Flashcards in Arthritis - Johnston, Smith Deck (24)
RF -- spinal finding
Fused C1 and C2
RF --> tender red/purple papules that become non-healing necrotic ulcers
CV associations w/ RF
Vasculitis, CAD, HF
What on CXR?
RA + pneumoconiosis + pulmonary nodules
Hyperlucency (dark, air-trapping)
RA, splenomegaly, pancytopenia
RA is the most common cause of secondary ____
Schirmer's test (eye water), slit-lamp test
RA --> what causes joint destruction?
Pannus formation --> bone erosion and joint fusion
RA -- genetics
A classification criteria score of ___ confirms RA
What are the criteria? (LOOK UP)
Must have active inflammation for ___ to make diagnosis
First line DMARDs?
What is the 2nd one?
Leflunomide = pyrimidine antagonist - used in treatment of RA (instead of MTX)
If pregnant w/ RA, treatment?
Anti-malarial (hydroxychloroquine), Sulfasalazine
Biologic DMARDs -- risks?
Infection (ex. TB reactivation), neoplasia, MS, autoimmune
Etanercept, infliximab, adalimumab, rituximab
Commonalities to the SNSAs
- SPINE + symmetric SI JOINTS
- RF negative, ACCP negative
- Morning stiffness
- New bone formation
SNSAs - how to see erosions?
How to see inflammation?
General treatment for SNSAs
Biologic DMARD - for joint damage halting
Young male, reduced lumbar flexion, dorsal kyphosis, less chest expansion
Signs on imaging?
Squaring, shiny corners, bamboo spine, SI joint pseudo-widening and sclerosis/fusion
Cauda equina syndrome -- bowel/bladder problems
What is DISH? Signs (5)
Diffuse idiopathic skeletal hyperostosis
- Males > 50 w/ DM
- Multiple flowing osteophytes
- 4+ vertebrae calcification
- NO SI JOINT
- Ligament calcification
Male, LE arthritis, asymmetrical SI joint, rash on penis, sausage finger, painless plaque lesions on palms and soles
Classic triad for this?
What are the specific findings above called? (3)
Urethritis, conjunctivitis, arthritis
Chlamydia or GI bug
- Circinate balanitis
- Keratoderma blennorrhagicum
Self-limited, NSAID, steroid, OR Azithromycin/Doxycycline (if Chlamydia)
Pitting nails, pencil-in-cup deformities
Patient w/ IBD, large joint arthritis of LE, small joint arthritis of UE, SNSA signs
Potential extra-arthritis signs? More likely in what?
Skin = PG, EN
MORE LIKELY IN CD (rather than UC)
SMOADs - names?
Symptom-modifying OA drugs = "OSTEO BIFLEX"
- MMPI, Risedronate, Doxy, Glucosaime, Chondroitin)