Difference between revisions of "Joints Inflammatory - Pathology"

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#redirect[[:Category:Arthritis]]
 
 
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|backcolour =CDE472
 
|linkpage =Musculoskeletal System - Pathology
 
|linktext =Musculoskeletal System
 
|maplink = Musculoskeletal System (Content Map) - Pathology
 
|pagetype =Pathology
 
|sublink1=Joints - Pathology
 
|subtext1=JOINTS
 
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==Arthritis==
 
[[Image:Cattle fibrinopurulent arthritis.jpg|right|thumb|100px|<small><center>Fibrinopurulent arthritis in cattle (Image sourced from Bristol Biomed Image Archive with permission)</center></small>]]
 
[[Image:Cattle suppurative arthritis.jpg|right|thumb|100px|<small><center>Suppurative arthritis in cattle (Image sourced from Bristol Biomed Image Archive with permission)</center></small>]]
 
 
 
*Inflammation of intra-articular structures
 
*In farm animals usually due to infection
 
*In small animals usually due to non-infectious causes
 
 
 
 
 
*Classification:
 
**According to number of joints involved - '''polyarthritis'''
 
**According to type of inflammatory exudate
 
***'''Serous'''
 
****Increased synovial fluid production
 
****Resolves if uncomplicated
 
***'''Fibrinous'''
 
****Early stages:
 
*****Increased and more opaque synovial exudate
 
*****Enlarged hyperaemic villi
 
*****Small haemorrhages in synovial membrane
 
****Later stages:
 
*****Less exudate
 
*****Thickend synovial connective tissue
 
*****Marked villi proliferation (branching in microscopic preparations)
 
*****Proliferated synovial tissue -> peripheral fibrous tissue attempting repair across defective surface = '''pannus'''
 
****Mild cases resolve
 
****More severe cases - residual inflammation remains
 
****Most severe cases - organising fibrosis +/- ankylosis
 
***'''Purulent'''
 
****Usually from haemoatogenous spread e.g. neonatal navel ill
 
****May extend from adjacent abscesses
 
****More destructive
 
****Erosion of articular surfaces to underlying bone
 
****Forms abscesses
 
****Possible fistulation to the skin
 
 
 
 
 
*Caused by:
 
**Trauma
 
**Infectious organisms (e.g. bacteria, viruses)
 
**Foreign material (urate crystals = gout)
 
**Immune-mediated disease
 
 
 
 
 
==Infectious arthritis==
 
 
 
*'''Bacterial arthritis'''
 
**Most common in food animals, especially young
 
**Portals of entry include:
 
***Navel and GI tract -> bacteraemia
 
***Haematogenously -> polyarthritis
 
***Traumatic inoculation
 
***Extension from bone or periarticular soft tissue
 
 
 
*'''Viral arthritis'''
 
**Progressive inflammatory and degenerative joint disease
 
**Synovitis with cartilage destruction
 
**Chronic mononuclear inflammatory reactions
 
 
 
 
 
===In Sheep===
 
 
 
*[[Retroviridae|'''Maedi visna virus''']]
 
*Bacterial infections mostly affects lambs except for Mycoplasmal artheritis
 
*[[Erysipelothrix rhusiopathiae|'''''Erysipelothrix rhusiopathiae''''']]
 
**Clinical sighns:
 
***Cutaneous erysipelas
 
***Polyarthritis in lambs
 
***Rarely fatal septicaemia
 
**Enters via:
 
***Cuts, abrasions
 
***Castration or docking wounds
 
***Haematogenous spread -> subacute or chronic '''fibrinopurulent polyarthritis'''
 
**Morbidity up tp 50%
 
**Affects mostly unthrifty lmbs
 
**Fibrosis and [[Musculoskeletal Terminology - Pathology|osteophyte]] formation in later stages -> persistent lameness
 
*'''''[[Corynebacterium pyogenes]]'''''
 
**May cause post-dipping joint infections
 
*[[Streptococci|'''''Streptococcus'' spp.''']]
 
**Commonly cause suppurative polyarthritis in lambs
 
**Naval infection -> bacteriamia -> polyarthritis
 
***May also cause blindness and nervous signs if uvea or meninges are affected
 
**Larger joints are more afected
 
***May spread to other organs
 
*[[Staphylococcus spp.|'''''Staphylococci''''']]
 
**Sporadically infect joints
 
**May complicate 'tick-borne fever'
 
*[[:Category:Chlamydophila species|'''''Chlamydia sp.''''']]
 
**Sporadic or outbreaks of lamb polyarthritis
 
**High morbidity, low mortality
 
**Commonly together with conjunctivitis
 
**Most recover but may remain lame
 
 
 
 
 
===In Pigs===
 
 
 
*[[Erysipelothrix rhusiopathiae|'''''Erysipelothrix rhusiopathiae''''']]
 
**Most important and most common cause of arthritis
 
**Causes '''chronic serofibrinous polyarthritis'''
 
**Also causes '''discospondylitis'''
 
***Similar to [[Joints Inflammatory - Pathology#In Dogs|discospondylitis in dogs]]
 
**Thickening of synovial membrane lining + plus hyperaemia and villus formation + lymphocyte and plasma cell infiltration
 
**Acute stage
 
***Increased joint fluid + hot swollen joints
 
***Also expresses as septicaemic and urticarial lesion on the back (diamond shaped)
 
***May involve [[Endocardial - Pathology#Inflammatory-Endocarditis|endocarditis]] as a sequel
 
**Chronic stage
 
***More commonly encountered
 
***Erosion of articular surface of joints with formation of [[Musculoskeletal Terminology - Pathology|pannus +/- joint ankylosis]]
 
***Vaccination prevents septicaemic and urticarial forms but has no effect on joints
 
****Probably due to dead bacteria still stimulating host immune system
 
**Septicaemia lo9calises in meninges and joints
 
**Well known in piglets in their first two months of life
 
**Expresses as acute '''fibrinopurulent''' arthritis
 
*[[Corynebacterium species|'''''Corynebacterium pyogenes''''']] and [[Staphylococcus spp.|'''''Staphylococci''''']]
 
**Cause purulent arthritis
 
**In one or more joints
 
**Commonly contaminate wounds
 
*[[Haemophilus species|'''''Haemophilus suis'' and ''H. parasuis''''']]
 
**Cause Glasser's disease
 
**Fibrinous polyserositis, polyarhritis, meningitis
 
*[[Mycoplasmas|'''''Mycoplasma hyosynovia'' and ''M. hyorhinis''''']]
 
**Produce syndrome similar to [[Haemophilus species|Glasser's disease]] with milder expression
 
**Menigitis is rare
 
**Arthritis most consistent
 
 
 
 
 
===In Cattle===
 
 
 
*Neonatal polyarthritis by:
 
**[[Streptococci|'''''Streptococcus'' spp.''']]
 
***Via umbilicus
 
***Also involves eyes and meninges
 
**[[Escherichia coli|'''''Coliforms''''']]
 
***Localises in joints and meninges in sevee non-fatal neonatal colibacillosis
 
***May remain as chronic arthritis in larger joints
 
*Infections at any age:
 
**[[Corynebacterium species|'''''Corynebacterium pyogenes''''']]
 
***Suppurative arthrtis
 
***Often due to pebetrating wound into or close to joints
 
**[[Mycoplasmas|'''''Mycoplasma spp.''''']]
 
***May be respinsible for some chronic cases but difficult to prove as hard to isolate
 
***Fibrinous polyarthritis
 
**[[:Category:Chlamydophila species|'''''Chlamydia sp.''''']]
 
***Severe disease in young calves
 
***High mortality
 
***Can be seen in smears of synovial fluid from swollen joints
 
***Oedematous and hyperaemic surrounding tissue
 
***Possibly due to intrauterine infection
 
**'''''[[Brucella abortus]]'''''
 
***Uncommonly localises in joints
 
***Usually in '''carpal bursitis (hygroma) in cattle and bursitis in horses'''
 
 
 
 
===In Horses===
 
 
 
*Arthritis can occur following neonatal infections by:
 
**'''''[[Actinobacillus equuli]]'''''
 
**[[Streptococci|'''''Streptococcus'' spp.''']]
 
**[[Escherichia coli|'''''Coliforms''''']]
 
**[[Salmonella|'''''Salmonella''''']]
 
 
 
 
 
 
 
===In Goats===
 
 
 
*[[Caprine Arthrirtis Encephalitis Virus]]
 
**Arthritis is commonly the main expression
 
**Large limb joints are thickened
 
**'''Carpal hygroma''' is often present
 
***Subcutaneous cystic swelling on cranial surface of the knee, contains serous fluid
 
**In advanced cases
 
***Synovial villus hypertrophy
 
***Necrosis
 
***Mineralisation
 
***Mononuclear cell infiltration
 
***[[Musculoskeletal Terminology - Pathology|Pannus]] formation
 
***[[Joints - Anatomy & Physiology#Articular cartilage|Articular cartilage]] destruction
 
 
 
===In Dogs===
 
 
 
*[[Staphylococcus spp.|'''''Staphylococci''''']]
 
**May cause '''discospondylitis'''
 
**Destructive inflammatory lesion
 
**Bacterial localise in ''[[Joints - Anatomy & Physiology#Fibrocartilagenous joints|''annulus fibrosis'']] -> may spread to local bone
 
 
 
 
 
==Non-infectious arthritis==
 
 
 
*No causative agent has been found
 
*Seem to be immune-mediated diseases
 
 
 
 
 
===Erosive===
 
 
 
====Rheumatoid arthritis====
 
*Occurs in the dog, mainly smaller breeds
 
*Uncommon
 
*Progressive erosive polyarthritis
 
*Mostly involves elbows, stifles, carpal and tarsal joints
 
*Grossly:
 
**Marked villus hypertrophy of synovial membrane
 
**Cartilage erosion
 
**[[Musculoskeletal Terminology - Pathology|Pannus and periarticular osteophyte]] formation
 
**In severe cases ankylosis
 
*Histologically:
 
**Hyperplasia of lining cells
 
**Proliferative synovitis
 
**Synovial membrane has fibrin deposits
 
**Lymphoid and plasma cell infiltration
 
**Surrounding haemorrhagic areas
 
**Macrophages containing [[Pigmentation and Calcification - Pathology#Haemosiderin|haemosiderin]]
 
**Connective tissue may contain foci of necrosis
 
**Areas of erosion of peripheral articular cartilage and underlying subchondral bone
 
*Pathogenesis:
 
**May involve deposition of immune complexes within joints
 
**Substances degrading cartilage are released by synovial cells and macrophages involved in pannus formation
 
 
 
 
 
===Non-erosive===
 
 
 
====Systemic lupus erythematosus (SLE)====
 
 
 
*Occurs in dogs
 
*Clinical signs:
 
**Anaemia
 
**Thrombocytopaenia
 
**[[Muscles Inflammatory - Pathology#Myositis|Polymyositis]]
 
**[[Kidney Glomerular Disease - Pathology#Glomerulonephritis|Glomerulonephritis]]
 
 
 
 
 
====In chronic diseases====
 
 
 
*E.g. pyometra, otitis externa, [[Endocardial - Pathology|endocarditis]], [[Intestine Inflammatory - Pathology#Inflammation - Contents|enteritis]]
 
*Can lead to immune complex deposition in joints
 
 
 
 
 
====Gout====
 
 
 
*Occurs in humans, reptiles and birds (have no uricase enzyme)
 
*The urate triggers inflammation
 

Latest revision as of 16:37, 3 March 2011

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