Pattern Recognition in Rheumatology Flashcards
Oligoartritis
2-4 joints affected
Insidious
Slow onset ,didn’t even realize
Describe hand joints
Summary slide
Diff for monoartritis (red hot joint)
- Septic Arthritis
- Crystal arthropathy (gout)
- Trauma
- Haemarthrosis
- polyarticular diseases
occasionally, present as monoarthritis
Gout 4 stages
Mimics of monoarthritis
Cellulitis
Bursitis
Tendinitis
Useful investigation for monoarthritis
Aspirate the joint
Diff for polyarhritis
EMS
Early morning stiffness, due to inflammation
Osteoarthritis vs RA
Summary of workup
Important not to miss when someone comes in with back pain:
• Inflammatory back problems (Spondyloarthropathies)
• Malignancy (mets/primary bone tumours, myeloma)
• Osteoporotic fracture
• Infection (TB, paraspinal abscess, Brucellosis)
• Widespread pain syndrome (FMS)
• Acute lymphadenopathy
• Thyroiditis
• Meningitis/septicaemia
• ABD problem: AAA, ca pancreas, nephrolithiasis, endometriosis
• Pagets
Spondyloarthropathies signs
• Insidiuos onset
• Pain not releived by rest
• Age <40yrs
• Improves with Exercise
• Nocturnal discomfort, NSAID response very good response
Backache red flags
Investigations for back pain
• FBC, CRP, ESR
• If suspecting underlying Ca or metabolic bone
disease:
– Ca2+
– Alk Phos
• Urinalysis
• Imaging
– Not needed in non-specific acute back pain
• Psychosocial issues (yellow flags)
Ankylosing spondylitis
Pain management for back pain
– Paracetemol Tramadol Trypiline
– (NSAIDS) – don’t usually work well for mech LBP
– Antidepressants Ice, heat Physiotherapy
Rheumatoid arthritis
Psoriatic arthrit
Psoriatic arthrit
Osteoarthritis
SLE
Gout