Rheuma: Introduction to Rheumatology Flashcards
what are the 2 main divisions of diseases that rheumatologists deal with?
musculoskeletal (structural) and locomotor (functional)
in which population are these conditions more common?
- no particular difference in gender (unless autoimmune)
- increasing age
misconceptions about rheumatic disease
- this is part of the ageing process
- considered irreversible
what is the musculoskeletal unit
the joint containing the articular and periarticular structures
how can rheumatic disease be classified?
- articular or periarticular
- monoarticular or polyarticular
- inflammatory or noninflammatory
what are the signs of inflammation?
- heat
- redness
- swelling
- pain
- loss of function
- stiffness (EMS)
how is gout classified?
monoarticular
articular
inflammatory
how is OA classified?
monoarticular/polyarticular
articular
non-inflammatory
how is bursitis classified?
one-site
periarticular
inflammatory
how is trigger finger classified?
one-site
periarticular
non-inflammatory
how is RA classified?
polyarticular
articular
inflammatory
how is polymyalgia rheumatica?
many sites
periarticular
inflammatory
how are fibromyalgia and osteoporosis?
many sites
periarticular
non-inflammatory
how can inflammatory rheumatic disease be classified?
limited to the musculoskeletal system or having systemic symptoms
what are the 5 main outcomes of rheumatic diseases?
- discomfort
- disability
- dollars
- drug toxicity
- death
from where would rheumatic pain originate from?
- inflammation
- muscle spasm
- articular cartilage loss
how to assess daily living (screening questions)
- getting out of bed
- getting out of the house
- doing work, housework
- cook
- dress independently
- eat independently
- perform personal hygiene
what are the finanical implications?
- direct cost (health care, meds, related items)
- indirect cost (due to loss of function)
- intangible cost (increased pain, reduced life quality)
- communal cost (access facilities)
complications of rheumatic disease
- renal failure (SLE)
- premature coronary artery disease from inflammatory disease
- hip fracture (osteoporosis)
key questions in a rheumatic history?
- is the problem from the joint or around the joint?
- acute or chronic condition?
- inflammatory or non-inflammatory condition?
- what is the pattern of the affected areas/joints?
- impact of the condition on the patient’s life?
how do you do a musculoskeletal examination?
GALS (gait, arms, legs, spine)
observe and make the patient move
investigation of pain
SOCRATES
pain might be referred from somewhere else
classification of joint involvement
monoarticular
pauci/oligoarticular (less than 4)
polyarticular (more than 4)
axial (spine is mainly affected)
involvement of other symptoms
check for general symptoms
look for features of inflammation in other body parts
