Scoliosis & Arthritides Flashcards
MC age for scoliosis and gender
Female age 13-19
Scoliosis is named for the side of
Major Convexity
Spinous deviate to concavity
Rotatory scoliosis
Spinous deviate to convexity
Simple scoliosis
Lines of mensuration for scoliosis
Cobbs and Rissers Ferguson
Scoliosis measurements age
25 and younger
Under 20 degrees
Adjust and monitor
21 to 40 degrees
Send to orthopedist for bracing (MILWAUKEE)
Over 40 degrees
Surgical consult
Over 50 degrees
Cardio Pulmonary compromise and DJD
Monitoring Scoliosis
Risser’s sign
Wrist Films
Tanner’s staging - best one
Assessing skeletal growth potential using Tanner staging and Risser grading
Types of Inflammatory arthritides
- RA
- Ankylosing Spondylitis
- Enteropathic Arthropathy
- Psoriatic Arthritis
- Reiter’s AKA Reactive Arthritis
- SLE
- Scleroderma
- Osteitis Condensans Ilia (AKA OSteitis Triangularis)
RA in children is known as
Still’s disease
Symmetrical distribution
Bilateral uniform loss of joint space
RA
Rat bite erosions
Pannus formation
Localized periarticular osteoporosis
RA
What joint instability is caused by RA
Atlanto-axial joint instability
What joint is spared with RA
DIP
What nodes and deformity is associated with RA?
Haygarths (MCP) nodes
Swan neck and boutonnierres deformity
Lanois deformity
What is Lanois deformity?
Ulnar or fibular deviation
What cyst is associated with RA?
Baker’s cyst (benign swelling of the semimembranous bursa)
What kind of anemia is associated with RA
Normocytic Normochromic Anemia
Labs for RA
\+RA latex \+FANA \+ESR \+C Reactive Protein Seropositive arthritis
RA when presenting with dry eyes and mouth is called
Sjogren’s
Akylosing Spondylitis AKA
Marie Stumpells Disease
MC demographic for AS and symptoms
Male 15-35 with low back pain with morning stiffness
AS associated with what eye condition
Iritis
AS starts in which joint?
SI joint
Positive ortho test for AS
Chest expansion
Foorestier’s bowstring
Lewin supine
Radiographic sign in SI joints for AS
Bilateral SI joint fusion (ghost joint)
Shiny corner sign (early)
Bilateral marginal syndesmophytes
Squaring of the vertebral bodies
AS
Radiographic “signs” associated with AS
Trolley track
Bamboo spine
Dagger sign
Poker spine
Identical to AS in pelvis with GI dysfunction
Enteropathic Arthropathy
Males 20-50 with silver scaly lesions on EXTENSORS
Pitted nails
Psoriatic Arthritis
Cocktail sausage digits
Psoriatic Arthritis
Psoriatic Arthritis has increase or decrease joint space?
Increase
What deformities are associated with Psoriatic Arthritis
Mouse ear deformity
Pencil in cup deformity
Ray sign
Non marginal syndesmophytes in the spine
Psoriatic Arthritis
Note: Marginal syndesmophyte occur in AS
What joint instability is associated with Psoriatic arthritis?
Atlanto axial
Atlanto axial instability associated with what condition
Psoriatic Arthritis
RA
Lab for Psoriatic Arthritis
+HLA B27
Lab for AS
+HLA B27
+ESR
Male 20-30
URETHRITIS, CONJUNCTIVITIS, ARTHRITIS
Reiter’s
STD associated or cause Reiter’s
Chlamydia
Calcaneal spur
Non marginal syndesmophytes
Fluffy periostitis
Reiters
Lab for Reiter’s
+HLA B27
Female, sunlight percipitates a skin rash (MALAR/ butterfly rash), Oral ulcers, discoid lesions, alopecia, Raynaud’s phenomenon
SLE
What deviation is associated with SLE?
Ulnar deviation of the phalanges with no joint destruction
+ Rebound test
SLE
+LE prep, +FANA, +RA latex
+ ESR
Leukopenia, thrombocytopenia, Anti DNA
SLE
Management for SLE
co manage with rheumatologist
Management for AS
co manage with rheumatologist
Progressive Systemic Sclerosis AKA
Scleroderma
Female 30-50, associated with erosion of distal tufts of the phalanges
Scleroderma
Associated with CREST syndrome, sclerodactyly
Raynaud’s, calcinosis, esophageal dysphagia, talengiectasis, calcification of soft tissue middle finger
Scleroderma
+FANA
+RA latex (30%)
Scleroderma
Osteitis Condensans Ilia AKA
Osteitis triangularis
Multiparous females age 20-40
Bilateral sclerotic areas on lower half of the ilium
Osteitis Condensans Ilia
Joint space with Osteitis Condensans Ilia
normal
Labs for Osteitis Condensans Ilia
Self resolve
No lab
Case management for Osteitis Condensans Ilia
Trochanteric belt for stability
Inflammatory arthritides condition in women
Scleroderma
Osteitis Condensans Ilia
SLE
+HLA B27 conditions
AS
Psoriatic
Reiters
+ESR conditions
RA
AS
SLE
+FANA conditions
RA
Scleroderma
SLE