ELDER TIP Primary osteoarthritis is strongly associated with aging, and indeed aging may predispose to the cartilage degeneration common in persons with osteoarthritis.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Psoriatic arthritis:
Causes
(Professional Guide to Diseases (Eighth Edition))
Evidence suggests that predisposition to psoriatic arthritis is hereditary; 20% to 50% of patients are human leukocyte antigen-B27 positive. However, onset is usually precipitated by streptococcal infection or trauma.
About 5% to 7% of patients with psoriasis develop psoriatic arthritis. It occurs in up to 1% of the general population.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Septic arthritis:
Causes and incidence
(Professional Guide to Diseases (Eighth Edition))
In most cases of septic arthritis, bacteria spread from a primary site of infection — usually in adjacent bone or soft tissue — through the bloodstream to the joint. Common infecting organisms in children are group B Streptococcus and Haemophilus influenzae. Adults are usually infected by Staphylococcus, Streptococcus (pneumonia), and group B Streptococcus, whereas chronic septic arthritis is caused by Mycobacterium tuberculosis and Candida albicans.
Various factors can predispose a person to septic arthritis. Any concurrent bacterial infection (of the genitourinary or the upper respiratory tract, for example) or serious chronic illness (such as malignancy, renal failure, rheumatoid arthritis, systemic lupus erythematosus, diabetes, or cirrhosis) heightens susceptibility. Consequently, elderly people and those who abuse I.V. drugs run a higher risk of developing septic arthritis. Of course, diseases that depress the immune system and immunosuppressive therapy increase susceptibility. Other predisposing factors include recent articular trauma, joint arthroscopy or other surgery, intra-articular injections, and local joint abnormalities.
Septic arthritis may be seen at any age in children, but it occurs most often in children younger than age 3. It’s uncommon from age 3 until adolescence, at which time the incidence increases again.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Psoriasis:
Causes and incidence
(Professional Guide to Diseases (Eighth Edition))
The tendency to develop psoriasis is genetically determined. Researchers have discovered a significantly higher-than-normal incidence of certain human leukocyte antigens (HLAs) in families with psoriasis, suggesting a possible immune disorder. Onset of the disease is also influenced by environmental factors. Trauma can trigger the isomorphic effect or Koebner’s phenomenon, in which lesions develop at sites of injury. Infections, especially those resulting from beta-hemolytic streptococci, may cause a flare of guttate (drop-shaped) lesions. Other contributing factors include pregnancy, endocrine changes, climate (cold weather tends to exacerbate psoriasis), and emotional stress.
Generally, a skin cell takes 14 days to move from the basal layer to the stratum corneum, where, after 14 days of normal wear and tear, it’s sloughed off. The life cycle of a normal skin cell is 28 days, compared with only 4 days for a psoriatic skin cell. This markedly shortened cycle doesn’t allow time for the cell to mature. Consequently, the stratum corneum becomes thick and flaky, producing the cardinal manifestations of psoriasis.
Psoriasis affects approximately 2% of the population in the United States, and incidence is higher in whites than other races. Although this disorder is most common in young adults, it may strike at any age, including infancy.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Polyarticular Arthritis:
Differential Overview
(Field Guide to Bedside Diagnosis)
❑ Osteoarthritis
❑ Rheumatoid arthritis
❑ Lyme arthritis
❑ Systemic lupus erythematosus
❑ Psoriatic arthritis
❑ Polyarticular gout
❑ Viral arthritis
❑ Scleroderma
❑ Reiter syndrome
❑ Inflammatory bowel disease
❑ Gonococcal arthritis
❑ Ankylosing spondylitis
❑ Systemic vasculitis
❑ Sarcoidosis
❑ Pseudogout (CPPD)
❑ Acute rheumatic fever
❑ Still disease
» READ BOOK EXCERPT ONLINE »
Source: Field Guide to Bedside Diagnosis, 2007
Acute Monoarticular Arthritis:
Differential Overview
(Field Guide to Bedside Diagnosis)
❑ Injury
❑ Gout
❑ Osteoarthritis
❑ Lyme disease
❑ Gonococcal arthritis
❑ Seronegative spondyloarthropathy
❑ Septic arthritis
❑ Pseudogout
❑ Septic bursitis
❑ Avascular necrosis
» READ BOOK EXCERPT ONLINE »
Source: Field Guide to Bedside Diagnosis, 2007
Osteoarthritis:
Causes
(Handbook of Diseases)
Osteoarthritis is widespread, occurring equally in both sexes until age 55. After age 55, incidence is higher in women. Incidence is after age 40; its earliest symptoms generally begin in middle age and may progress with advancing age.
The degree of disability depends on the site and severity of involvement; it can range from minor limitation of the fingers to severe disability in persons with hip or knee involvement. The rate of progression varies, and joints may remain stable for years in an early stage of deterioration.
Primary osteoarthritis, a normal part of aging, results from many things, including metabolic, genetic, chemical, and mechanical factors. Secondary osteoarthritis usually follows an identifiable predisposing event — most commonly trauma, congenital deformity, or obesity — and leads to degenerative changes.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
Psoriatic arthritis:
Causes
(Handbook of Diseases)
Evidence suggests that predisposition to psoriatic arthritis is hereditary; 20% to 50% of patients are human leukocyte antigen-B27-positive. However, its onset may be precipitated by streptococcal infection or trauma.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
Septic arthritis:
Causes
(Handbook of Diseases)
In most cases of septic arthritis, bacteria spread from a primary site of infection, usually in adjacent bone or soft tissue, through the bloodstream to the joint.
Common infecting organisms include four strains of gram-positive cocci — Staphylococcus aureus, Streptococcus pyogenes, Streptococcus pneumoniae, and Streptococcus viridans — and two strains of gram-negative cocci — Neisseria gonorrhoeae and Haemophilus influenzae. Various gram-negative bacilli — Escherichia coli, Salmonella, and Pseudomonas, for example — also cause infection.
Anaerobic organisms such as gram-positive cocci usually infect adults and children older than age 2. H. influenzae most often infects children younger than age 2.
Risk factors
Various factors can predispose a person to septic arthritis. Any concurrent bacterial infection (of the genitourinary or the upper respiratory tract, for example) or serious chronic illness (such as cancer, renal failure, rheumatoid arthritis, systemic lupus erythematosus, diabetes, or cirrhosis) heightens susceptibility. Consequently, alcoholics and elderly people run a higher risk of developing septic arthritis.
Of course, susceptibility increases with diseases that depress the autoimmune system or with prior immunosuppressant therapy. I.V. drug abuse (by heroin addicts, for example) can also cause septic arthritis.
Other predisposing factors include recent articular trauma, joint surgery, intra-articular injections, and local joint abnormalities.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
Psoriasis:
Causes
(Handbook of Diseases)
The tendency to develop psoriasis is genetically determined. Researchers have discovered a significantly higher-than-normal incidence of certain human leukocyte antigens (HLA) in families with psoriasis, suggesting a possible immune disorder. Onset of the disease is also influenced by environmental factors.
Trauma can trigger the isomorphic effect or Koebner’s phenomenon, in which lesions develop at sites of injury. Infections, especially those resulting from beta-hemolytic streptococci, may cause a flare-up of guttate (drop-shaped) lesions. Other contributing factors include pregnancy, endocrine changes, climate (cold weather tends to exacerbate psoriasis), and emotional stress.
Generally, a skin cell takes 14 days to move from the basal layer to the stratum corneum, where after 14 days of normal wear and tear, it’s sloughed off. The life cycle of a normal skin cell is 28 days, compared to only 4 days for a psoriatic skin cell. This markedly shortened cycle doesn’t allow time for the cell to mature. Consequently, the stratum corneum becomes thick and flaky, producing the cardinal manifestations of psoriasis.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
Septic Arthritis:
Septic Arthritis - pathophysiology
(The 5-Minute Pediatric Consult)
- Entry of bacteria into joint space:
- Hematogenous spread
- Direct inoculation (penetrating trauma)
- Extension from bone infection (mainly in children <1 year old when vessels cross from metaphysis to epiphysis)
- Influx of inflammatory cells within the joint capsule
- Rapid destruction of cartilaginous structures within the joint by bacterial and lysosomal enzymes:
- If untreated, may progress to necrosis of the intra-articular epiphysis
Septic Arthritis - etiology
- Bacteria:
- Staphylococcus aureus most common etiology outside of perinatal period (Methicillin-sensitive and Methicillin-resistant)
- Streptococci
- Kingella kingae
- Haemophilus influenzae
- Salmonella
- N. gonorrhoeae
- Neisseria meningitidis
- Borrielia burgdorfderi (Lyme)
- Aseptic arthritis:
- Rubella
- Parvovirus
- Hepatitis B or C
- Mumps
- Herpesviruses (Epstein-Barr virus, cytomegalovirus, herpes simplex virus, varicella zoster virus)
- Epstein-Barr virus
- Varicella
- Candida albicans (neonatal)
>
» READ BOOK EXCERPT ONLINE »
Source: The 5-Minute Pediatric Consult, 2008
Osteomyelitis and Septic Arthritis:
Etiology
(Pediatric Infectious Disease)
Children are colonized with a variety of bacteria; a culture of the nasopharynx
of an asymptomatic child could yield any number of bacteria, including
Staphylococcus aureus and Streptococcus pneumoniae. Usually, these organisms reside on body surfaces with no ill effects. However,
by a process not always well defined, these colonizing bacteria enter the
bloodstream.
Once the bacteria enter the bloodstream, numerous things can occur (Fig. 2.1).
Bacteremia can be transient and resolve without sequelae; this is often the
case with viridans streptococci. Bacteremia, by its very presence in the
systemic circulation, can cause overwhelming sepsis, as is often the case with
Neisseria meningitidis. Bacteria can also be deposited in secondary sites, such as the cerebrospinal
fluid or bone.
The bones are a frequent site of secondary infection because the blood supply
takes a hairpin turn at the metaphyses of long bones, increasing the chance of
the bacteria being deposited. This secondary seeding of bones from the blood is
the major mechanism of pediatric osteomyelitis. This is in contrast to adults,
who usually acquire osteomyelitis from direct inoculation following trauma or
surgical procedures.
Pyogenic arthritis develops in a fashion similar to osteomyelitis, whereby
blood-borne organisms are deposited in the synovium of the joint space. Similar
to the long bones of children, the joint space is highly vascularized and is an
area where bacteremic organisms are readily deposited. Bacterial arthritis can
also spread from a contiguous osteomyelitis; blood vessels can deposit
infection from the metaphysis into the joint space. The organisms of septic
arthritis are similar to those of osteomyelitis.
S. aureus is the most common organisms, followed by S. pneumoniae, Kingella kingae, and group A streptococcus.
» READ BOOK EXCERPT ONLINE »
Source: Pediatric Infectious Disease, 2004
Learn about psoriatic arthritis including the symptoms and treatment of this disease
While the exact cause of psoriatic arthritis is unknown, scientists do know that various factors play a role. What are they?
New treatments, including drugs known as TNFinhibitors, are proving important in the treatment of many cases of psoriatic arthritis. Here's a...
A diagnosis of psoriatic arthritis brings with it a slew of treatment options and choices to make. Here we give you an overview of your options.
See full list of 30 related videos
» Next page: Symptoms of Psoriatic Arthritis
Rate This Website
What do you think about the features of this website?
Take our user survey and have your say:
Website User Survey
Medical Tools & Articles:
Next articles:
Tools & Services:
Medical Articles:
Forums & Message Boards
- Ask or answer a question at the Boards:
