Rheumatological Red Flags

Question 1

List some of the common symptoms patients with giant cell arteritis might experience

Answer 1

• Think about this in terms of the affected arteries
  
  • Ophthalmic - visual defects
  • Temporal - headache/jaw claudication
  • Subclavian - arm claudication
  • Renal - renovascular hypertension
  • Aorta - valve incompetence
  • Coronary - IHD, angina
  • Internal carotid - TIA/stroke
  • Iliac - leg claudication
  • Mesenteric - bowel ischaemia
• Shoulder/limb girdle stiffness (PMR association)
• Weight loss, fatigue, low grade fever

Question 2

What are the risk factors for septic arthritis?

Answer 2

• Young or advanced age
• Recent joint trauma
• Bacteraemia and risk factors for same
• Corticosteroid therapy
• Diabetes, CKD, CLD
• Immunodeficiency
• Joint prosthesis

Question 3

List some symptoms that might be found in a small-vessel vasculitis

Answer 3

• Constitutional
• Myalgias/arthralgias
• Rashes
• Digital infarcts
• Mononeuropathy multiplex
• URTIs
• Haemoptysis
• Haematuria