Overview of Rheu Dis and Approach to Locomotor System Pain Flashcards
What are the key clinical steps in evaluating a patient with rheumatic disease?
Careful anamnesis, physical examination, and targeted laboratory tests.
What are the distinguishing features of inflammatory vs. non-inflammatory joint pain?
Inflammatory pain worsens with rest (e.g., morning stiffness), while non-inflammatory pain worsens with movement and improves with rest.
What are the main causes of chronic monoarthritis?
Chronic infections (e.g., tuberculosis, brucella) and tumors.
How does the pattern of joint involvement help in diagnosing rheumatic diseases?
Monoarthritis suggests infection or crystal arthritis, oligoarthritis may indicate spondyloarthropathies, and polyarthritis points to connective tissue diseases.
Which factors in a patient’s history are crucial for diagnosing rheumatological diseases?
Symptom duration, precipitating factors (e.g., drugs, trauma, infections), and response to previous treatments.
How does the number of joints affected assist in differential diagnosis?
Monoarthritis suggests septic or crystal arthritis, while polyarthritis suggests systemic diseases like RA or SLE.
What are common causes of acute inflammatory polyarthritis?
Infections (viral, bacterial), acute rheumatic fever (ARF), and serum sickness.
List chronic inflammatory causes of polyarthritis.
Rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), spondyloarthropathies, polyarticular gout.
What are the causes of non-inflammatory polyarthritis?
Osteoarthritis and metabolic diseases.
Describe the characteristics of Raynaud’s phenomenon.
It involves sequential pallor (paleness), cyanosis (bruising), and rubor (redness), often triggered by cold or stress.
What are the potential underlying conditions associated with Raynaud’s phenomenon?
Systemic rheumatic diseases, trauma, drug exposure, and occlusive vascular diseases.
Why is it important to question diarrhea in patients with joint pain?
Diarrhea may indicate enteropathic arthritis linked to inflammatory bowel diseases or reactive arthritis following infections.
Which rheumatological diseases are associated with ocular involvement?
Scleritis, episcleritis, uveitis, and optic neuritis—commonly seen in SLE and spondyloarthropathies.
What specific skin manifestations are linked to rheumatologic diseases?
Malar rash in SLE, psoriasis in psoriatic arthritis, and erythema nodosum in Behçet’s disease or sarcoidosis.
What are common musculoskeletal symptoms in Sjögren’s syndrome?
Dry eyes, dry mouth, and parotid gland swelling, with joint pain in some cases.
Explain the significance of aphthous ulcers in rheumatologic evaluation.
They are seen in Behçet’s disease, nutritional deficiencies (B12, folate), and inflammatory bowel disease.
Which systemic conditions should be considered when evaluating chronic back pain?
Spondyloarthropathies (e.g., ankylosing spondylitis), inflammatory bowel disease, and familial Mediterranean fever.
What role do environmental and lifestyle factors play in rheumatic diseases?
Drugs, infections, diet, trauma, and environmental exposures can trigger or exacerbate symptoms.
What are the diagnostic clues from the distribution of joint involvement?
Symmetrical distribution suggests RA, while asymmetrical suggests spondyloarthropathies or reactive arthritis.
Why is the pattern of disease progression important in rheumatology?
Episodic, additive, or migratory patterns help distinguish between autoimmune, infectious, and mechanical causes.
How can plantar fasciitis relate to rheumatologic diseases?
In young patients, it may indicate underlying spondyloarthropathies.
Which rheumatologic condition is frequently associated with vaginal dryness?
Sjögren’s syndrome.
What laboratory tests are essential for diagnosing rheumatologic diseases?
Inflammatory markers (ESR, CRP), autoimmune antibodies (ANA, RF), and synovial fluid analysis in joint effusions.
What are the hallmarks of inflammatory bowel disease-related arthritis?
Peripheral arthritis and sacroiliitis, affecting 10-20% of ulcerative colitis and Crohn’s patients.
How is inflammatory arthritis differentiated from osteoarthritis?
Inflammatory arthritis has morning stiffness and systemic symptoms, while osteoarthritis is mechanical and worsens with activity.
What is the diagnostic value of night pain in back pain assessment?
Night pain suggests inflammatory causes like ankylosing spondylitis rather than mechanical pain.
Why is it important to evaluate constitutional symptoms in rheumatology?
Symptoms like fever, fatigue, and weight loss indicate systemic inflammation or autoimmune disease.
