Flashcards in Nonarticular Rheumatism Deck (24)
In 65% of dialysis pt's receiving dialysis > 10 years, what might happen?
What joints are affected with destructive arthritis?
interphalangeal joints, metacarpophalangeal joints, wrists, shoulders, and knees
What is deposited in destrcutive arthritis?
amyloid deposition (an arthrotropic β2-microglobulin)
Fybromyalgia- clinical presentation
chronic widespread musculoskeletal pain that is poorly localized. It is accompanied by fatigue, sleep, memory, and mood issues.
Fibromyalgia- 3 important labs
complete blood count, erythrocyte sedimentation rate, thyroid function studies
NSAIDS and sleep meds
What 3 things are an indication for more extensive examination in acute low back pain?
Objective leg weakness or bladder or bowel dysfunction
Which 2 Sx are indicitive of a neoplastic or infectious process?
Substantial weight loss or pain that increases with recumbency
Which 3 Sx suggests a spinal nerve root irritation?
Radiating pain, weakness, or numbness in an extremity
What is a pseudoclaudication?
narrowing of the lumbar spinal canal. This puts pressure on the spinal roots and affects the control and sensation of the lower limbs. It is named pseudoclaudication because claudication is a vascular problem giving the same symptoms.
Which maneuvers improve the Sx of pseudoclaudication?
improve with leaning forward on a shopping cart while walking or with sitting
What are the 5 most important cases to get radiographs of a pt with acute low back pain?
1st episode after 50 y/o, Hx of neoplasm, Fever, weight loss, neurological Sx.
What is the initial treatment of acute nonspecific low back pain?
reassuring the patient because 90% of all patients with acute low back pain have considerable improvement in 6 weeks
What causes bursitis?
Irritative stimuli due to trauma or overuse, microcrystalline disease, chronic inflammatory arthritis, and infection
What are the two organisms commonly involved with septic bursitis?
Staphylococci (80%) and streptococci
What causes septic bursitis?
puncture wounds, cellulitis, or due to a local injection
Septic bursitis- Sx
Bursal warmth is the best predictor of infection. Restricted joint range of motion is a red flag for deep infection
Septic bursitis- Tx
empirically with antistaphylococcal and antistreptococcal oral antibiotics
What is polymyalgia rheumatica?
an inflammatory disorder that causes muscle pain and stiffness.
Polymyalgia rheumatica- populations
females > males over 60 years old.
Polymyalgia rheumatica- Sx
Presents with onset of aching and morning stiffness in the proximal musculature (hips, shoulder girdles).
Polymyalgia rheumatica- Labs
increase in ESR and CRP
Polymyalgia rheumatica- Tx