History and Examination in Inflammatory Joint Disease Flashcards
Inflammatory type of arthritis?
Rheumatoid arthritis
Non-inflammatory type of arthritis?
Osteoarthritis
What lines joints?
Synovium
->lubrication, control of synovial fluid, articulation
Which investigation shows ongoing inflammation?
Doppler ultrasound
Which condition has early morning stiffness which gets better as day goes on?
Rheumatoid arthritis
In which type of arthritis are constitutional symptoms more common e.g. malaise, fatigue, weight loss…
Inflammatory arthritis e.g. rheumatoid
When does inflammatory pain tend to be best and worst?
Best on movement
Worst on rest
When does mechanical pain tend to be best and worst?
Best on rest
Worst on movement
What are some of the questions to ask if suspecting connective tissue disease?
Raynaud’s
Photosensitivity
Mouth ulcers
Genital ulcers
Hair loss
Miscarriages
Thromboembolic events (FH too)
Rashes are important in inflammatory joint disease.
Which rashes should be asked and looked for?
Psoriasis (inc FH)
Erythema nodosum
Photosensitive rashes
What is nail pitting associated with?
Psoriatic arthritis
What does swelling of joints fell like in inflammatory arthritis?
Hard and boney
What does swelling of joints fell like in synovitis?
Soft and spongy
Dactylisis?
Sausage shaped fingers or toes
What is dactylisis associated with?
Spondylyoarthritis
Do you just check joints for inflammatory joint disease?
No- often affects systemically too e.g. lungs, gut, bone, eyes, heart
Investigations for connective tissue disease?
Urinalysis and BP
Investigations for gout?
Urate- but can be low/normal/high in an acute flare-up
If there is joint swelling, what investigation can be done?
If you can collect a sample, send for microbiology!!
Random but parts of this lecture gives an overview of a lot of conditions we’ve covered so would be a good revision lecture!
Well…gonna watch it?
Firbomyalgia?
Widespread pain in multiple regions of body for >3months
Increased fatigue, emotion, sensitivity to sound, light
Who can prescribe biologics?
Secondary care, cannot prescribe in primary care
