Rheumatology Flashcards
DDx if DIPs not involved?
RA
SLE
DDx if DIPs involved?
OA
Psoriatic arthritis
Gout or pseudogout
Signs of RA?
Signs of steroid use - thin skin, bruising, cushingoid features Joint swelling and effusions Ulnar deviation Volar subluxation Swan necking Boutonnieres Z deformity of the thumb Nil DIP involvement
Signs of Psoriatic arthritis?
Psoriatic rash Dactylitis Telescoping of fingers Interphalangeal joint disease Nail changes - pitting, onycholysis, ridging, discolouration
Signs of reactive arthritis?
Dactylitis
Shortening and Telescoping of fingers
Interphalangeal joint disease
Keratoderma Blenorrhagicum
Signs of gout?
Polyarticular
Tophi
Signs of OA?
Hebedens nodes - DIPs
Bouchards nodes - PIPs
Bunions
Can cause severe deformity
X-Ray changes of RA?
Peri-articular and joint erosions with sparing of DIPs
Loss of joint space
Effusions
Xray changes of psoriatic arthritis?
Pencil in cup deformity
?X-ray changes with connective tissue disorders?
Destructive changes in all the joints
Bony erosions
Signs of Ankylosing Spondylitis?
Male Kyphosis Loss of lumbar lordosis Vertebral tenderness Loss of back flexion, extension and rotation Positive schober's test Occiput-to-wall distance >0 Pain on springing ASISs Achilles tendonitis Plantar fasciitis
Extra-articular manifestations of AS?
Decreased lung expansion <3cm Apical fibrosis Aortic regurgitation Mitral valve prolapse Uveitis IBD Amyloid - hepatosplenomegaly
X-ray changes in AS?
SIJs:
- loss of cortical outline
- Juxta-articular osteosclerosis
- Erosions
- Joint ankylosis
Lumbar spine:
- loss of lordosis
- squaring of vertebrae
- Syndesmophytes
- Bamboo spine
- Apophyseal joint fusion
Cauda equina syndrome?
Back, buttock and leg pain
Saddle sensory loss
Lower limb weakness
Loss of sphincter tone
