MUSKULOSKELETAL Flashcards
what are signs of osteoarthritis?
- mild to moderate pain which improves with rest
- stiffness lasting under 30 minutes
- gradual in onset and progressive
what joints are involved in osteoarthritis?
Weight bearing joints mainly the hips and knees
what are signs of rheumatoid arthritis?
- worse after resting
- systemic features of fatigue and weight loss
what is the joint involvement in rheumatoid arthritis?
symmetrical polyarthritis
what blood tests can be done in rheumatoid arthritis?
- FBC can show anaemia
- raised ESR
- IgM Rf in the blood
What is a definition of polymyalgia rheumatic (pmr)?
An inflammatory syndrome that manifests as pain and morning stiffness involving the neck, shoulder girdle in individuals over 50
what are clinical features of PMR?
- symmetrical limb girdle pain
- stiffness worse in the morning
- malaise, fever, weight loss
- bilateral stiffness of the shoulder, neck and spine
- difficulty rising from sitting position
What are clinical features of giant cell arteritis?
Headache often in the temporal regions
Malaise, weight loss, fever, night sweat
- jaw claudication
- temporal tenderness
how is PMR diagnosed?
The bird criteria:
Three or more of: bilateral shoulder pain weakness, duration of onset under 2 weeks, initial ESR>40 morning stiffness lasting over 1 hour, aged over 65, depression, weight loss
what histological changes are there in GCA?
- infiltration of CD4 T cell
Macrophages and giant cells in the vessel wall
granulomatous inflammation of the intima and media
breaking of the internal elastic lamina
what is management of PMR?
prednisolone 10mg
calcium/vit D/ bisphosphonates to protect from steroids
what is the management of GCA?
60mg prednisolone
