Treatment Flashcards
Fibromyalgia
TCA (amitriptyline)
SSRIs
Lyrica
Lifestyle modification (exercise, sleep, therapy)
SLE
(NSAIDs)
hydroxychloroquine (fatigue/skin)
HD cortocosteroids (renal)
cyclophosphamide (immunosuppressant)
Can also rx methotrexate, azathioprine
Scleroderma
NO CURE - SYMPTOMATIC
ACE inhibitors (renal)
Calcium channel blockers (Raynauds)
Cyclophosphamide (lung)
Promotility drugs (GI)
Polymyositis
HD steroids
methotrexate/azathiaprine
IVig (severe)
Sjogren’s
Pilocarpine
Restasis
Artifical tears and saliva
PMR
LD Steroids 1-2 years
GCA
HD steroids
GWP (granulomatosis)
HD steroids
cyclophosphamide
methotrexate/azathiaprine
Rituxan
PAN
HD steroids
cyclophosphamide
methotrexate/azathiaprine
antivirals (for Hep B)
OA general
Lifestyle: dec weight, exercise
Acetaminophen, topical NSAIDs
Injections
Then total joint replacement
RA
10mg prednisone, NSAIDs, methotrexate
Progress thru DMARDs
Osteoporosis
Lifestyle: exercise, take Ca, etc.
Biphosphonates
HRT
SERMs
Septic Arthritis
Surgical debridement (I & D)
Staph: IV vanco or ceftriaxone 6 weeks
Niesseria: IM or IV ceftriaxone daily for 2 weeks
Osteomyelitis
6 week abx therapy
surgical debridement
Gout
Acute: NSAIDs, ice, elevation
Steroid injections
Colchicine
Chronic: XOI (allopurinol or probenecid)
Surgical excision
Pseudogout
Same as gout
Hip OA
Conservative (rest, NSAIDs/acetamin, PT, cortisone injection, dec weight)
Surgical: THA*, debridement, fem head resurfacing
AVN
Conservative + NSAIDs, anticoags, statins, biphosphonates
Surgical: hip resurface, core decompression, fibular grafting, THA
Greater Trochanteric Bursitis
Conservative
Surgical: excision
Quad/Hamstring strain
Conservative (RICE!)
Surgery: repair, evacuate hematoma, fasciotomy
Extensor mechanism rupture
Surgery: repair with sutures, may brace then PT
Conservative if too sick: cast for 6-8 weeks then PT
OA of knee
Conservative 1st
Surgery: knee arthroscopy, tibial/femoral osteotomy, TKA
Patellofemoral pain syndrome
Conservative + brace, foot orthotics
Surgery: MPF ligament reconstruction, lateral release, tibial tubercle osteotomy
MCL/LCL/ACL/PCL Injury
Conservative (grades 1, 2, maybe 3) + brace
Surgery: ligament reconstruction
Meniscus tear
Conservative (improves ONLY sx)
Surgical: repair, menisectomy
Pre-patella bursitis
Conservative + knee pad, cortisone (CAREFUL), and aspiration
Shin splints/tibial stress fx
Conservative + orthotics, crutches maybe
Surgery: Fasciotomy (RARE)
Achilles tendon rupture
Surg then cast 8 weeks
Cons: cast 12 weeks
Ankle sprain
Conservative + splint
Surgical reconstruc of ligaments
plantar fasciitis
Conservative + orthotics, night splints
Surgical release as last resort
metatarsalgia/stress fx
Conserv + metatarsal pad, orthotics, cast if bad
if stress fx, cast 4 weeks
Charcot foot
Total contact cast: 6-9 months to be stable
Carpal Tunnel
Surgery - release transverse carpal ligament
(Conserv + NSAIDs, night splints)
Scaphoid fx
thumb spica splint for 2 weeks even if no fx seen
re-XR every 2 weeks
Mallet finger
splint in full extension for 8 weeks
Jersey finger
splint in flexion & refer
must be surgically repaired
Boutonniere deformity
splint PIP in extension for 6 weeks
leave DIP joint free
ankylosing spondy
NSAIDs 1st
DMARDs (methotrexate)
Etanercept
Reactive arthritis
NSAIDs (sx)
sulfasalazine, methotrexate, or etanercept
psoriatic arthritis
NSAIDs (mild)
corticosteroid injections
DMARDs
Spinal stenosis
Acetaminophen/NSAIDs/tramadol
Decompressive surgery
