Rheumatology - handbook Flashcards
how long si chronic?
> 6 weeks
how long is acute?
<1week
inflammatory symptoms?
worse in morning, stiffness >30min,
pain worse with rest,
improves with activity
extra-articular features in RA?
rash nodules myalgias weakness red eyes IBD oral ulcers urethral discharge
joint main differential dx mnemonic?
SOFTER TISSUE sepsis OA Fracture tendon/muscle epiphyseal referred
tumour ischaemia seropositive arthritis seronegative arthritis urate extraarticular rheumatism (polymyalgia/fibro)
septic arthritis organisms common?
staph aureus
strep
n.gonorrhoea
risk factors for septic arthritis ?
extra articular infection with hematogenous seeding
IVDU
RA/DM/Malign
prior joint damage
preceding bacteraemia in septic arthritis ?
skin lesions,
tenosynoitis,
migrating polyarthritis
purulent monoarthritis
what is the gonococcal triad septic arthritis ?
migratory arthritis
tenosynovitis next to inflamed joint
pustular skin rash
Classic triad for reactive arthritis?
peripheral arthritis
conjunctivitis
urethritis/cervicitis
other reactive arthritis manifestiations?
diarrhoea
spondylitis
skin manifestations
how to manage reactive arthritis?
Abx for non-articular infections
NSAIDS
local joint injections
systemic steroids
Osteoarthritis primary etiology?
idiopaathic
Osteoarthritis secondary etiology?
post-truamatic most-inflammatory (RA) post infectious scoliosis endocrine ( acromegaly, hyperparathyroidism metabolic (gout, pseudogout neuropathis (charcot joints, DMII) avascular necrosis
who gets Osteoarthritis commonly?
genetics age >75 obesity 2:1 female trauma malnutrition
most common Osteoarthritis joints?
hip, knee, hands, spine
less common Osteoarthritis joint?
elbows, shoulder, wrist, ankle
Ix for Osteoarthritis?
normal CBC ESR, CRP
neg RF, ANA
4 hall marks of Osteoarthritis in x-ray
joint space narrowing
osteophytes
subcondral sclerosis
subcondral cysts
Gout precipitants mnemonic?
FACT furosemide aspirin/alcohol cytotoxic drugs thiazides
cystals for gout?
negative birefringence
needle shaped
crystals for pseudogout?
positive birefringence
rhomboid shaped
treatment of acute gout?
NSAIDS
corticosteroids
cochicine
