1 / 0

Rheumatology Board Review

Rheumatology Board Review. Accessory Handout. Autoantibodies. Systemic Sclerosis and related syndromes. Monoarthritis Monoarthralgia. Exclude Periarticular Disease Tendonitis, Bursitis, Bone lesion, Myofascial Pain, Sprain/Overuse, soft tissue infection, peri-articular GC infection.

lyris
Download Presentation

Rheumatology Board Review

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Rheumatology Board Review

    Accessory Handout
  2. Autoantibodies
  3. Systemic Sclerosis and related syndromes
  4. Monoarthritis Monoarthralgia Exclude Periarticular Disease Tendonitis, Bursitis, Bone lesion, Myofascial Pain, Sprain/Overuse, soft tissue infection, peri-articular GC infection Monarticular Arthritis/ Arthalgia Always consider Aspiration of joint for diagnosis Cell count, Crystals, Gram stain, Culture Crystalline disease Gout/pseudo gout True inflammatory changes in joint with urate or CPPD crystals on synovial fluid examination; cell count of 2000-50,000; Cystic erosions (gout) or chondorcalcinosis (pseudgout) on X-ray Osteoarthritis/trauma Absence of inflammatory changes and <30 minutes AM stiffness with the presence of pain, crepitus, mild swelling, osteophytes; X-ray changes of joint narrowing, osteophytes formation, sclerosis; Joint fluid aspirate either bloody or cell count<2000; If diabetic, consider neuropathic joint Seronegativespondyloarthropathy Inflammatory changes of joint (particularly knee or ankle); Synovial fluid cell count of 2000- 50,000; involvement of eyes (conjunctivitis or uveitis) or back/sacroiliac joints with prolonged (>1 hour AM stiffness) Early onset inflammatory arthritis RA or SLE Inflammatory joint changes with other etiologies excluded; with prolonged (>1 hour AM stiffness); with positive RF or ANA Infection Gonococcus Staphylococcus Streptococcus Diagnostic features: True joint Inflammation with pain, swelling, erythema, Leukocytosis and fever, Synovial fluid cell count >50,000, Positive gram stain and culture
  5. Polyarthritis/ Polyarthralgia Determine by History and Physical if inflammatory (Prolonged AM stiffness, erythema, swelling, warmth, pain) Evaluation dictated by history and physical may include CBC, urinalysis, liver and kidney function, RF, ANA, ANCA, ESR, TSH, CPK, HBA1C, CXR and regional/back/SI joint X-rays Non- Inflammatory AM stiffness < 1 hour No joint erythema, swelling and Normal ESR Negative RF or ANA Implies a differential diagnosis of Myofascial pain Fibromyalgia Osteoarthritis Endocrinopathy Pain syndrome Inflammatory AM stiffness > 1 hour Joint erythema, swelling, or pain And Elevated ESR (must exclude other inflammatory diseases such as infection or cancer) Or Positive RF Positive ANA Implies a differential diagnosis of: Rheumatoid arthritis Connective tissue disease (lupus, PSS, PM/DM, Sjogren’s) Viral infection Seronegative spondyloarthropathy Sarcoidosis Does not clearly fit into either category, Consider: Seronegative RA Seronegative spondyloarthropathy
More Related