(3) Lupus, Systemic Sclerosis & Gout Flashcards
What areas of the body are affected by Lupus?
- multiple organ systems
- primarily skin, joints, kidneys
(affects ligaments > bone)
What demographic is Lupus more common in?
women of childbearing age
What are the general clinical manifestations of Lupus?
- gradual onset
- chronic fever & malaise
- skin rash (malar rash)
- arthralgia (late stage; BL symmetric)
Lupus is characterized as a ____-____ disorder
collagen-vascular
What radiographic characteristics of Lupus are caused by vasculitis?
- soft tissue calcifications
- osteonecrosis
What deformities may be caused by Lupus?
(reversible subluxations)
- swan neck
- boutonniere
- hitch-hiker thumb
- ulnar drift
What imaging test is required before any treatment to the neck in a patient with any autoimmune condition?
c/s radiographs with flexion/extension
The butterfly rash of systemic lupus erythematosus is also known as ____
malar rash
How does soft tissue calcification in Lupus appear radiographically?
diffuse (tiny white dots everywhere)
What are the 3 radiographic findings for osteonecrosis in order of occurrence?
- sclerosis
- flattening
- fragmentation
What are the relevant lab findings for Lupus?
- ^ESR/CRP
- ANA
- Anemia (ACD)
- Anti-DSDNA
What are the radiographic findings of Lupus?
- osteopenia
- reversible subluxations in hands (deformity w/o arthropathy)
- soft tissue calcification
- osteonecrosis
- atlanto-axial instability (^ADI)
What is a possible complication of corticosteroids used for Lupus?
avascular necrosis (AVN)
(Lupus already predisposes to AVN on its own)
What are other names for systemic sclerosis?
- progressive systemic sclerosis
- scleroderma (old name; implies skin only)
Systemic sclerosis is a ____-____ disorder
collagen-vascular
(excess collagen + vasculitis)
How does vasculitis present in patients with systemic sclerosis?
Raynaud phenomenon (finger/toe tips, ears, nose)
What is CREST syndrome?
Aspects of progressive systemic sclerosis:
- Calcinosis
- Raynaud phenomenon
- Esophageal motility issues
- Skin/subcutaneous calcification
- Telangiectasia (bruising)
What are the clinical features of progressive systemic sclerosis?
- peripheral pain & swelling
- Raynaud phenomenon
- thickening of skin (sclerosis; Vitiligo)
- mouse-like facies
- dilation of esophagus (GERD)
- decreased bowel function
- pleural/pericardial effusion
- may have deformity w/o arthropathy
What are the radiographic characteristics of systemic sclerosis?
- Acro-osteolysis (ungual tuft resorption)
- soft tissue retraction, tapered fingers
- calcinosis cutis (working surface)
Gout is characterized by ____ deposition throughout the body
sodium monourate crystal
(uric acid crystals)
What population is primarily affected by gout?
M>F (20:1)
40-50s
What is often the initial joint affected by gout?
big toe (1st MTP)
Gout in the big toe is called ____
Podagra
What would be on your differential diagnosis list for a patient with 1 big, red, swollen joint within a day?
- septic arthritis
- gout
- cellulitis
- osteomyelitis
