Rheumatology Flashcards
What joints are commonly affected in OA
DIP
PIP
CMC
Herebeerdens and bouchards are found in what, and which joints?
Osteoarthritis, swollen nodes
H - DIP
B - PIP
What is seen on X ray in osteoarthritis
Loss of joint space
Osteophytes
Subarticular sclerosis
Subchondral cysts
Presentation of RA
Swollen symmetrical painful and stiff small joints of hands and feet
Extra-articular features - pericarditis, fever, pleurisy, weight loss
What joints are affected in RA
Swollen MCP
PIP, wrist or MTP joints
Boutonniere and swan neck deformities
What antibodies are high in RA
Anti-CCP
Investigations in RA
Rheumatoid factor - high titres associated with disease severity
Anti-CCP
Anaemia of chronic disease
Increased CRP and ESR
X-ray of joints
US/MRI - can identify synovitis
Management of RA
Refer to rheumatologist
MDT
Lifestyle- stop smoking, control cardiac risk factors, DEXA, vaccines
NSAIDs
DMARDs- first line is methotrexate
Second line combination (sulfasalazine, hydroxychlorquine)
Biological therapies - anti-tnf - adalimumab, infliximab
RA vs psoriatic arthritis
No set pattern like RA or OA
Psoriatic arthritis presentation
- symmetrical polyarthritis (similar to RA)
- DIP (RA does not affect these)
- can start not in hands - e.g. feet
- dactylitis
- nail changes (pitting)
What is limited cutaneous systemic sclerosis? Features?
Localised version of systemic sclerosis
Also called CREST syndrome
Calcinosis Raynauds Eosophageal dysfunction (heartburn) Sclerodactyly (thickening or tightening of skin on fingers/toes) Telangiectasia
Auto antibodies in limited cutaneous systemic sclerosis
Anti-centromere
ANA
Antibodies in systemic sclerosis (diffuse)
ANA
Anti-Scl 70
Autoantibodies in Dermatomyositis and polymycitis
ANA
ANTI-jo-1
Antibodies associated with SLE
ANA
Anti-dsDNA
What most supports a diagnosis of ankylosing spondylitis in a good history of it
X-ray - sacroilitis
