16. Inflammatory disease - RA - Kidd Flashcards
What are the three different categories for MSK pain?
Myalgia
Arthralgia
Back pain
What is myalgia?
Pain in a muscle or group of muscles
What is arthralgia?
Pain in a (small) joint
What are the different sources of MSK pain?
Referred/radicular pain - central pain that is being referred to the MSK system
Non referred/radicular:
Bone
Soft tissue
Joint
What are the three different types of inflammatory disorders?
Autoimmune disorder (RA)
Crystal arthropathy
Infection
What is ‘polyarthritis’?
Arthritis that is affecting five or more joints simultaneously
What is the incidence rate of RA?
12,000 new cases each year
Is RA more common in males or females?
Males 3:1 women
Is genu varus OA or RA?
Genu varus - OA
Is genu valgus OA or RA?
Genu valgus - RA
Why are Bakers cysts formed in RA?
Build up of synovial fluid
This cannot move anteriorly due to patella and cannot move laterally due to ligaments so forms posteriorly and the Bakers cyst forms
What is a common differential diagnosis for Bakers cyst and WHY IS THIS DANGEROUS?
DVT
DVT - want to coagulate but coagulation is the worst possible thing for a Bakers cyst
What occular complications can occur in RA?
Keratoconjunctivitis sicca
Scleritis and episcleritis
Scleromalacia perforans
What is Keratoconjunctivitis sicca?
Sicca syndrome - cannot produce tears or saliva and this can result in massive conjunctivitis
Dry eyes stimulates an immune response and there is inflammation in the sclera
What is a common peripheral symptom of early RA?
Carpal tunnel syndrome - tingling in the index finger
What is a common central symptom of RA?
Subluxation of the cervical spine - can compress nerves and the spinal chord - myelopathy
‘Atlanto-axial subluxation’
Define subluxation
Misalignment of the vertebrae - partial dislocation
How does atlanto-axial subluxation present?
Hyper-reflexia
Spasticity
What are systemic cardiac complications associated with RA?
Ischaemic heart disease
Pericarditis
Nodules
Endocarditis
What is the major bone complication associated with RA?
Accelerated osteoporosis
What is the current diagnostic criteria for RA?
Inflammation of three or more joints
Rheumatoid factor/anti-CCP
Raised ESR/CRP
What is systemic lupus erythematous
Aka. lupus - autoimmune disease
What are the two typical presentations of systemic lupus erythematous?
Butterfly rash over the face
Alopecia
What is scleroderma?
Chronic hardening and contraction of the skin and the connective tissue
What is the typical presentation of scleroderma?
Thickened, waxy appearance of the skin
In severe cases - fingers or hand may become necrotic
What is dermatomyositis?
Inflammation of the skin and the underlying muscle tissue - degeneration of collagen
What is ankylosing spondylitis?
Form of spinal arthritis
Who is mainly affected by ankylosing spondylitis?
Young males
What is reactive arthritis?
Joint pain and swelling triggered by another infection in the body
Bow legs is genu varus or genu valgus?
Genu varum
Location of bakers cyst is?
Behind the knee - posterior to the patella
