MSK - Rheumatology History

Question 1

What are the 6 main Rheuamtological complaints represented by the acronymn

PRISMS?

Answer 1

• Pain
• Rashes and skin lesion
• Immune
• Stiffness
• Malignancy
• Swelling and Sweats

Question 2

Extra-articular manifestations of rheumatological disease - what condition is each symptom assoacited with?

1. Red/painful eyes (uveitis)
2. Dry eyes
3. Breathing difficulties
4. Urethritis
5. Fever

Answer 2

1. Ankylosing spondylitis
2. Sjogren’s syndrome
3. ILD due to RA/SLE
4. Reactive arthritis
5. Inflammatory arthropathies / septic arthritis

Question 3

What systems do you check in suspected SLE?

Answer 3

• Constitutional symptoms (fatigue, fever, weight changes)
• Neuropsychiatric (seizure, psychosis)
  
  • “Have you noticed any changes in your thoughts or mood?”
• Dermatological symptoms (malar rash/butterfly rash), photosensitivity, discoid lupus)
  
  • “Have you noticed any rashes or skin changes recently?”
• Cardiac (pericarditis, myocarditis)
  
  • “Have you experienced any chest pain recently?”
• Pulmonary (pneumonitis, interstitial lung disease)
  
  • “Have you felt more short of breath recently?”
• Renal (acute nephritic disease)
  
  • “Have you noticed any blood or other changes in your urine?”
• Gastrointestinal (nausea, dyspepsia, abdominal pain)
• Musculoskeletal symptoms (arthralgia, myalgia)
  
  • “Do you have any aching in any of your joints or muscles currently?”
• Haematological (leukopenia, anaemia, thrombocytopenia)
  
  • “Have you felt more fatigued or found that you are bruising more easily recently?”

Question 4

What 3 main symptoms are associated with Sjorgen’s Syndrome?

Answer 4

1. Dry eyes
2. Dry mouth
3. Chronic cough