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Arthritis
Osteoarthritis (OA)
 local degenerative joint disorder
 rt aging & wear and tear from repetitive stress
Patho
 Proinflammatory Cytokines- TNF & IL1
 Loss of articular cartilage
 Wear of underlying bone
 Formation of bone spurs
 Weight-bearing joints often affected
Arthritis
Osteoarthritis S & S
osteophytes & irregular cartilage surface
cause
 Localized joint pain
 inc with wt bearing & activity
 Crepitus
Bone spurs cause
 Heberden’s nodes
 Joint near nail
 Bouchard’s nodes
 Middle joint
Infectious (septic) Arthritis
 Joint infection due to bacteria usually via
bloodstream
 Lyme disease
 deer tick-borne spirochete
 produces red macule or papule, flulike S & S
S & S
 RT localized infection (one joint) & systemic
inflammation
Autoimmunity
Rheumatoid Arthritis (RA)
 Type III -Immune Complex
 Cell-mediated tissue destruction of
connective tissues
 Women
 Cause multifactorial
 genetics HLA-DR4
 environment
 hormones
Arthritis
RA Autoimmunity
S & S
Systemic
 Anorexia
 Fatigue
 Weakness
 Low grade fever
 Rheumatoid Factors
(RF)
 Antibody against
IgG & IgM
Local
 Bilat small joints
 Swollen
 Stiff
 Pain
 Red
 Warm
 At least 3 joints > 6
weeks
RA Long term S & S
 Deformity of joint
 Skeletal muscle
atrophy
 Joint fibrosis
 Alt bone alignment
Juvenile Rheumatoid Arthritis [JRA]
chronic inflammatory disease affecting
synovium – Acute onset
RF NOT present ANA present
3 subtypes JRA
1. Systemic onset- Stills disease
2. Polyarticular arthritis
 localized to 5 or more joints
3. Pauciarticular arthritis
 affecting 4 or fewer joints
 Uveitis- iris inflamm
Adult-Onset Still Disease
 Seronegative polyarthritis
Same S & S of JRA
 High-spiking fever
 Rash on trunk & extremities
 Possible sore throat
 Hand joints
 Visceral involvement
Ankylosing Spondylitis
Autoimmune HLA-B27
S & S
 Low back pain
 Severe am stiffness
 Limited ROM (rigidity)
Complication
 Postural changes
 Osteoporosis
Acute Gouty Arthritis
deposits of uric acid crystals & urate salts
(purine waste product) in tissue
Etiology
 Dec excretion by kidneys
 Genetic- lack of uricase
S & S
 Elev uric acid
 Joint warm, red, & tender
 great toe MTP joint
 Tophi (lg hard nodule) ~ 10 years later
 Ears, eyes, cardiac & renal
Arthritis
Fibromyalgia Syndrome
 Cause remains unknown
Primary Symptom
 Widespread pain in all quadrants of body
 18 specific trigger points for pain & tenderness
 additional symptoms
 Fatigue
 Insomnia
 Depression
 Concentration problems

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Arthritis

  • 2. Osteoarthritis (OA)  local degenerative joint disorder  rt aging & wear and tear from repetitive stress Patho  Proinflammatory Cytokines- TNF & IL1  Loss of articular cartilage  Wear of underlying bone  Formation of bone spurs  Weight-bearing joints often affected
  • 4. Osteoarthritis S & S osteophytes & irregular cartilage surface cause  Localized joint pain  inc with wt bearing & activity  Crepitus Bone spurs cause  Heberden’s nodes  Joint near nail  Bouchard’s nodes  Middle joint
  • 5. Infectious (septic) Arthritis  Joint infection due to bacteria usually via bloodstream  Lyme disease  deer tick-borne spirochete  produces red macule or papule, flulike S & S S & S  RT localized infection (one joint) & systemic inflammation
  • 6. Autoimmunity Rheumatoid Arthritis (RA)  Type III -Immune Complex  Cell-mediated tissue destruction of connective tissues  Women  Cause multifactorial  genetics HLA-DR4  environment  hormones
  • 8. RA Autoimmunity S & S Systemic  Anorexia  Fatigue  Weakness  Low grade fever  Rheumatoid Factors (RF)  Antibody against IgG & IgM Local  Bilat small joints  Swollen  Stiff  Pain  Red  Warm  At least 3 joints > 6 weeks
  • 9. RA Long term S & S  Deformity of joint  Skeletal muscle atrophy  Joint fibrosis  Alt bone alignment
  • 10. Juvenile Rheumatoid Arthritis [JRA] chronic inflammatory disease affecting synovium – Acute onset RF NOT present ANA present 3 subtypes JRA 1. Systemic onset- Stills disease 2. Polyarticular arthritis  localized to 5 or more joints 3. Pauciarticular arthritis  affecting 4 or fewer joints  Uveitis- iris inflamm
  • 11. Adult-Onset Still Disease  Seronegative polyarthritis Same S & S of JRA  High-spiking fever  Rash on trunk & extremities  Possible sore throat  Hand joints  Visceral involvement
  • 12. Ankylosing Spondylitis Autoimmune HLA-B27 S & S  Low back pain  Severe am stiffness  Limited ROM (rigidity) Complication  Postural changes  Osteoporosis
  • 13. Acute Gouty Arthritis deposits of uric acid crystals & urate salts (purine waste product) in tissue Etiology  Dec excretion by kidneys  Genetic- lack of uricase S & S  Elev uric acid  Joint warm, red, & tender  great toe MTP joint  Tophi (lg hard nodule) ~ 10 years later  Ears, eyes, cardiac & renal
  • 15. Fibromyalgia Syndrome  Cause remains unknown Primary Symptom  Widespread pain in all quadrants of body  18 specific trigger points for pain & tenderness  additional symptoms  Fatigue  Insomnia  Depression  Concentration problems

Hinweis der Redaktion

  1. OA
  2. Bony bumps on the finger joint closest to the fingernail are called Heberden's nodes. Bony bumps on the middle joint of the finger are known as Bouchard's nodes.
  3. http://www.wormsandgermsblog.com/2010/09/articles/diseases/other-diseases/lyme-disease-in-australia/
  4. Introduction of foreign proteins Ag-Ab complexes form Deposited & trapped in tissues kidneys, lungs, skin, joints, or blood vessels normally removed from blood results in inflammatory response Complement Neutrophils- lysosomes Tissue destruction Human Leukocyte antigen (HLA)
  5. Granulation occurs (Pannus)- nodules in tissue
  6. Antinuclear antibodies
  7. Arthritis of sacroiliac joints