MSK and rheumatology Flashcards
What is ankylosing spondylitis
Pain in the lumbar spine and sacroiliac joints associated with fusion
What gene is associated with ankylosing s?
HLA B27 - not diagnostic
What is diagnostic of ankylosing spondylitis?
X-RAY of sacroiliac joints
What is associated with ankylosing spondylitis?
6 A’s:
Anterior uveitis
Aortic stenosis
Achilles tendinitis
Atypical fibrosis
AV node block
Amyloidosis
How does ankylosis spondylitis present
Gradual onset, >30 mins stiffness in morning
Treatment of ankylosing spondylitis?
NSAIDs
Steroids in a flare
Bisphosphonates
Surgery?
Exercise and mobility
What are risk factors for septic arthritis
Diabetes
Immunodeficiency
Prior joint damage (gout, RHEUMATOID ARTHRITIS)
Treatment for septic arthritis?
Flucloxacillin (clindamycin if pen allergic)
Treatment for raynards
Nifedipine
What is rheumatic fever
Develops after 2-4 weeks of group a strep throat —> muscle weakness, skin changes, heart issues, joint pain
Tests for rheumatic fever
CRP/ESR - most likely to be abnormal
ASO - peak at 2-4 weeks, less likely to be abnormal in acute disease. Most specific, appropriate test
What is the treatment for RA?
Acute flare - methylpredinsolone
Long-term management -
Mild: hydroxycholoroquine
DMARD (methotrexate, sulfasazine)
2nd line 2xDMARD
3rd kind TNF INHIB (infliximab)
How is RA different to psoriatic arthritis?
RA spares DIP
Psoriatic arthritis includes DIP joints and also associated with skin, eye and nail changes. Sausage fingers
How are gout and pseudo four different
G - needle shaped, non-biofringent. Allopurinol prophylaxis
PG - rhomboid shaped, biofringent.
Colchicine to treat both
How to distinguish ankylosing spondylitis from stenosis?
AS = rheumatological condition SO…
1) better on excercise
2) morning stiffness
3) constitutional symptoms (fever, fatigue)
