Rheum SC Flashcards
Antibodies associated with scleroderma.
What is each associated with?
Anti-Scl-70 - pulmonary fibrosis, diffuse scleroderma
Anti-centremere - pulmonary HTN + esophageal dismotility, limited scleroderma
Anti-RNA polymerase III - renal crisis, diffuse scleroderma
What is Z thumb defomity
IP hyperextenion
MCP flexion
Nail changes in psoriatic arthritis (7)
Nail pits
Onycholysis
Leukonychia (white lines on nails)
Paronychia
Red spots in lunula (half moon shape of nail)
Nail plate crumbling
Subungual hyperkeratosis
X-ray changes of psoriatic arthritis
- “pencil in cup” deformitis
- periostitis (fluffy)
- osteolysis
- marginal bone erosions
NO osteopenia - can get “ivory phalynx” (increased density of entire phalynx)
X-ray changes of rheumatoid arthritis
- peri-articular osteopenia
- bone erosions
- joint space narrowing
- deformities
X-ray findings of OA
Joint space narrowing
Osteophytes
Subchondral cysts
Subchondral sclerosis
X-ray findings of gout
Soft tissue swelling
Tophi
Punched out juxta-articular erosions
Secondary sclerosis
X-ray findings of scleroderma
Acro-osteolysis
Calcinosis
Systemic manifestations of Ank Spond
Ocular - anterior uveitis
CVS - AV conduction disease, AR
Resp - ILD (apical)
MSK - enthesitis (achilles tendonitis, plantar fasciitis)
Amyloidosis
X-ray changes of ankylosing spondylitis
SI joints:
Loss of cortical outline
Juxta-articular osteoclerosis
Erosions
Joint space widening (GIII) or ankylosis (complete fusion in G4 sacro-iliac disease)
Lumbar spine:
Loss of lumbar lordosis
Squaring of vertebrae
Syndesmophytes
Bamboo spine
Osteoperosis
Apophyseal joint fusion
Extra - articular manifestations of RA
Haem
- Feltys syndrome
- anemia
Eyes
- scleritis
Neuro
- carpal tunnel syndrome
- cervical cord
- mononeuritis multiplex
Renal
- mesangioproliferative/membranous GN
- vasculitis
Lung
- pulmonary fibrosis/caplans syndrome
- pulmonary nodules
Cardiac
- pericarditis/myocarditis
- Afib
- atherosclerosis (IHD)
Skin
- raynayds
- erythema nodosum
Report this hand x-ray
Major differential?
Joint space narrowing and erosions (wrsits, MCP, interphalangeal joints)
Erosive subluxation and ulnar deviation at the MCP joints with ulnar deviation
Destructive changes of the carpal bones and ulnar-carpal articulation
Peri-articular osteopaenia (particularly of the MCP regions)
Dx = RA
Report this x-ray
Bilateral sacroiliac joint sclerosis + irregular widening
Romanus leions inferiorly L1 + 2
ANk spond with GIII sacrolitis
Report this x-ray
Subcutaneous calcifcation at distal phalanges
Acro-osteolysis (distal resorption) most prominent at the 4th distal phalynx
