Video: Osteoarthritis & Rheumatoid Arthritis | MMBmarised
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Keywords: Alan Bates , Bones, James Glanville, Tony Dickenson, Kristine Oleinika
OtherMMBDiseases
Articular Cartilage
Timestamps: 0:00 2:35 Osteoarthritis / degenerative joint disease 3:00 Structure of healthy cartilage – aggrecan and hyaluronan 3:53 Crepitus 4:55 Osteophytes/ Heberden’s Nodes 6:10 X ray Osteoarthritis (LOSS) 7:36 Other causes of Osteoarthritis 8:09 OA Histology – eburnation, tidemark advancement, cysts 11:00 Treatment of OA Rheumatoid Arthritis – RF (seropositive) 13:36 HLADRB1 susceptibility gene for RA 13:45 Ulnar Deviation 14:10 Pannus 14:31 Rheumatoid nodules 17:40 Treatment of RA with DMARDS 14:50 Rheumatoid arthritis pathophysiology – ACPA
DMARDS
Methotrexate (inhibits DHF reductase, also used for leukemias)
B cell depletion rituximab (anti-CD20) ,
TNF block infliximab
T cell co-stim (CTLA4) block: abatacept
Il-6-R blockade Tocilizumab
Amitriptyline, gabapentin,
NSAIDS, porphymornas ginvialis ,
Smoking and oral periodontal disease can lead to citrullinated peptides being generated
Many ACPA’s become generated which leads to osteoclasts becoming activated and munching away at the trabecular bone L
Clinical skills, locomotor exam, knee exam
Fibroblasts aggressively make chondrocytes
A second hit – ie stress on the bone needs to occur in order for SYNOVIAL INFLAMMATION (RA), vitamin D deficiency, degenerative joint disease