LEC 6 arthritis

• Osteoarthritis:

  • Risk Factors:
  • Age: More common in older individuals due to wear and tear on joints over time
  • Obesity: Excess weight can increase mechanical stress on joints, leading to cartilage damage
  • Joint Overuse: Repetitive stress or injury to joints can contribute to osteoarthritis
  • Genetics: Family history of osteoarthritis can increase the risk
  • Joint Misalignment: Structural abnormalities can predispose individuals to osteoarthritis
• Aetiology:

  • Primary Osteoarthritis: Idiopathic degenerative changes in joints
  • Secondary Osteoarthritis: Resulting from underlying conditions like joint trauma
• Pathogenesis:

  • Cartilage Degeneration: Breakdown of articular cartilage due to mechanical stress
  • Subchondral Bone Changes: Alterations in subchondral bone density
  • Synovial Inflammation: Low-grade inflammation in the synovium
  • Osteophyte Formation: Bony outgrowths at joint margins
• Morphology:

  • Fibrillation: Irregularities and fraying of articular cartilage
  • Osteophytes: Bony outgrowths at joint margins
  • Subchondral Sclerosis: Increased bone density beneath cartilage
  • Joint Space Narrowing: Reduced space between joint surfaces
  • Synovial Thickening: Inflammation and hypertrophy of the synovial lining
• Clinical Manifestations/Complications:

  • Joint Pain: Worsens with activity and improves with rest
  • Stiffness: Morning stiffness and reduced range of motion
  • Swelling: Joint swelling due to synovial inflammation
  • Crepitus: Audible or palpable joint noises during movement
  • Functional Impairment: Difficulty performing daily activities
  • Joint Deformities: Malalignment, contractures, or bony enlargements
  • Complications: Increased risk of falls, joint instability, and reduced quality of life
• Rheumatoid arthritis:

  • Risk Factors:
  • Genetic Predisposition: Family history increases the risk
  • Gender: Women are more commonly affected
  • Environmental Factors: Exposure to certain infections or toxins
  • Smoking: Significant risk factor
  • Age: More common in middle-aged individuals
• Aetiology:

  • Autoimmune Disorder: Immune system attacks the synovium
  • Genetic Factors: Variations in certain genes
  • Environmental Triggers: Infections, smoking, and other factors
• Pathogenesis:

  • Synovial Inflammation: Chronic inflammation of the synovial membrane
  • Pannus Formation: Abnormal proliferation of synovial tissue
  • Cartilage Erosion: Destruction of articular cartilage
  • Bone Erosion: Progressive destruction of bone tissue
  • Systemic Manifestations: Can affect other organs and systems
• Morphology:

  • Synovial Pannus: Invasive, hyperplastic synovial tissue
  • Joint Erosions: Bone loss and destruction at joint margins
  • Synovitis: Inflammation of the synovial membrane
  • Rheumatoid Nodules: Subcutaneous nodules
• Clinical Manifestations/Complications:

  • Symmetrical Polyarthritis: Involvement of multiple joints
  • Morning Stiffness: Prolonged stiffness in the morning
  • Fatigue: Persistent fatigue and malaise
  • Systemic Symptoms: Fever, weight loss
  • Extra-articular Manifestations: Affect organs such as the lungs, heart, and eyes
  • Joint Deformities: Severe joint damage can lead to deformities
• Gouty arthritis:

  • Risk Factors:
  • Diet: High intake of purine-rich foods
  • Genetics: Family history predisposes individuals
  • Age and Gender: More common in men, particularly after middle age
  • Medical Conditions: Obesity, hypertension, diabetes, and kidney disease
  • Medications: Certain medications can trigger gout attacks
• Aetiology:

  • Hyperuricemia: Elevated levels of uric acid in the blood
  • Crystal Deposition: Deposition of urate crystals in joints and tissues
  • Impaired Uric Acid Excretion: Reduced excretion of uric acid by the kidneys
  • Overproduction of Uric Acid: Increased production of uric acid
• Pathogenesis:

  • Acute Gouty Arthritis: Sudden onset of severe joint pain
  • Chronic Gout: Recurrent attacks leading to joint damage
  • Tophi Formation: Deposits of urate crystals in soft tissues
  • Inflammatory Response: Activation of the immune system
  • Joint Degeneration: Chronic inflammation and crystal deposition
• Morphology:

  • Urate Crystals: Needle-shaped monosodium urate crystals
  • Tophi: Nodules containing urate crystals
  • Joint Effusion: Swelling of joints due to inflammatory fluid
  • Erosive Arthritis: Joint damage and erosion of bone
• Clinical Manifestations/Complications:

  • Acute Gout Attack: Sudden onset of severe joint pain
  • Tophaceous Gout: Formation of tophi in joints and tissues
  • Chronic Arthritis: Recurrent attacks leading to joint deformities
  • Renal Complications: Uric acid kidney stones, nephropathy
  • Cardiovascular Risk: Associated with an increased risk of cardiovascular disease