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Rhumatoid arthritis

Rhumatoid arthritis. Autoimmune inflamatory disease Occre in adults Multisystemic disorder فوضى متعددة شاملة Seropositive arthritis Mainly affect the small joints of the hands and feets

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Rhumatoid arthritis

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  1. Rhumatoid arthritis • Autoimmune inflamatory disease • Occre in adults • Multisystemic disorderفوضى متعددة شاملة • Seropositive arthritis • Mainly affect the small joints of the hands and feets • Cervical spine and rarly large joints are also affected,speciallyatlantoaxial and shoulder joint

  2. Radiological appearances • Soft tissue swelling.periostitis spindle shape appearances of digits • Osteoporosis.periarticular • Bone erosion • Alignment deformity,eg.ulnardeviation,swan neck and botounare. • Periosteal reactionرد فعل سمحاقي • Secondry osteoarthritis

  3. Clinical and x-ray manisfestations • Seropositiverh factor is present in blood • Gointpain,fever,weight loss etc • Soft tissue swellings spindle shape of interphalengeal joints • Osteoporosis • Joint space changes and alignment deformities • Periostitisالتهاب السمحاق • Erosions • Secondry osteoarthritis

  4. Invistigations • X-ray • Ultrasound • CT • Radionuclide studies • MRI

  5. Psoriasiatic arthritis • Seronegative arthritis • Affect the small jpints of hands and feet • Nail changes and skin changes • Affect distal and proximal interphalangealgoints • Affect the spine with syndesmophyte formation • Sacroillitis

  6. Reiters disease • Syndrome of arthritis,urethritis and conjunctivitis • Affect the feet more than the hands • Painfull erosion of calcaneus with spur formation • Sacroillitis • Young adults

  7. Ankylosingspondylitis • Seronegative arthritis • HLA –B27 is positive • Affect young adults • Mainly affect the spine with chacteristic changes • Squaring of vertebral bodies and bamboo spine • Sacroillitis is bilateral and symetrical.sacroillic joints are assesed with prone view of sacroilliac joints

  8. Gout • A metabolic disease with abnormality of uric acid • Affect the great toe of feet • Bone erosions • Osteoporosis تحلل العضام • Tophi formation

  9. Osteoarthritis • Degenerative disease • Affect mainly the weight bearing jointsيوثر على المفاصل بسبب الوزن • Primary when no cause is known • Secondry when the goint is abnormal • Mainly affect old people • Main complain of patient is pain and stiffnessتصلب • More common in over wight people

  10. X-ray appearences • Joint space narrowing • Increase bone density • Osteophyte formation • Loose body • Cyst formation • Vacuum phenomenon in the intervertebral spaces

  11. Invistigations • X-ray • CT scan

  12. Spondylolisthesis • When there is slip of one vertebra over another • Usually occure due to stress fracture in the parse • Four grades • 25% • 50% • 75% AND TOTAL

  13. OSTEOPOROSIS • Due to decrease bone mass • Decrease bone mass result in increase incidence of fracture • Senile osteoporosis occue in old people.there is loss of cortical and trabecularbone.Fractureoccure more commonly in femoral neck and humerous • Postmenopausal osteoporosis.occure in womenabove 50 years of age.vertebral fractures are more common

  14. Rickets • Vitamin D defficency disease • Occure in childern • There is lack of mimeralisation of bones • Lack of vitamin D • Lack of calcium • The above defficiency may be either nutritional or disease process

  15. X-ray appearences • Loss of normal zone of proviosnal calcification • Fraying of growth plate • Splaying cupping of metaphysis • Osteoporosis • Pigeon chest • Rickety rosy • Bending of bones(bowing of bones)

  16. Osteomalacia • Vitamin defficency disease occure in addults • More common in females • Bone become soft so bowing occure • Looser zones bilateral and symetrical • Compression of vertebrae • Cordfish vertebra

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