1. 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 3. Osteoarthritis S & Sosteophytes & irregular cartilage surfacecause Localized joint pain inc with wt bearing & activity CrepitusBone spurs cause Heberdens nodes Joint near nail Bouchards nodes Middle joint 4. Infectious (septic) Arthritis Joint infection due to bacteria usually viabloodstream Lyme disease deertick-borne spirochete produces red macule or papule, flulike S & S S&S RT localized infection (one joint) & systemicinflammation 5. AutoimmunityRheumatoid Arthritis (RA) Type III -Immune Complex Cell-mediated tissue destruction ofconnective tissues Women Cause multifactorial geneticsHLA-DR4 environment hormones 6. RA AutoimmunityS&S Systemic Local Anorexia Bilat small joints Fatigue Swollen Weakness Stiff Pain Low grade fever Red Rheumatoid Factors Warm(RF) Antibodyagainst At least 3 joints > 6 IgG & IgM weeks 7. RA Long term S & S Deformity of joint Skeletal muscleatrophy Joint fibrosis Alt bone alignment 8. Juvenile Rheumatoid Arthritis [JRA]chronic inflammatory disease affectingsynovium Acute onsetRF NOT presentANA present 3 subtypes JRA1. Systemic onset- Stills disease2. Polyarticular arthritis localized to 5 or more joints3. Pauciarticular arthritis affecting 4 or fewer joints Uveitis- iris inflamm 9. 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 10. Ankylosing SpondylitisAutoimmune HLA-B27 S&S Low back pain Severe am stiffness Limited ROM (rigidity) Complication Postural changes Osteoporosis 11. Acute Gouty Arthritisdeposits of uric acid crystals & urate salts(purine waste product) in tissue Etiology Dec excretion by kidneys Genetic- lack of uricaseS&S Elev uric acid Joint warm, red, & tender great toe MTP joint Tophi (lg hard nodule) ~ 10 years later Ears, eyes, cardiac & renal 12. 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