MSK Flashcards
What does squaring of the wrist show?
Check for squaring of the carpometacarpal (CMC) joint
What is the seronegative arthirtiis?
Reactive arthritis
IBD arthritis
Psoriatic arthritis
Ankylosing spondlitis
HLA-b27
What is RA?
Polyarthropathy
Symmetrcal
Worse in morning
Worse at rest
das28
What are the markers of RA?
Anti-ccp and anti-RF
What are some causes of osteoathritis?
Obesity
What is pseudogout characterised by?
Calcium pyrophosphate
For RA, what can be used instead of methotrexate in pregnancy?
In which case leflunomide or sulfasalazine should be used
• Hydroxychloroquine can be considered as an alternative for mild or
palindromic disease
• Short term glucocorticoids (up to 3 months) should be considered
What is the epidemiology of RA?
1% of the population
• F:M 2:1
• Typical age of onset 40-60 yo
• Genetic & environmental risk
factors (esp smoking)
• Characterised by synovitis
• Small joints
• Symmetrical involvement
• Polyarthritis
What are the risk factors for pseudogout?
Pseudogout (or “false gout”) is a form of arthritis that results from deposits of calcium pyrophosphate crystals.
Risk factors
Hyperparathyroidism
Haemochromatosis
Hypomagnesaemia
Hypophosphataemia
Presentation
Inflammation and pain in one joint (usually monoarticular arthritis but may be oligoarticular)- commonly the wrist or shoulder that worsens over weeks
Affected joints are acutely inflamed with swelling, effusion, warmth and tenderness
Microscopy Findings
Positively berefringent romboid shaped crystals made of calcium pyrophosphate
Treatment
Acute episodes of pseudogout are treated very similarly to those of gout.
Treatment is usually with a course of NSAIDs.
References
What is enthesitis?
Enthesitis is inflammation of the entheses, the sites where tendons or ligaments insert into the bone.
Features of pseudogout
Shoulder
Ankle
Wrist
Metabolic
Acute
Young
What is a common problem with spondyarthropathies?
Tendonitis
HLA-B27
Enthesitis
Dactylitis
Ankle pain
No autoantibodies
Enthesitis (painful tendons)
Synovitis
What diseases are associated with pseudogout?
Hyperparathyroidism
Haemochromatosis
Hypomagnesiumia
Hypophosphatemia
How is pseudogout treated?
NSAIDs
What does this show?
Keratoderma Blennorrhagicum is a manifestation on the skin that appears in patients diagnosed with reactive arthritis (this condition was previously known as Reiter syndrome). The condition manifests itself by lesions that appear on the skin, initially on the palm of the hands and soles of the feet.
