Rheum Flashcards
Pt don’t want you to move their joints
BBC joints:
- bugs
- blood (trauma, A/C, haemophilia)
- crystals
3 pattern of joint pain
Inflammatory
Mechanical
Fibromyalgia
Fat floating on blood from joint tap
Intraarticular #
Shoulders differential
- stiffness: PMR
- limited ROM: adhesive capabilities, glenohumeral OA
- weakness: polymyositis. cervical radiculopathy
- mostly pain: rotator cuff injury, acromioclavicular OA
PMR rare
< age 50
In Afro-Americans
PMR most common
In Caucasian women
PMR clinically
Not a myopathy (misnomer)
Not an arthritis
It’s a periarticular synovitis
Bilateral carpal tunnel sy
DMT2, amyloid, PMR, RA, pregnancy, hypothyroid
RS3PE - what is it? And Tx
Remitting seronegative symmetric synovitis w pitting edema (? variant of PMR)
Tx: low dose of prednisone
PMR -Tx
- 10-20 mg prednisone daily (sometimes need to split the dose)
- Begin taper at 4 wks; Tx for 24 months
- 10% remittent
- 10% will develop GCA
Rotator cuff muscles
Subscapularis - int rotation
Supraspinatus - abduction
Infraspinatus, teres minor - external rotation
A/C joint OA
Point tenderness at high overhead and cross body adduction
Rotator cuff injury - Tx
PT and adjunct steroid injection
Gardner’s rule 13
OA in unusual locations think unusual pathology
Popeye muscle
Rupture of the long head of biceps
