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