Rheumatology Flashcards
Which condition causes swan neck deformity?
RA
Which condition causes Boutonniere deformity?
RA
What are the differential dx of RA?
- Psoriatic arthritis
- Nodal osteoarthritis
- Viral arthritis (Parvovirus B19)
Rheumatoid arthritis:
- Investigations
FBC, LFT, U&E
ESR, CRP
Rheumatoid factor
Anti CCP
X-ray of hands and feet
- loss of joint space
- juxta-articular osteoporosis
- soft-tissue swelling
- periarticular erosions
- subluxation
Osteoarthritis:
- Investigations
CRP and ERS normal
X-ray of the affected area
- Loss of joint spaces
- Osteophytes
- Subarticular sclerosis
- Subchondral cysts
Which condition causes heberden nodes?
OA
Hard node on DIP
Which condition causes Bouchard nodes?
OA
Hard node on PIP
What investigation would you request for Raynaud’s?
- FBC, U&E, CRP, ESR
- ANA, RF, Specific antibodies for SLE, SS, Dermatomyositis
- Nailfold capillaroscopy
What is the management of Raynaud’s?
- Treat underlying cause
- Keep hands warm
- Smoking cessation
- Calcium Ch Blockers (nifedipine)
- Severe: Prostaglandin analogue (Iloprost)
How do you differentiate limited vs diffuse systemic sclerosis?
Limited: only distal to elbow
Diffuse: Extends proximal to elbow
What is CREST syndrome?
Seen in limited SS
C: Calcinosis
R: Raynaud’s
E: Eosophageal dysmotility
S: Sclerodactyly
T: Telengiactisia
What are the systemic complications needs to be checked in suspected SS?
- ILD
- PHT and HF
- BP and dipstick for renal involvement
- Nailfold capillaroscopy for early signs of vasculopathy
What investigations would you request in suspected SS?
- FBC, U&E, LFT, CRP, ESR
- Most ANA positive
- Anti centromere = limited
- Anti Scl 70 = diffuse
What is the management of SS?
- Avoid steroids (risk for renal crisis)
- DMARDs
- MMF
- Rituximab or Tocilizumab
- Ace inh. for renal crisis
- Nifedipine for Raynaud’s
