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LAPORAN PAGI

OSTEOARTHRITIS

Hannia Dinanda Rizki


15103 - 14227

DATA PASIEN

Nama
Jenis Kelamin
Usia
Tgl Pemeriksaan
Klinis
Permintaan Foto

Ny. S
Perempuan
54 tahun
23 Mei 2016
Suspek arthritis genu
Foto polos genu AP &
lateral view

HASIL PEMERIKSAAN
Foto genu AP dan lateral view, kondisi cukup, hasil:
Tak tampak soft tissue swelling
Tak tampak diskontinuitas tulang
Tampak osteofit pada condylus lateral dan medial os tibia
et femur bilateral disertai subchondral sclerotic genu
bilateral
Tampak deformitas condylus medialis os tibia sinistra
Eminentia intercondylaris dextra meruncing, eminentia
intercondylaris sinistra tak meruncing
Tampak kalsifikasi di pembuluh darah regio poplitea
bilateral dan kalsifikasi di soft tissue regio poplitea bilateral
Joint space dextra et sinistra menyempit

KESAN
Osteoarthritis genu dextra grade III
dan osteoarthritis genu sinistra grade
IV
Arteriosklerosis regio poplitea
bilateral
Fabela poplitea bilateral

OSTEOARTHRITIS

NORMAL KNEE JOINT

NORMAL KNEE JOINT

NORMAL KNEE JOINT

PRIMARY OSTEOARTHRITIS
Also known as Primary Degenerative Arthritis,
Degenerative Joint DiseaseDJD)
The most common form of arthritis, prevalence
with increasing age
Results from intrinsic degeneration of articular
cartilage mechanical stress of excessive wear &
tear in weightbearing joints
Mostly involves hips, knees & hands
Imaging findings (Figure):
Marginal osteophyte formation
Subchondral sclerosis
Subchondral cysts
Narrowing of joint space

Marginal osteophyte formation

Subchondral sclerosis

Subchondral cyst formation

SECONDARY
OSTEOARTHRITIS
Predisposing condition

Trauma
Infection
Avascular necrosis
Calcium pyrophosphate
deposition disease
Rheumatoid arthritis

Most frequently
trauma damages
or leads to damage of
the articular cartilage

Radiographic
findings (same as
primary form with
several special
clues)
Atypical age
Atypical
appearance
(unilateral,
asymmetrical)
Unusual location

RISK FACTOR

Joint dysplasia
Trauma
Occupation
Bone density
Obesity
Family history

CLINICAL MANIFESTATION
Symptom

Sign

Pain (aggravated by
exertion, relieved by
rest)
Stiffness
Swelling
Deformity
Loss of function

Joint swelling
Muscle wasting
Deformity
Local tenderness
Limited movement
Crepitus
Instability

KRITERIA DIAGNOSIS
Based klinis & lab
Sn 92% Sp 75%

Based klinis &


radiologi
Sn 91% Sp 86%

Based klinis & lab


Sn 95% Sp 69%

Nyeri lutut dg 5 dari


9:

Nyeri lutut dg 1 dari


3:

Nyeri lutut dg 3 dari


6:

Usia >50 tahun


Kekakuan >30
Krepitus
Bony tenderness
Pembengkakan
tulang
No palpable
warmth
ESR <40 mm/jam
RF <1:40

Usia <50 tahun


Kekakuan <30
Krepitus
Osteofit

Usia >50 tahun


Kekakuan <30
Krepitus
Bony tenderness
Pembengkakan
tulang
No palpable
warmth

KELLGREN-LAWRENCE GRADING
SCALE

KELLGREN-LAWRENCE GRADING
SCALE

RHEUMATOID
ARTHRITIS

RHEUMATOID ARTHRITIS

More common in females


Frequently involving PIP and wrists
It is usually bilateral and symmetrical
Imaging findings:
Soft tissue swelling
Periarticular osteoporosis
Erosions carpal-metacarpal, MCP & PIP joints
Ulnar deviation at MCP joints, subluxation of
MCP joints, and ligamentous laxity swanneck & boutonnire deformities

RHEUMATOID ARTHRITIS
Erosions of carpals, ulnar styloid
Narrowing of radiocarpal joint space
Marked uniform narrowing of joint space with
little or no subchondral sclerosis of the larger
joints
Ligamentous laxity of cervical spine forward
subluxation of C1 on C2 (atlantoaxial
subluxation) produce cord compression if
severe
RA may also cause narrowing, sclerosis, and
eventual fusion of the facet joints in the cervical
spine

GOUT ARTHRITIS

GOUT ARTHRITIS
Deposition of calcium
urate crystals in the joint
Extremely long latent
period (5-7 years)
between onset of
symptoms and
visualization of bone
changes not a radiologic
diagnosis
Tends to be
monoarticular at its
onset and asymmetric
later

More common in males


Often affect MTP of the
great toe
Imaging findings:
Sharply marginated,
juxtaarticular erosion,
which tends to have a
sclerotic border ratbites
Joint space narrowing (late
finding)
Little or no periarticular
osteoporosis
Tophi

TERIMA KASIH
MOHON ASUPAN