Inflammatory Arthropathies (OA, RA, Ax SpA, JIA)

5 clinical signs of inflammation?

1. swelling

2. redness

3. pain/tenderness

4. heat

5. loss of function

what is osteoarthritis?

degenerative joint disease

the protective (hyaline) cartilage at ends of joints gradually wears down → causes bones to rub together → leads to joint pain

what are some symptoms for OA?

• joint pain

• stiffness

• swelling

• reduced rom/flexibility

• grinding or clicking sensation in the joint

what can OA cause?

formation of osteophytes

whats an osteophyte?

a bone spur

= extr bit of bone that grows along the edges of a joint

why do osteophytes form?

body tries to repair or stabilise a damaged joint by growing more bone

what symptoms can the formation of osteophytes cause?

• joint stiffness

• reduced rom/flexibility

• pain → if rub against nearby tissue or nerves

What is rheumatoid arthritis (RA)?

a long-term autoimmune disease

immune system mistakenly attacks the lining of the joints (synovium) → causes chronic inflammation

what are some symptoms for RA?

• joint pain

• swelling

• stiffness- especially morning lasting over 30 mins

• fatigue

• joint symmetry

whats is Axial Spondyloarthritis (Ax SpA)?

chronic inflammatory arthritis that affects the axial skeleton → the spine and sacroiliac (pelvis) joints

what are some symptoms of Ax SpA?

• chronic low back pain

• morning stiffness

• pain better with exercise/worse with rest

• fatigue

• swelling at joints

• eye or bowel inflammation

• bamboo spine

what is a syndesmophyte?

bridge of new bone that forms between the bones of the spine (one vertebrae to the next)

due to chronic inflammation

why does the spine become stiff?

due to chronic inflammation and new bone formation

why can chest expansion be reduced?

inflammation affects the joints and tissues that normally allow the rib cage to move during breathing

what is enthesitis?

inflammation at an enthesis

this is the point where a tendon, ligament, or joint capsule attaches to bone

what enthesis are affected by Ax SpA?

• achilles tendon insertion → back of heel

• plantar fascia insertion → bottom of the heel/foot

• rib attachments to spine or sternum → can contribute to chest pain/stiffness

• spinal ligament attachments → contributes to spinal pain and stiffness

What is juvenille idiopathic arthritis?

• group of arthritis conditions that affect children and teenagers under 16 years old

• It is an autoimmune/inflammatory condition where the immune system attacks the joints

what are the different sub-groups of JIA?

1. Oligoarticular JIA (4 or less joints affected)

2. Polyarticular JIA (5+ joints affected in first 6 months)

3. Systemic JIA (arthritis with persistent rash/fever)

4. Enthesitis-related JIA (most concerning)