Rheumatology Flashcards
C-reactive protein
protein found in plasma
levels rise in response to inflammation
ESR
erythrocyte sedimentation rate
Rate at which RBCs sediment in a period of one hour
non specific measure of inflammation
most common symptoms of joint disease
pain, stiffness and swelling
3 types of normal joint
fibrous, fibrocartilaginous and synovial
e.g of fibrous and fibrocartilaginous joints
intervertebral discs
sacroiliac joints
pubic symphysis
costochondral joints
eg synovial joints
ball and socket joints eg hip
hinge joints eg interphalangeal
athralgia
joint pains when the joint appears normal on examination
arthritis
term used when there is objective evidence of joint inflammation (swelling, deformity or an effusion)
common cause of acute non-traumatic monoarthritis or oligoarthritis
disseminated gonococcal infection
investigation of acute monoarthritis
urgent
synovial fluid aspiration with gram stain and culture, and analysis for crystals in gout and pseudogout
blood test findings for MSK disease
normochromic, normocytic anaemia is common
ESR and CRP raised
imaging used for MSK disease
plain xrays - fractures, deformity, soft tissue swelling, decreased bone density
bone scinitigraphy (isotope bone scan) identifies sites of increased bone turn over
DXA - dual xray absorptiometry measures the bone mineral density in osteoporosis
inflammatory diseases causing joint pain
autoimmune - rheumatic arthritis, spondyloarthropathy, connective tissue disease
crystal arthritis
infection
non inflam diseases causing joint pain
degenerative (eg osteoarthritis) non degenerative (eg fibromyalgia)
inflam vs degen pain
inflam vs degen
pain eases w use / pain increases w use
inflam vs degen stiffness
inflam vs degen
significant >60m early morning / not prolonged
inflam vs degen swelling
synovial swelling / none
inflam vs degen inflammed
inflam vs degen
hot and red / not clinically inflammed
inflam vs degen pt demographics
inflam vs degen
young, psoriasis, fam hx / older, prior occupation or sport
inflam vs degen joint distribution
inflam vs degen
hands and feet / 1st CMCJ, DIPJ, knees
inflam vs degen NSAID response
inflam vs degen
responds to NSAIDs / less convincing response to NSAIDs
