RA classification criteria involves blood tests for an abnormal autoimmune response?

Blood tests for compounds Signup and view all the answers

What is the purpose of the 51 joints being assessed in the context of diagnosing RA?

To evaluate deformity, tenderness, and swelling Signup and view all the answers

Study Notes

Arthritis Overview

Arthritis is a general term for joint inflammation.
The presentation discusses rheumatoid arthritis (RA) and osteoarthritis (OA).

Rheumatoid Arthritis (RA)

RA is a chronic, systemic autoimmune disease.
It causes inflammation in connective tissues, primarily in joints.
The first tissue affected is the synovial membrane, which then spreads to articular cartilage, fibrous joint capsule, and surrounding ligaments and tendons.
RA is characterized by inflammation of the synovial membrane, systemic signs and symptoms, and normal synovial fluid.

Joint Disease Classification

Joint diseases are classified as inflammatory or non-inflammatory.
Inflammatory joint diseases, like RA, are characterized by inflammation of the synovial membrane.
Non-inflammatory joint diseases, like OA, are not characterized by this inflammation.
Joint disease diagnosis involves evaluating synovial membrane inflammation, systemic signs & symptoms, and synovial fluid.

Rheumatoid Arthritis (RA) Key Characteristics

Rheumatoid factors (autoantibodies) are present in the synovial fluid and synovial membranes of people with RA.
Around 80% of people with RA are rheumatoid factor positive, while 20% are RF negative.
The interaction between rheumatoid factor and immunoglobulins initiates an inflammatory reaction.
The cause of RA is unknown but likely involves a combination of genetic and environmental factors.

Pathogenesis of Rheumatoid Arthritis (RA) Step by Step

An unknown cause triggers an immune response.
The immune response becomes abnormal.
Inflammation starts in the synovium, the synovial membrane where cartilage is present.
The inflammatory response is perpetuated, leading to continuous inflammation.
Progressive joint destruction occurs.

Synovial Joint Anatomy

Ligaments and tendons support the bones and control joint motion.
Synovial membrane has 2 layers, which facilitate phagocytosis of bacteria and synovial fluid's viscous quality
Periosteum, the deep layer of bone, contains cells involved in bone formation.
Articular hyaline cartilage reduces friction within a joint and distributes weight-bearing forces.

Rheumatoid Arthritis (RA): Additional Manifestations

RA can affect other body systems, including cardiovascular, pulmonary, and gastrointestinal systems.
Infections and osteoporosis are additional potential manifestations.

Rheumatoid Arthritis (RA): Epidemiology

In 2015, approximately 300,000 Canadians had RA, with a 0.9% cumulative prevalence.
The prevalence of RA has been steadily increasing.
Median life expectancy is reduced by 3-7 years in people with RA.
Onset typically occurs between the ages of 20 and 50, however men and women are equally affected after the age of 60.

Rheumatoid Arthritis (RA): Diagnosis and Criteria

Diagnosis is challenging in early stages due to gradual onset and waxing/waning symptoms.
Joint involvement, blood tests for abnormal immune response (autoantibodies), and duration of symptoms are used to diagnose.
Radiography and MRI can be used to assess joint changes.
At least 6 out of 10 classification criteria are required for an RA diagnosis.

Osteoarthritis (OA)

OA is a slowly progressive articular disease, starting in cartilage and affecting underlying bone, soft tissues and synovial fluid.
Two classifications:
- Primary OA: Unknown cause, thought to be related to a defect in articular cartilage.
- Secondary OA: Known cause (trauma, infection, lower limb alignment issues).

Cartilage

Cartilage provides friction-free movement within the joint.
It also absorbs shock, and disperses weight-bearing forces across the joint surface.

Cartilage Characteristics

Cartilage requires elasticity, regaining form after compression.
It requires high tensile strength to remain effective.

Cartilage Components

Chondrocytes produce the collagen and proteoglycans within the cartilage Matrix.
Water makes up 70-85% of the cartilage matrix.

How Proteoglycans Work

Proteoglycans are negatively charged, so their aggregation causes them to repel each other, taking up more volume in the matrix.
The matrix is limited by the collagen framework, contributing to cartilage stiffness.

Cartilage Absorption

When cartilage is compressed, proteoglycans aggregate together, increasing their repulsive force.
This contributes to increasing compressive stiffness.

Cartilage Maintenance

Chondrocytes synthesize matrix (anabolic activity) and secrete matrix-degradation enzymes (catabolic activity) to maintain cartilage's normal turnover
The health of chondrocytes determines the integrity of joints.

Osteoarthritis (OA): Epidemiology

OA is the most common joint disease.
Prevalence increases with age being estimated at 60% in men and 70% in women aged 65+.
Hip OA is more common in men, while OA of IP joints and thumbs are more prevalent in women.

Osteoarthritis (OA): Etiology

OA is a multifactorial disease with intrinsic and extrinsic factors.
Intrinsic factors (non-modifiable): Age, gender, genetic susceptibility and nutritional factors play a role.
Extrinsic factors (modifiable): Physical activity (repetitive) and obesity.
Smoking can influence the severity of OA presentations

Osteoarthritis (OA): Pathogenesis

The pathological process of OA originates in excessive joint loading causing failure of the cartilage (Scenario 1).
Articular cartilage and subchondral bone are normal but the material properties of either are inferior (Scenario 2).

Osteoarthritis (OA): Pathogenesis of Cartilage

Degradation of cartilage (OA) is the end result of an imbalance in catabolic and anabolic repair activities.
Early changes to the cartilage matrix include enzymatic breakdown of the collagen network and proteoglycan aggregation interfering with load bearing abilities affecting mechanical transfer.
Water and synovial fluid are disrupted, affecting stability.

Osteoarthritis (OA): Later Cartilage Changes

With loss of cartilage, inflammation occurs with ligamentous laxity and muscle weakness.
Mechanical stress shifts to subchondral bone.
New bone called osteophytes form and "joint mice" can be produced from small cartilage fragments which irritate the synovial membrane.

Osteoarthritis (OA): Clinical Presentation

OA pain is often motion related, not aneural (not arising from cartilage itself).
Pain can result from nerve endings in the periosteum covering osteophytes, microfractures, joint instability and/or synovial inflammation.

Osteoarthritis (OA): Additional Clinical Presentation Characteristics

Common symptoms beside pain include:
- Limited range of motion
- Crepitus (grinding) in motion.
- Joint effusion.
- Joint malalignment and deformities are also possible.
Stiffness (often less than 30 minutes) after inactivity can occur.

Clinical Presentation of Osteoarthritis (OA)

Pain and symptoms generally increase or occur with motion.
Stiffness (often less than 30 minutes) is present after periods of inactivity such as sitting or sleeping.
Swelling, if presented is generally mild and focal to the affected joint.

OA Affected Joints

Commonly affected joints include: hips, knees, ankles, feet, hands, wrists, neck and the lower back (lumbar and sacroiliac joints).

Contrast OA and RA

OA is usually one sided, and primarily affects weight bearing joints, while RA is symmetrical.
Mornings stiffness is usually decreased by physical activity in OA and remains in RA
OA can be triggered by factors such as trauma, infection and lower limb alignment issues, while RA has an uncertain, likely multifactorial, cause.
No systemic symptoms exist for OA, while RA may exhibit these symptoms like fatigue and weight loss.
RA is associated with rheumatoid factors whilst OA is not.

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Description

Test your knowledge on osteoarthritis, its effects on joints, and the role of chondrocytes and ligaments in maintaining joint health. This quiz covers prevalence statistics, joint changes in rheumatoid arthritis, and the impact of mechanical loading on cartilage. Perfect for students and professionals interested in musculoskeletal health.