Inflammation withing the musculoskeletal system Flashcards

1
Q

State the WHO classification of the rheumatic diseases

A
  • Back pain
  • Regional periarticular or ‘soft-tissue’ diseases
  • Osteoarthritis and related disorders
  • Inflammatory arthropathies
  • Osteoporosis and metabolic bone diseases
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2
Q

Define enthesitis

A

Inflammation where a tendon inserts into a bone

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3
Q

Give an example of an ethesis involving the achilles tendon

A
  • Enthesis is where a tendon inserts into bone

- eg the achilles tendon attaches to calcaneus (heel bone)

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4
Q

Define olecranon bursitis

A

bursitis at the tip of the elbow

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5
Q

Define tenosynovitis

A

-Inflammation of the synovium that surrounds the tendon, leading to joint pain,swelling & stiffness

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6
Q

Define dactylitis

A

swelling of an entire digit eg finger

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7
Q

Define spondylitis

A

Inflammatory condition of the spine. This is a degenerative change

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8
Q

How can we categorise rheumatology

A
  1. ) Non-inflammatory
    - drugs that modulate the immune system will have no effect
  2. ) Inflammatory
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9
Q

What are the 4 cardinal signs of inflammation

A
  • Dolor= pain
  • Calor=increased heat
  • Tumor= swelling
  • Rubor= redness
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10
Q

State some inflammatory arthropathies

A
  • RA
  • Juvenile idiopathic arthritis
  • Seronegative spondyloarthropathies
  • Crystal arthritis
  • Connective tissue diseases and vasculitides
  • septic arthritis
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11
Q

Outline multisystem diseases

A
  • connective tissue diseases eg SLE, Scleroderma, dermatomyositis
  • Vasculitis
  • Relapsing polychondritis
  • Periodic fever syndromes
  • Sarcoid
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12
Q

Explain how we come to a rheumatological diagnosis

A
  • History
  • Examination (urinalysis)
  • Supporting evidence : radiological;antibodies
  • Pathological: synovial fluid/biopsy; lupus nephritis, skin rash, myositis,vasculitis
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13
Q

How can we define a clinical syndrome?

A
  1. ) Onset
    - acute, chronic
  2. ) Arthralgia or arthritis
    - is there definite joint swelling
  3. ) Distribution
    - Mono,oligo or polyarticular
    - symmetrical
  4. ) Other features
    - rashes, mouth ulcers etc
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14
Q

Which autoimmune diseases is diurnal variation common to?

A
  • Crohn’s disease
  • Asthma
  • Rheumatoid arthritis
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15
Q

What presenting symptoms may someone with an autoimmune disease have

A
  • Pain
  • Swelling
  • Stiffness
  • Weakness
  • Multisystem presentation: systemically unwell, PUO
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16
Q

How can pain be described

A
'SOCRATES'
Site( joints-symmertrical/not; spine; muscles; everywhere)
Onset(sudden/gradual; progressive/recessive)
Character (paraesthesia)
Radiation
Association( any other symptoms?)
Time course(follow any pattern?)
Exacerbating/relieving factors
Severity
17
Q

Outline different patterns of joint involvement

A
  • Very helpful in defining an arthritis
  • Monoarticular ( 1 joint)
  • Pauciarticulaer( up to 4 joints)
  • Polyarticular(>4 joints)
  • Aial ( predominantly spinal involvement)
  • Symmetrical
  • Large or small joints
18
Q

Outline some characteristic clinical signs of inflammation within the musculoskeletal system

A
  • Sclerodactyl
  • Nail changes
  • Nodules
  • Tophi
  • Skin rashes ( photosensitive/vasculitic)
19
Q

what investigations can we use when diagnosing diseases associated with inflammation of the musculoskeletal system

A
  • ESR/CRP
  • FBC& biochemistry
  • Antibodies( ANA, RhF, CCP, ENA,dsDNA, ANCA)
  • Imaging
  • Urine PCR/cytology
  • Synvoial fluid analysis
  • Biopsy( skin,synovium,kidney, muscle,lip)
20
Q

Describe the GALS examination

A

Gait
Arms
Legs
Spine

-Quick screening tool to detect locomotor abnormalities and functional disability in a patient